Female Incontinence, Prolapse

The involuntary loss of urine is called urinary incontinence (UI), a condition suffered by millions of women. Some women may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine. Many women experience both symptoms.

Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine - water and wastes removed by the kidneys - in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body. 

During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body.

Incontinence will occur if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine. Urine may escape with less pressure than usual if the muscles are damaged, causing a change in the position of the bladder. 

In addition, weakness of the pelvic floor leading to incontinence may cause a condition called prolapse, where the vagina or bladder begins to protrude out of your body. This condition is also important to diagnose at the time of an evaluation. 

Incontinence challenges for women

UI can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends. Urine loss can also occur during sexual activity and cause tremendous emotional distress. 

Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. Both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.  Older women experience UI more often than younger women. But incontinence is not inevitable with age. UI is a medical problem.

Obesity, which is associated with increased abdominal pressure, can worsen incontinence. Fortunately, weight loss can reduce its severity.

Your doctor can help you find a solution. No single treatment works for everyone, but many women can find improvement without surgery.