Millions of Americans — women and men — experience urinary incontinence. If you are or you know one of them, you are not alone. Urinary incontinence is a common health concern that can greatly interfere with a person’s ability to participate in a variety of activities. Thankfully there are many treatment options that can help.

At the University of Chicago Medicine, our pelvic health experts offer a conservative, yet effective, and comprehensive approach to treating female and male incontinence. Our team develops personalized treatment plans, including educational resources, pelvic floor muscle exercises, strategies to manage discomfort and more.

Our physicians have expertise in the least invasive treatment options, avoiding surgery in many cases. And, when surgery is the best option, our urogynecologists and urologists are exceptionally skilled in performing today’s most advanced techniques and procedures.

What is urinary incontinence?

Urinary incontinence is a loss of bladder control, which causes urine leakage. In many cases, incontinence leads individuals to avoid their favorite sports or events, because the physical activity causes "leaks" or accidents.

While risk does increase with age, incontinence is not a mandatory part of aging. Whenever urinary leakage occurs, it is important to see your doctor so they can correctly diagnose the type of incontinence. Many treatment options are available, including pharmaceutical, behavioral and surgical interventions.

There are several different types of urinary incontinence. It often takes a visit to your doctor’s office to receive the testing necessary to confirm your diagnosis and form the best treatment plan for your urinary leakage.

There are two main kinds of chronic incontinence: stress incontinence and urge incontinence.

Stress Incontinence

Stress incontinence is the most common type of bladder control problem in women — especially after childbirth — but, it also occurs in men.

This type of urinary leakage occurs when a person coughs, sneezes, or participates in exercises or activities that increase abdominal pressure.

 

 Women

Men

Who

Common in women who have undergone childbirth, pelvic surgery or menopause.

May occur in men who have undergone a radical prostatectomy or other urogenital surgery.

When

Occurs when pelvic floor and urethral muscles weaken.

Occurs when the urinary sphincter mechanism is disrupted. 

How 

A strong pelvic floor muscle helps hold the urethra, bladder, vagina and rectum in place. When this muscle weakens, the continence mechanism in the urethra does not work as well, and small increases in abdominal pressure can cause urine to leak.   

After removal of the prostate, some men may experience some loss of urinary control for a number of reasons. Because of the sensitive location of the prostate, its surgical removal may cause disruption of either the anatomic continence mechanism or the nerves that influence urinary control.  

What

Urine loss occurs with activities that increase pressure on your bladder, such as sneezing, coughing, laughing, standing, lifting, jogging, etc. 

Urine loss occurs with activities that increase pressure on your bladder, such as sneezing, coughing, laughing, standing, lifting, jogging, etc.  

Urge Incontinence

Urge incontinence happens when you have a strong need to urinate but can't reach the toilet in time.

Mixed Incontinence

Mixed incontinence is a combination of different types of bladder control problems, usually stress and urge incontinence.

Bladder obstruction

A blockage of the outflow of urine from the bladder

Potential causes:

  • Benign prostatic hypertrophy

  • Strictures that cause narrowing of the urethra

  • Diseases that affect the nerves associated with urinary sphincter function; common example: multiple sclerosis

Loss of contractility

When the bladder loses its contractile power, and can no longer efficiently squeeze out urine.

Potential causes:

  • Pelvic surgeries such as a hysterectomy or major bowel surgery

  • Lower back surgeries

  • Diseases that affect the nerves associated with bladder function; common examples: multiple sclerosis, diabetes

Learn More

What causes urinary incontinence?

Loss of bladder control is an important health problem known to affect a large number of women. Since many women do not seek help for symptoms of urinary incontinence, it is impossible to know exactly how many suffer with unintended urine loss.

Adult women are twice as likely as adult men to experience bladder and pelvic health problems due to:

  • Physical differences in the pelvic anatomy
  • Physical changes after pregnancy and childbirth
  • Physical changes related to the loss of estrogen after menopause

There is no one cause for female urinary incontinence, but several risk factors do exist, such as:

Men can experience loss of bladder control after certain illnesses or surgeries or simply as a result of aging.

Although male incontinence may have many causes, men are much more likely than women to suffer from overflow incontinence. This is because men have prostates that may become enlarged with age and block the outflow of urine from the bladder.

Some risk factors for male incontinence:

Male Incontinence & Prostate Cancer

Many men experience incontinence caused by an enlarged prostate gland, surgical removal of the prostate or external beam radiation to treat prostate cancer.

Your physician may perform a gentle exam and attempt to reproduce the problem with some bladder testing. In some cases, testing may include urodynamics, which involves filling up the bladder with fluid to measure pressure. Urodynamics can also test for bladder spasms, weak urethral muscles or trouble emptying the bladder, which are symptoms that indicate different types of incontinence. With a better understanding of what is causing the problem, your physician can provide a more customized treatment plan for you.

Particularly if you have stress incontinence, your physician will likely recommend a non-surgical approach and medication. Our physical therapists specialize in teaching techniques on an individual basis to help women and men regain bladder control.

Components may include:

  • Simple, effective exercises to help strengthen the pelvic floor muscles, also known as Kegel exercises. These exercises, which can be done at home, are highly successful for many individuals with urinary incontinence.
  • Biofeedback, a painless technique for learning to control pelvic floor muscles
  • Education on lifestyle changes to decrease bladder irritability including fluid and diet management
  • Maintaining a voiding diary and making scheduled bathroom trips
  • Relaxation and breathing techniques
  • Various types of medication including anti-spasmodic drugs that help calm an overactive bladder

If your condition requires surgery, our urogynecology and urology experts offer several minimally invasive procedures using today's most advanced surgical techniques. Individual treatment depends on the type of problem you have and what best fits your lifestyle. 

Treatment for Female Incontinence

Pessary

A pessary is a ring that the physician or nurse inserts into the vagina. This helps reposition the urethra to help reduce stress incontinence.

Urethral Bulking

Another option for some women is a minor procedure during which the physician injects a substance into the wall of the urethra to “bulk it up” to help reduce leakage. During this procedure, the doctor inserts a thin tube called a cystoscope into the urethra and injects collagen or a similar substance into the tissue around the urethra.

Vaginal Sling (Midurethral Sling)

One of the most common surgeries for stress incontinence is the placement of a "sling" under the urethra. During this minimally invasive outpatient procedure, the surgeon inserts a strip of lightweight mesh under the urethra through a small incision in the vagina. The mesh helps the urethra remain closed when appropriate, preventing involuntary urine leakage.

Treatment for Male Incontinence

For some men with urinary incontinence caused by nerve damage, surgery may be the best option. Some of the common procedures include:

Artificial Sphincter

This implanted device that keeps the urethra closed until men are able to urinate. The device includes a cuff that fits around the urethra, a small balloon inserted in the abdomen and a pump placed in the scrotum. When it is time to urinate, the man squeezes the pump to open up the cuff so that urine moves into the balloon and flows out the urethra.

Male Sling

The surgeon wraps a strip of material round the urethra and attaches the ends to the pelvic bone. This puts more pressure on the urethra, providing extra support so it doesn’t release urine accidentally.


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