Bladder control problems can disrupt every aspect of your life. While many women feel that few other women have their problem, it is thought that over 13 million women in the United States experience loss of urine. While urine control problems most often start in a woman’s 40’s or 50’s, they can occur in women in their 20’s or 30’s. It is hard to feel confident in your social, exercise, or sexual activities when you have to worry about leaking urine or being close to a bathroom. Unfortunately, leakage problems usually get worse with time, & many women find that they give up more & more activities as their leakage worsens. It is not uncommon for women to stop exercising due to leakage. This can lead to weight gain which worsens the leakage & results in a vicious cycle. Many women do not seek treatment because they don’t think that anything can be done about it, or they have been told that it is”just part of being a woman.” This is just not true there are almost always some treatment options which can improve things for you, often without surgery.

Goals for the Treatment of Bladder Control Problems

It is important to have goals for your treatment. These goals may include resuming specific social or exercise activities, being to go longer between using the bathroom , eliminating the use of sanitary pads, or traveling. Our goal for your treatment is for you to be able to resume the activities which you enjoy, & be comfortable & confident about your bladder control.

For some women, the complete cure of leakage may not be realistic,however much we would like it be so. The tissues, muscles, & nerves are never going to be as healthy as they were a couple or a few decades ago; but treatment still should provide you with a major improvement in your bladder control. Activities such as walking, running, hiking, golf, & sex can usually be engaged in without leakage (although it is still a good idea to empty your bladder first). Jumping on a trampoline or
strenuous weight lifting with a full bladder without leakage is probably not a realistic goal. Amazingly enough, recent studies have shown that up to 80%of young college women athletes who have never been pregnant have leakage with intense exercise. This tells us that even when the tissues are healthy bladder control can still be a problem.

Depending on what is causing your leakage, treatment options can include exercises, medications, bladder training, or surgery. Our philosophy is that we would like to find treatment other than surgery for you if possible. If medicines are indicated, we would like to wean or eliminate them with time.
Types of Leakage Problems

The medical term for urine leakage is “incontinence.” In most women, leakage problems are usually due to either a problem with bladder support (“genuine stress incontinence” ) or a problem with bladder spasms(“overactive bladder”). Some women may have both problems (“mixed incontinence”).

Genuine Stress Incontinence

Genuine Stress Incontinence is usually due the opening of the bladder (the urethra) losing support & “dropping” into the vagina. In women, the urethra is only about an inch long, so it does not take much loss of support to result in leakage. The urethra is weakened by a combination of childbirth injury,genetics, & time. It is common for women to develop this problem around the time of menopause, but many women develop it in their 30’s or even their 20’s. In some women, the nerves & muscles to the opening of the bladder can be damaged & contribute to their leakage.

The most common symptom is the loss of urine with physical stress such as coughing, sneezing, exercising, hiking, straining, lifting, standing, bending,or sex. With time, it takes less & less to cause the leakage, & many women give up activities which they enjoy.