Urinary incontinence

• Beverages and foods that increase urine production and stimulate the bladder
• Constipation
• Medications, such as diuretics (water pills), certain antidepressants, antihistamines and cold medications

• Hysterectomy and other surgery that affects the female reproductive organs
• Menopause because lower levels of the estrogen hormone can weaken pelvic muscles
• Pregnancy and childbirth

• Benign prostatic hyperplasia (BPH) or enlarged prostate
• Surgery to remove the prostate

• Mental health conditions that affect cognition (thinking), such as dementia, anxiety, or severe depression
• Neurological disorders or injuries that affect the central nervous system (brain, spinal cord, and nerves) such as multiple sclerosis, Parkinson’s disease, stroke, or a tumor
• Obesity
• Obstruction (blockage) in your urinary tract, such as a tumor or urinary stone
• Urinary tract infections (UTIs)

Our team offers an integrated pelvic floor rehabilitation program to treat UI, which you can do along with other treatments. The program focuses on self-care and behavioral techniques including:

• Healthy eating plan: You can avoid foods and beverages that stimulate the bladder, and eat more fiber to relieve constipation.
• Pelvic floor exercises: Physical therapy can help strengthen your pelvic floor muscles to better support your bladder and other pelvic organs. Our specialized pelvic floor physical therapists work with you to customize a plan, teaching you exercises to do at home.
• Bladder training: These techniques help the bladder hold more urine and empty each time so you can better control the urge to urinate.

Our urogynecologists and nurse practitioner offer additional nonsurgical treatments in the office, including:

• Injections: For urge incontinence (overactive bladder), our urogynecologists can inject Botox® to help relax bladder wall muscles. Injections of bulking agents, such as collagen, in tissues surrounding the urethra help prevent bladder leaks due to stress incontinence.
• Medications: A wide variety of medications in pill form can relax the bladder, help prevent muscle spasms, and increase bladder capacity.
• Percutaneous tibial nerve stimulation (PTNS): To treat an overactive bladder, we place a thin needle electrode under the skin of your ankle near the tibial nerve. A stimulator sends mild electrical pulses through the needle to the tibial nerve and then to other nerves that control bladder function.
• Vaginal pessary: This small, reusable device goes into your vagina to support pelvic floor muscles and the urethra. Pessaries are an option for women with stress incontinence.

If non-surgical treatments aren’t working for you, our urogynecologists offer several surgeries and procedures to treat UI. As specialists in female pelvic medicine and reconstructive surgery, we have years of training and experience in the latest minimally invasive techniques. With smaller incisions, these procedures can help you recover faster and reduce your risk of complications.

We specialize in minimally invasive approaches including:

• Laparoscopic: This approach uses a few small incisions on the abdomen (belly) to access the area for treatment.
• Robotic-assisted: In a laparoscopic procedure, we use robotic equipment to operate surgical instruments, which make more precise movements than a human hand.
• Vaginal (for females): We make small incisions in the vagina to access the area near the urethra.

Procedures include:

• Sling procedures: These procedures use your tissue, donor tissue, or synthetic material to support the urethra and help it stay closed to prevent leaks.
• Suspension procedure: This procedure secures the urethra and bladder neck to strengthen their ability to close and prevent leaks.
• Neuromodulation device: Your doctor implants a small stimulator device under the skin in your buttock. It sends mild electrical pulses to the nerves that control bladder function.