Urinary incontinence simply means leaking urine. Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
It is common for other symptoms to occur along with urinary incontinence:
- Urgency—Having a strong urge to urinate
- Frequency—Urinating often
- Nocturia—Waking from sleep to urinate
- Dysuria—Painful urination
- Nocturnal enuresis—Leaking urine while sleeping
Urinary incontinence in women can be divided into three main types:
- Stress Urinary Incontinence (SUI) is leaking urine when coughing, laughing, or sneezing. Leaks also can happen when a woman walks, runs, or exercises.
- Urgency Urinary Incontinence is a sudden strong urge to urinate that is hard to stop. Women with this type of urinary incontinence may leak urine on the way to the bathroom. If you have an “overactive bladder” (OAB), it means that you have symptoms of urgency and frequency that may or may not include incontinence.
- Mixed Incontinence combines symptoms of both SUI and urgency urinary incontinence.
Frequently Asked Questions
We generally first recommend nonsurgical treatment. This may include lifestyle changes, bladder training, physical therapy, and using certain bladder support devices. For urgency urinary incontinence, the treatment may involve medication. Surgery may help certain types of incontinence. Often, several treatments are used together for the best effect.
MonaLisa Touch Treatments: a vaginal laser includes a series of 3-4 treatments to help restore elasticity to the vaginal wall, which has been shown to reducing incontinence and mild urgency in a high percentage of women treated.
The synthetic midurethral sling is the most common type of surgery used to correct SUI. This sling is a narrow ribbon made of synthetic mesh that is placed under the urethra. The most common type of sling we do is a Transobturator Sling or TOT.
Midurethral sling surgery usually takes less than 30 minutes to perform. It is an outpatient procedure, meaning that you usually can go home the same day. Recovery time generally is quicker than with other procedures for SUI.
If synthetic mesh is used, there is a small risk (less than 5%) that the mesh will erode through the vaginal tissue. Infection, long-term pain, and other problems rarely occur with the use of synthetic mesh. Additional surgery may be needed to fix these problems.
Overall the TOT sling is very successful with 90- 95% of patients reporting no leakage even long after their surgery.
After surgery, discomfort may last for a few days or weeks. During this time, you may be told to avoid anything that puts stress on the surgical area including lifting more than 20lbs and placing anything in the vagina for 6 weeks.