Bladder Conditions

What is urinary incontinence?

Urinary incontinence is the loss of bladder control ranging in severity from a little leaked urine when you cough or sneeze to experience the urge to pee so suddenly that you don’t have time to get to a toilet.

What are the different types of urinary incontinence?

There are several types of urinary incontinence:

• Stress incontinence is the most common continence problem in women. It is the loss of urine when stress is placed on the bladder due to coughing, sneezing, laughing, exercising or heavy lifting.
• Urge incontinence is also a common continence issue. It is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Overactive bladder is a type of urge incontinence, although not everyone with overactive bladder leaks urine.
• Overflow incontinence occurs when one cannot adequately empty the bladder, which results in the frequent or constant involuntary dribble of urine.
• Functional incontinence is common in older adults, who may experience continence problems due to a physical or mental impairment.
• Mixed incontinence occurs when an individual experiences more than one type of continence problem.
• Short-term incontinence describes continence problems due to urinary tract infections, constipation, or certain foods, beverages and medications. Once these issues are addressed, the continence problem resolves.

What are the symptoms of urinary incontinence?

Symptoms of urinary incontinence may include:

• Involuntary (accidental) release of urine ranging from small leaks or dribbles to a large volume that wets your clothing
• Urine leakage when you cough, sneeze, laugh, exercise, etc.
• Sudden, intense urges to urinate and/or the need to urinate often
• A weak urine stream
• Feeling that your bladder is not empty, even after urinating

Talk with your doctor if you are experiencing these symptoms.

What causes urinary incontinence?

Urinary incontinence can be caused by:

• Weakened pelvic floor muscles, which may be due to pregnancy, childbirth or weight gain
• Problems or damage either in the urinary tract or in the nerves that control urination
• Bladder disease or irritation
• Urinary tract obstructions
• Prior pelvic surgeries
• Neurological disorders, such as Parkinson’s Disease
• Emotional stress

How is urinary incontinence diagnosed?

Your physician can diagnose urinary incontinence using the following tests:

• Urinalysis for signs of infection, traces of blood or other abnormalities
• Pelvic ultrasound and electrodiagnostic testing, which measures the nervous system’s control of the pelvic organs
• Bladder capacity testing and cystoscopy, which is used to view the inside of the urethra and bladder.
• Postvoid residual measurement using ultrasound or catheterization.

How is urinary incontinence treated?

Urinary incontinence can be treated with:

• Behavioral techniques such as bladder training, scheduled toilet trips, double voiding, and fluid and diet management
• Pelvic floor physical therapy
• Prescription medications
• Insertion of a medical device for incontinence, such as a pessary or a urethral insert
• Injections to keep the urethra closed
• Nerve stimulators
• Botox Injections into the bladder
• Minimally invasive procedures, including:
  • Bulking material injections, which help to increase closure in the urethra and build thickness in the urethral wall so it seals properly
  • Sacral nerve stimulators which help to stimulate pelvic nerves in order to improve bladder function.
• Minimally invasive surgery, including:
  • Sling procedures, which use strips of your body’s tissue, synthetic material or mesh to create a pelvic sling or hammock around your bladder neck and urethra to lift them back into a normal position to help keep the urethra closed, especially when you cough or sneeze. There are many types of slings, including tension-free, adjustable and conventional.
  • Bladder neck suspension, a procedure that uses a suturing technique to help provide support to your urethra and bladder neck, which helps to alleviate the symptoms of stress urinary incontinence.

Talk with your doctor to determine which treatment is right for you.

What is overactive bladder and what are the symptoms?

Overactive bladder (OAB) is a condition that causes you to pee more frequently, have uncontrollable urges to pee, experience incontinence and have to pee at night. It is estimated to affect more than 40% of women.

Symptoms of OAB include:

• Urinary urgency, a sudden, uncontrollable need to pee.
• Frequent peeing. or going to the bathroom more often than usual.
• Urge incontinence, a sudden, uncontrollable need to pee and leaking pee.
• Nocturia, the need to get up to pee at least two times each night.

Talk with your doctor if you are experiencing these symptoms.

What causes overactive bladder?

