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How many women in America have urinary incontinence? Is it common?

Urinary incontinence is a common problem that approximately 30 million women in America face. That’s more the number of women who suffer from diabetes!


What are signs and symptoms of stress incontinence?

The most tell-tale sign of stress incontinence is the loss (leakage) of urine when a woman:

  • coughs
  • sneezes
  • laughs
  • dances
  • exercises (anything from CrossFit to running to yoga to Zumba)
  • lifts up the kids
  • lifts up the grandchildren
  • lifts, carries or pushes anything heavy
  • has sexual intercourse


What is the most common cause of urinary incontinence?

In about 95% of cases, urinary incontinence is caused simply by childbirth. Labor can be very traumatic to the pelvic muscles that hold the bladder in place. In fact, 1 out of every 3 women who have had babies has urinary incontinence. Sometimes it develops immediately (you should be out of diapers by the time your child is) or it comes on later in life as the muscles weaken further. Pelvic-area surgery or hormone deficiencies can also cause incontinence.


How do most women handle incontinence?

My typical patient has incontinence for ten years without telling her doctor. In fact, they never tell anyone- not their mothers, not their children, not their sisters, not their co-workers. It remains “their little secret” for at least ten years. Those who never do anything suffer for life- stress incontinence doesn’t go away without medical intervention.


So, then, how do most women manage incontinence?

I wouldn’t call it “managing” their bladder leakage at all, but most women wear pads or diapers (an average of 3 per day). TV commercials try to convince women that it’s “cool” to wear adult diapers or pads, but it certainly doesn’t solve the problem or decrease embarrassing moments.


What are treatment options? Can incontinence be cured?

Most cases of urinary incontinence can be cured with a simple 30-minute, outpatient procedure that allows you to return to all activities very soon afterwards. I define “cured” as eliminating the need for pads, not just decreasing the amount.


Can kegel exercises cure urinary incontinence?

Pelvic floor exercises like kegels are great, if you don’t already have incontinence. They can maintain the pelvic tone in kegel muscles for years if done properly. However, once you are wearing one or two or three pads per day, it’s already too late. All the exercises in the world won’t help.


What about physical therapy for incontinence?

Nope, same discussion as with kegels.


What about medicines for urinary incontinence- can those treat stress incontinence?

These medicines are meant to address overactive bladder (OAB) only, not stress incontinence. That’s why an exact diagnosis from tests performed by an incontinence specialist, is so important.


Can Botox treat urinary incontinence?

Botox is another excellent treatment for overactive bladder if other options have failed. It’s an aggressive treatment that requires multiple injections directly into the bladder and must be repeated every six months. For some people suffering from overactive bladder, this option can be a life-saver. But it will do nothing for urinary incontinence.


How do I know if I have overactive bladder instead of urinary incontinence? What’s the difference between them?

With an overactive bladder, you get a sudden urge to relieve yourself and have to run for the bathroom, but you can’t make it in time or stop the flow of urine once it starts. Stress incontinence gives no warning or urge, just involuntary loss of urine. Tests by a specialist will confirm which you have.


Can you have both overactive bladder AND stress incontinence?

Absolutely. About 70% of my patients have both problems at the same time. Typical simultaneous treatments include pills for OAB and the 30-minute outpatient procedure for incontinence.


How do you know if you need incontinence treatment?

This is a quality of life issue. If it bothers you, it should be treated. There’s no reason you should be confined to adult diapers if you don’t want to be. Ask yourself, does living DRY sound better than living SOAKED? Ask yourself, on a scale of 1-10, how much does my incontinence bother me? Most of my patients came in when they were at 8 or above. Would you rather “manage” incontinence, going through multiple, expensive pads a day for the rest of your life, or would you rather cure incontinence and never have to wear pads again?


Who do I talk to if I think I have urinary incontinence?

Many of my patients report that their general physicians and OBGYNs told them 1 of 3 inaccurate things:

  • You just have to learn to live with incontinence.
  • This is the price you pay for being a woman/mother.
  • This is normal for women who have had children and there’s nothing wrong with it.


This is all terrible advice. It’s not fine and you don’t have to suffer or put up with it. Many non-specialists are misinformed and may not even know that there’s a treatment option available for urinary incontinence.


You need to find an expert in urinary incontinence, someone who takes care of it every day, all day long, and has extensive experience in treating incontinence.


Are there risks associated with the surgery to treat incontinence?

Just like with any other surgery, there are some risks to this procedure which include infection, reactions to anesthesia, internal bleeding, and a few others which I discuss with my patients prior to the surgery. Which is why it’s important to trust a surgeon who specializes in this procedure, performing it hundreds of times a year instead of only a few once in a while.