Urinary Incontinence

Nationally Recognized Leaders in the Treatment of Urinary Incontinence

Loyola Medicine takes an integrated, multidisciplinary approach to the diagnosis and treatment of urinary incontinence. Far too many women needlessly suffer in silence, keeping their struggle with incontinence to themselves and going years without receiving proper treatment. Loyola’s team of highly experienced specialists will evaluate your symptoms, provide you with the correct diagnosis and develop an individualized treatment plan to improve your quality of life and return you to the important things in your life.

Why Choose Loyola for Urinary Incontinence?

Loyola provides truly integrated clinical care for urinary incontinence, bringing together specialists in urology, urogynecology, gynecologic surgery and reconstructive pelvic surgery to provide women with advanced care in a compassionate environment. As part of an academic medical center, Loyola’s expert clinicians perform and teach the latest surgical techniques and medical treatments in numerous locations across the Chicago area. In addition, our nurses have earned Magnet status, which means they have been recognized for delivering the highest level of care.

Loyola is a leader in the treatment of urinary incontinence. Our clinicians and resident scientists have several ongoing clinical trials that allow us to offer patients the latest innovative techniques and medications. We have developed numerous well-tested and alternative therapies for urinary incontinence. If your situation does not improve with medical treatment, our widely acclaimed urogynecologic surgery team has great success in surgically treating incontinence.

If your incontinence is related to a chronic pelvic pain condition, you can be assessed by our Chronic Pelvic Pain Program specialists. Loyola was one of the first medical centers in the nation to establish such a unique program. It was founded by an all-female team of doctors, surgeons and advanced practice nurses, some of whom have been providing women’s healthcare for more than 30 years.

What is Urinary Incontinence?

Urinary incontinence is the loss of control over your bladder. Laughing, coughing or sneezing may cause you to leak urine. You may not always make it to the bathroom in time when you need to urinate. For some people, urinary incontinence occurs occasionally, and for others it may only occur from time to time. Some may have a complete lack of control that persists for a long time. There are several types of urinary incontinence:

• Stress incontinence – A loss of urine during activity, such as laughing, coughing, sneezing or physical exercise
• Urge incontinence – A strong, sudden need to urinate immediately, followed by a bladder contraction that results in the loss of urine, often called overactive bladder
• Voiding dysfunction – Any abnormality in filling the bladder, holding urine or emptying the bladder

Urinary incontinence can be an embarrassing condition and affects millions of people in the United States. Although loss of bladder control is more common in women than in men, it is not an inevitable outcome of childbirth, menopause or aging. Urinary incontinence by itself is not a disease, but it is often an indication of another condition that should be treated.

Causes of temporary incontinence include:

• Constipation
• Damage to muscles or nerves as a result of a hysterectomy
• Foods or beverages that irritate the bladder
• Overconsumption of alcohol
• Over- or under-consumption of liquids
• Side effects of some medications, including diuretics (water pills)
• Urinary tract infections

Urinary incontinence from any of these causes usually is easily managed with simple treatment or a change in habits.

Persistent urinary incontinence is often caused by an underlying problem, such as a urinary tract obstruction, weakened muscles or nerve problems. This type of incontinence may result from:

• Muscle weakness
• Bladder habits
• Estrogen loss during menopause
• Interstitial cystitis (inflammation of the bladder wall)
• Nerve damage to the bladder from neurological disorders, such as Parkinson’s disease, stroke or spinal cord injury
• Pregnancy and childbirth (may not develop until many years later)

How is Urinary Incontinence Diagnosed?

In order to determine the cause of your urinary incontinence, your urologist or urogynecologist will take a detailed medical and family history and conduct a physical exam of your pelvis. Your doctor will ask several questions, such as how often and how much leakage you experience and whether you have trouble emptying your bladder. Your doctor may ask you to keep a diary of any leak incidents or urge problems.

You may be asked to give a urine sample for urinalysis, which will check for signs of infection, blood in the urine and other abnormalities. Your doctor may request further testing, including:

• Post-void residual measurement (PVR) – This test measures the amount of urine remaining in your bladder after going to the bathroom. This can be done with ultrasound imaging or a catheter.
• Urodynamics – This study is used to determine how well the bladder, sphincters and urethra are storing and releasing urine.
• Cystoscopy – Using a tube with a light and a camera, your doctor can evaluate urinary symptoms and anatomical abnormalities of the urethra and bladder.
• Intravenous pyelography – Your doctor may use this type of X-ray imaging to view your kidneys, bladder and urinary tract. Contrast dye is first injected into a vein in your arm so that your doctor can see how your urinary tract is working.

