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Don’t Make Me Laugh: Taking Back Bladder Control

A proper diagnosis is crucial to treating urinary incontinence.

By Laura Silverstein, MD

Urinary incontinence—uncontrolled loss or leakage of urine—is a very common problem that often worsens with age. According to the National Association for Continence, 25 million adult Americans are impacted by urinary incontinence and 26 percent of women between ages 18 and 59 have involuntary leakage.

Genetics, having children, having trauma at the time of a vaginal delivery and vaginal prolapse all can contribute to your symptoms.

There are three types of incontinence:
  • Stress urinary incontinence: leakage with laughing, coughing, sneezing, etc.
  • Urge incontinence: leakage due to spasm of the muscle of the bladder. 
  • Overflow incontinence: overfull bladder that leaks.

When you talk to your gynecologist about this problem, he or she will perform an exam to look for any physical causes of the leakage, such as prolapse. Prolapse is relaxation of the muscles of the vaginal wall that causes displacement of the surrounding organs. This relaxation can cause leakage of urine, problems with bowel movements or feeling like there is a bulge between your legs.

Your gynecologist also might perform urodynamics, a series of tests to see how much your bladder can hold and what causes the leaking of your urine.

Once the proper diagnosis has been made, treatment options will be reviewed.


Treatment options include:
  • Kegel exercises and pelvic floor physical therapy to improve the control and strength of your pelvic muscles.
  • Bladder training to retrain your bladder to empty less often.
  • Medication to help relax the muscles of your bladder.
  • A pessary, a silicone device that is placed during an office visit to treat prolapse.
  • Surgery. There are many same-day, minimally invasive procedures that can be done to treat your symptoms.

If you have urine leakage symptoms, talk to your gynecologist. The two of you can work together to improve your symptoms and remove the daily hassle of wearing a pad, always looking for the closest bathroom or avoiding the activities you love.

Laura Silverstein, MD, is an OB/GYN affiliated with ValleyCare Medical Foundation in Pleasanton. To make an appointment, please call 925-734-6655.

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