By Dr. Howard Goldstein and Dr. Babak Vakili

Urinary incontinence, the involuntary leakage of urine, is extremely common. Up to 50 percent of women over the age of 50 and as many as 35 percent of women in their 30’s may experience incontinence. That’s more common than conditions like breast cancer, depression, and thyroid problems, yet not nearly as publicized as these conditions. One reason why may be fear.

That fear can appear in different ways. It can be fear of leaking in embarrassing situations. It can be fear of feeling too young to have the problem. Perhaps it is the feeling of being the only one amongst your friends who leaks. Perhaps it is fear of the unknown concerning treatment options. While these fears are certainly not trivial, they can be overcome with education.

There are many different types of urinary incontinence. The three most common types are stress incontinence, overactive bladder, and mixed incontinence. These three comprise 95 percent of all patients with incontinence. Stress urinary incontinence is leakage caused by “stressors” like coughing, laughing, sneezing, exercise, jumping, and others. Overactive bladder is characterized by a stubborn urge to go to the bathroom, with or without incontinence, which usually results in a frequent need to urinate. Mixed incontinence describes symptoms of both stress incontinence and overactive bladder.

There are usually multiple factors that lead to the development of incontinence. These causes can vary by the type of incontinence a patient might have. Your genes also play a big role in the development of all types of incontinence. Inherited genetic factors do not doom one to incontinence; however, these factors do increase your level of risk. Acquired factors such as, but not limited to, child birth, aging, pelvic surgery, chronic straining, other medical conditions, and smoking can also influence the development of incontinence. A person with a low genetic risk might require many acquired conditions to develop incontinence, while another with a high genetic risk might require few or no acquired conditions at all.

The evaluation for incontinence can be very straightforward. It can simply consist of no more than a qualified physician taking a history and physical. Sometimes further testing is required. Treatment options vary greatly depending on the person and the type of incontinence encountered. Solutions can start with something as simple as changing your existing medications. Other treatments can include a guided exercise program, dietary and behavior changes, new medications, and surgery. Surgery options for incontinence vary by type but almost all of them have evolved into short outpatient procedures that cause little discomfort, require little to no down time, and do not interfere with your normal everyday life. If properly selected, they are also highly successful.

Future issues will address the different sub types of incontinence. Please read on and educate yourself. Alternatively, if you seek advice, information, or options please feel free to contact us. At the Center for Urogynecology and Pelvic Surgery, you will be evaluated by the only fellowship-trained physicians in the state of Delaware. We specialize in treating women with pelvic floor problems such as incontinence.

Babak Vakili, M.D. is the director of the Center for Urogynecology and Pelvic Surgery. Dr. Vakili is a fellow of the American College of Obstetrics and Gynecology and is the former director of research in the Division of Female Pelvic Medicine and Reconstructive Surgery at the Robert Wood Johnson Medical School.

Howard B. Goldstein, D.O., MPH, is a fellow of the American College of Obstetrics and Gynecology. He is a former resident and administrative chief resident in obstetrics and gynecology at Cooper University Hospital in Camden, N.J., where he completed a fellowship in female pelvic medicine and reconstructive surgery.

The Center for Urogynecology and Pelvic Surgery is located in Suite 1208 of Medical Arts Pavilion 2, on the campus of Christiana Hospital in Newark. Appointments are also available at the Christiana Care Center for Women’s Health, 3706 Kennett Pike in Greenville. To schedule an appontment, call 302-623-4055. For more information visit www.christianacare.org/urogynecology.