Expert Health Articles

Urinary Incontinence

Urinary incontinence (UI), the loss of bladder control, is a common and often embarrassing problem. An estimated 15 million adult women in the U.S. are affected by urinary incontinence. There are different types of urinary incontinence, including stress incontinence, overflow incontinence, urge incontinence or the most common type, mixed incontinence, which is a combination of all types.


Stress incontinence is the leaking of urine related to insufficient strength of the bladder. It is the loss of urine associated with coughing, laughing, sneezing or exercising and is typically related to anatomical weakness. Overflow incontinence is a form of UI, characterized by the involuntary release of urine from an overfull bladder, often in the absence of any urge to urinate. It can be related to an obstruction to the bladder, loss of neurologic control or weak bladder muscles that are unable to squeeze the bladder.


Urge incontinence is synonymous with overactive bladder and is caused by spasms of the detrusor muscle, which is the muscle around the bladder. These spasms result in urgency and uncontrolled leaking.


When incontinence begins to affect a person’s quality of life, it is important to determine the cause as there are a wide range of treatment options. Treatments can include physical therapy, medications, multiple different surgeries, nerve stimulation, botox injections or a pessary, a flexible device to support the bladder. The different types of urinary incontinence have different causes and, therefore, different treatment approaches.


Urodynamics, or cystometrics, is a specialized test that looks for the cause of UI. It is similar to an EKG of the bladder. Urodynamics investigates the function of the lower urinary tract, the bladder and the urethra, using physical measurements along with a clinical assessment. Urodynamic studies provide valuable diagnostic data for many of the bladder dysfunctions.


Urodynamics is an office procedure that requires little to no preparation. You are typically notified to come to the test with a full bladder. It entails the use of a small catheter, which allows the examination of both the filling and emptying stage of your bladder. There is no downtime needed after the procedure and patients can take themselves to and from the appointment.


In conclusion, treatment strategies for urinary incontinence are different depending upon the type of incontinence that is found. Urodynamics is a specialized test that allows the health care provider to evaluate the incontinence and determine the best treatment. Urodynamics can help to navigate the patient’s overlapping symptoms and provide specific information to outline the cause of their individual problem.


Sarah Weihrauch, physician assistant

Blanchard Valley Obstetrics & Gynecology