How is Urinary Incontinence Treated?

Loyola’s urologists and urogynecologists specialize in the diagnosis, treatment and management of urinary incontinence. Loyola’s clinicians have received specialized training to diagnose complex conditions and provide the most advanced treatment options.

In many cases, a combination of treatments is used to control or eliminate urinary incontinence. Treatments generally include behavioral changes, medical devices, medications and surgery. Your doctor will discuss all appropriate options in detail with you and answer any questions before beginning treatment.

Non-surgical Treatment Options

Your doctor will first explore conservative, nonsurgical treatments to address your condition. These may include:

• Biofeedback – A device is inserted into the vagina, anus or rectum to determine whether a patient is using the proper muscles to control urination. Biofeedback helps patients improve strength and coordination of the pelvic-floor muscles. Learn more about biofeedback.
• Diet and behavior modification – Bladder retraining for urinary incontinence, and eating more fiber in the case of fecal incontinence, are examples of diet and behavior modification therapies that can lead to notable improvements.
• Injections and medications – Medications can be injected into your bladder or urethra to relieve urinary incontinence symptoms.
• Physical therapy – These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate. Learn more about pelvic floor physical therapy.
• Pessaries – These devices can help control symptoms of pelvic organ prolapse and urinary incontinence.
• Cognitive behavioral therapy – Our psychologists will teach you how to challenge negative thoughts about yourself and your condition to alter unwanted behavior patterns.

Surgical Treatment Options

Your doctor will first explore conservative, nonsurgical treatments to address your condition. However, if surgery is deemed the best option, Loyola’s surgeons can provide expert care using the most advanced treatments. Surgical treatment for urinary incontinence may include:

• Bulking agent therapy – For patients experiencing urinary or fecal incontinence, this procedure may provide relief by reinforcing the thickness of the muscles in the urethra or anus to prevent leakage.
• Electrical stimulation – For patients with stress incontinence and urge incontinence, electrical stimulation may provide effective treatment by stimulating and strengthening the pelvic-floor muscles.
• Sacral nerve stimulation (neuromodulation) – Your doctor may recommend sacral nerve stimulation for the treatment of urinary incontinence, overactive bladder, fecal incontinence or other pelvic-floor disorders. This technique is used to stimulate the nerves that control bladder function and bowel movements through the use of a small device that is implanted under the patient’s skin.
• Sling placement – To prevent urinary leaks and stress incontinence, your doctor may place a sling to provide support for the bladder neck and urethra.

For most forms of urinary incontinence, treatment can lead to dramatic improvement. In addition to the reduction or elimination of your symptoms, many women experience an overall improvement in the quality of their lives.

Exceptional Services to Diagnose and Treat Urinary Incontinence

Loyola’s urology and urogynecology programs provide diagnosis and treatment in outstanding, conveniently located facilities. We have multidisciplinary facilities at the Loyola University Medical Center campus, in addition to outpatient services at other locations.

We offer the following specialized services to provide you with the most comprehensive care:

• Pelvic floor physical therapy — Loyola’s program works in conjunction with our Chronic Pelvic Pain Program, which was one of the first such programs in the United States. Our all-female team utilizes advanced techniques to provide relief for many treatment-resistant conditions. Our team is trained in pelvic health and may use hands-on techniques to release trigger points and re-educate muscles affected by pelvic and nerve pain. Loyola’s physical therapists are skilled in evaluating and treating dysfunction in the joints, muscles, nerves and scar tissue. These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate.
• Urogynecology and reconstructive pelvic surgery program for women — Our program was the first of its kind in the greater Chicago area and is still one of a few programs in the country that offers a single-site location for the multidisciplinary diagnosis and treatment of pelvic-floor dysfunction for women.

Ongoing Research to Improve Future Treatment of Urinary Incontinence

Loyola’s expert urogynecology program is actively pursuing new research with a focus on patient-centered outcomes, including studies on:

• Advanced forms of surgery
• Aging and pelvic-floor function
• Birth trauma
• Pelvic-floor dysfunction
• Urinary incontinence and the impact of bacteria on the bladder

As an academic medical center, Loyola is dedicated to improving future treatments by conducting research on new diagnostics and treatments. Loyola’s patients benefit from research discoveries made here. Read about Loyola’s current clinical trials.