An interview with
Laura McGuire, MD,
Obstetrics and Gynecology
The Women's Clinic
Urinary incontinence — When leaving the house gets harder to do
If you can't hold your urine long enough to get to a bathroom, you know how frustrating and embarrassing stress urinary incontinence (SUI) can be.
SUI occurs when there's a breakdown in the complex system of muscles and nerves involved in urination. In women, SUI often happens after menopause, when lack of estrogen causes muscles involved in bladder control to weaken.
SUI can also result from conditions such as multiple sclerosis, strokes or injury. Sometimes an infection or certain medicines can trigger temporary SUI.
Types of urinary incontinence in women include:
- Stress incontinence, when small amounts of urine leak during movements such as coughing or sneezing.
- Urge incontinence (overactive bladder), when large amounts of urine leak at unexpected times, including during sleep.
- Mixed incontinence, a combination of the two.
All types of urinary incontence can be treated. Your doctor may suggest:
- Lifestyle changes such as avoiding alcohol and caffeine, and losing weight, if needed.
- Pelvic muscle, or Kegel, exercises that strengthen the pelvic floor muscles.
- Medications that can help tighten and regulate muscles, and calm an overactive bladder.
- Bladder training, a process in which you gradually lengthen the time between urination, thus training your bladder to hold more urine.
- Injections of collagen or other bulking agents into the area surrounding the bladder opening, which can help control the flow of urine.
- Surgeries that raise and support the bladder, helping when weakened muscles have allowed it to drop.
If incontinence is keeping you from doing the things you enjoy, talk to your doctor and find out treatment options that are right for you.
Published January 2008.