Female Incontinence

What is female incontinence?

Female incontinence is the leakage of small amounts of urine due to loss of bladder control.

Also known as urinary incontinence, female incontinence is a common women's health issue that can profoundly impact a quality of life. There are many treatment options available to improve urinary control.

Types of female incontinence

  • Stress incontinence – Loss of urine when coughing, laughing, or sneezing or when walking, running, lifting heavy objects, or exercising; this is the most common type in younger women
  • Urge incontinence – Sudden strong urge to void and urine leakage before reaching the toilet; also called overactive bladder.
  • Mixed incontinence – Combination of both stress and urge incontinence; may cause more urine to leak than either type alone.
  • Overflow incontinence – Bladder does not empty all the way during voiding, allowing steady leaks of small amounts of urine.
  • Functional incontinence – Causes leaks to happen because other health problems (limited mobility) keep a woman from getting to the toilet in time.

What causes female incontinence?

There are many possible causes of female incontinence, including:

  • Urinary tract infections
  • Urinary tract abnormalities
  • Medications
  • Pelvic support problems – When the tissues and muscles that support the bladder and other pelvic organs become weak or stretched (due to pregnancy, childbirth and aging), the bladder may drop down and press against the vagina, causing urine leaks.
  • Poor muscle function – Childbirth, neuromuscular disorders, and other conditions can affect the proper function of the valve-like muscles that control the release of urine (urinary sphincter), which normally stay closed or contracted.

Factors that may worsen symptoms or increase the likelihood of developing stress incontinence include:

  • Age
  • Childbirth
  • Obesity
  • Illnesses that cause chronic coughing or sneezing
  • Smoking, which can cause frequent coughing
  • Diabetes, which can cause excess urine production and nerve damage
  • Excess consumption of caffeine or alcohol

How is female incontinence diagnosed?

Diagnosis starts with a detailed medical history and thorough physical exam. You may be asked to keep a voiding diary to record how much urine is leaking, how often, what you were doing at the time, fluids consumed, and other details.

Additional testing may include:

  • Urine and blood samples – To test for infection, kidney stones or other abnormalities
  • Neurological exam
  • Cough stress test
  • Bladder scan or ultrasound – To ensure bladder is emptying completely
  • Urodynamics – To test bladder function
  • Cystoscopy – To exam inside the bladder and urethra

How is female incontinence treated?

Treatment depends on the type of incontinence and the individual patient. Treatment strategies include:

  • Behavioral therapies – To help patients know why leaks occur and how to avoid them.
  • Muscle strengthening – To strengthen the pelvic floor and sphincter muscles through simple Kegel exercises.
  • Biofeedback – To help gain awareness and control of your pelvic muscles.
  • Pelvic floor electrical stimulation – To spur muscle contractions and strengthen muscles.
  • Devices – To help block urine leakage or strengthen pelvic muscles.
  • Surgery – To reposition the bladder and urethra and improve closure of the sphincter. Surgical options include injectable bulking agents, sutures to lift and support the bladder and urethra, a sling procedure to support the urethra, and a surgically implanted artificial sphincter.
  • Medications – To help restore normal bladder function.

How can I prevent female incontinence?

Healthy lifestyle habits may help prevent or ease the symptoms of stress incontinence, including:

  • Exercise to make your muscles stronger
  • Maintain a healthy weight
  • Eat plenty of fiber (to prevent constipation and the strain it places on pelvic floor muscles)
  • Limit or avoid caffeinated and alcoholic beverages
  • Don't smoke

Make an Appointment

To schedule an appointment with a Baylor College of Medicine physician specializing in female incontinence, call the department of Obstetrics and Gynecology at 713.798.7500.

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