Urinary Incontinence
Incontinence is not an inevitable part of aging, and it is not a disease. Incontinence is the loss of bladder or bowel control. The loss of bladder control, the more common condition, affects between 10 and 20 million adult Americans, with more than half of all women in the United States experiencing some degree of urinary incontinence.

The loss of bowel control affects approximately 10% of adults. Many people endure these conditions in silence, thinking they are the only ones who have a problem or that nothing can be done for them. Although incontinence is common, it can be treated.

Urogynecology- Sensitive expert care for problems that maybe difficult to talk about.

What causes urinary incontinence?
Urinary incontinence can appear as a side-effect of a medication prescribed for a non-urinary problem, or it can be caused by such conditions as a bladder infection. Pelvic muscle weakness after childbirth or thinning of the urethral lining after menopause cause incontinence to be more common in women than men. In other situations, the bladder outlet simply may not stay closed.

What are the different types of urinary incontinence?
There are three types of urinary incontinence, each classified by its symptoms or by the circumstances that occur at the time of urine leakage.

Stress incontinence
allows urine to leak during activities which strain or "stress" the abdomen. Stress incontinence is often caused by poor bladder support or a weak or damaged sphincter.

Urge incontinence
results when an "overactive" bladder contracts unexpectedly. For example, an infection that irritates the lining of the bladder often causes it to become overactive.

Overflow incontinence
occurs when the bladder weakens or a blocked urethra (the canal that carries urine from the bladder) prevents normal emptying. This type of incontinence most often develops in people with diabetes, in people who are heavy users of alcohol, or in people with certain neurological conditions.

How is urinary incontinence evaluated?
To determine the most effective treatment for each patient's condition, Dr. Mona Alqulali offers individualized evaluations for urinary incontinence. The evaluation begins with a comprehensive history and physical examination and urodynamic testing.

To confirm the diagnosis, some of the diagnostic tests mentioned below also may be ordered:

Urinalysis
A sample of your urine is examined for the presence of infection, blood or other abnormalities.

Post-void residual urine measurement
This test determines whether any urine remains after you have tried to empty your bladder completely. A small, soft tube, called a catheter, may be inserted into the bladder to drain and measure remaining urine.

Ultrasound
Using special sound waves directed at an organ such as the bladder, the ultrasound procedure produces shadow-like images. These images can reveal the amount of urine present in the bladder. Ultrasound can also determine the size and shape of the kidneys, bladder and other pelvic organs.

Cystoscopy
An examination of the inside of the bladder with a small viewing telescope called a cystoscope enables our doctors to visually check for problems. This can be dones as an office procedure.

Stress test
To find out whether stresses on the bladder cause leakage, you may be asked to cough, stand or do other activities while your bladder is full.

Urodynamic testing
These tests examine bladder and urethral sphincter muscle function by inserting a small tube into the bladder or examining the bladder with X-rays. Through several such tests, it can be determined whether you have normal bladder sensation and capacity and whether your bladder fills and empties normally. Can urinary incontinence be treated? Incontinence can almost always be treated--and treatment does not always mean surgery.

Options include:

Behavioral therapy
By following an individually designed regimen of exercises and instruction, you may be able to improve your bladder control.. Education regarding reasonable fluid intake and advice for bladder retraining, such as scheduling visits to the toilet, has helped many people with incontinence.

Medication
Drug therapy may be prescribed to relax the bladder. Your bladder control also can be adversely affected by certain medications that you may be taking for other conditions.

Surgery
Several operations for incontinence are available to correct poor bladder support and help the urethra close properly. In women, surgery may be required to restore the support of the pelvic floor muscles or to reconstruct or compress the sphincter. Minimally invasive techniques are used and patients often leave the hospital within 24 hours without the need for a catheter.

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