Overactive bladder can be caused by:

• Abdominal trauma, such as pregnancy and childbirth
• Neurogenic bladder, or nerve damage caused by pelvic or back surgery, herniated discs, Parkinson’s disease, multiple sclerosis, diabetes or stroke
• Medications, alcohol and caffeine
• Infection, such as a urinary tract infection
• Being overweight
• Estrogen deficiency after menopause

How is overactive bladder diagnosed?

Your physician can diagnose OAB. It can be diagnosed by:

• Physical exam
• Urine sample
• Measuring bladder function
• Cystometry test to measure pressure in your bladder

How is overactive bladder treated?

There is no cure for OAB, however, there are effective ways to manage OAB. Be sure to seek treatment for OAB because symptoms can worsen if left untreated. Over time, the muscles in your bladder that help control when you pee can become weak and your pelvic floor tissues can get thinner.

• Behavioral techniques such as bladder training, scheduled toilet trips, double voiding, and fluid and diet management. You may also be asked to keep a bladder diary to keep track of how much you drink, what you consume and how often you pee.
• Pelvic floor physical therapy
• Prescription medications
• Insertion of a medical device for incontinence, such as a pessary or a urethral insert
• Injections to keep the urethra closed
• Nerve stimulators
• Botox injections into the bladder
• Minimally invasive procedures, including:
  • Bulking material injections, which help to increase closure in the urethra and build thickness in the urethral wall so it seals properly
  • Sacral nerve stimulators which help to stimulate pelvic nerves to improve bladder function.
• Minimally invasive surgery, including:
  • Sling procedures, which use strips of your body’s tissue, synthetic material or mesh to create a pelvic sling or hammock around your bladder neck and urethra to lift them back into a normal position to help keep the urethra closed, especially when you cough or sneeze. There are many types of slings, including tension-free, adjustable and conventional.
  • Bladder neck suspension, a procedure that uses a suturing technique to help provide support to your urethra and bladder neck, which helps to alleviate the symptoms of stress urinary incontinence.

What is dysuria and what causes it?

Painful urination, or dysuria, is the feeling of pain, discomfort or burning when peeing. Painful urination can be caused by:

• Urinary tract infection (UTI)
• Bladder infection
• Bladder inflammation (Interstitial Cystitis)/ painful bladder syndrome
• Sexually transmitted diseases or infections

Talk with your doctor if you are experiencing painful urination.

How is painful urination diagnosed?

Your doctor may recommend the following tests to determine the cause of your painful urination:

• Urinalysis
• Sexually transmitted disease or infection screening
• Cystoscopy exam
• Biopsy

How is painful urination treated?

Treatment will be determined based on the underlying cause of your condition. For example, if your painful urination is caused by endometriosis, you will be treated for that condition.

Common treatment options include:

• Medication
• Bladder retraining
• Pelvic floor physical therapy
• Nerve stimulation
• Botox injections into the bladder

Talk with your doctor to determine the best treatment option for you.

What is hematuria and what causes it?

Hematuria, or blood in the urine, is a condition that occurs when the kidneys or other parts of the urinary tract let blood cells leak into urine. Blood in urine is not always visible to the naked eye and must sometimes be diagnosed by a urinalysis.

Hematuria can be caused by:

• Urinary tract infections (UTIs)
• Kidney infection
• A bladder or kidney stone
• Kidney disease
• Cancer
• Inherited illnesses
• Kidney injury
• Medication
• Hard exercise

How is hematuria diagnosed and treated?

Tests to determine the cause of hematuria include:

• Urine culture
• Cystoscopy exam
• Biopsy
• Blood tests
• Physical exam

Treatment for hematuria depends on the underlying medical condition. It can include:

• Antibiotics
• Using sound waves to break up bladder or kidney stones

Speak with your doctor if you are experiencing hematuria for diagnosis and treatment options.

What is bladder prolapse?

Prolapse of the bladder, also known as cystocele, occurs when the ligaments and muscles that hold up your bladder stretch or weaken. It can lead to difficulty urinating, urinary incontinence and pain when inserting a tampon or having sex. To learn more about bladder prolapse, click here.

What is pelvic organ prolapse?

Pelvic organ prolapse is a condition where weakened pelvic floor muscles cause one or more organs to sag. In severe cases, one or more of these organs can bulge into another organ or sag outside of your body. To learn more, click here.