Urinary Incontinence & Treatment | MedStar Health
MedStar urogynecology doctor Lee Richter is pictured with 2 urology fellows.

A symptom and not a disease, urinary incontinence — the inability to control the release of urine from your bladder — is often a result of weakness or nerve damage of the muscles of the pelvic floor and can severely affect a person's quality of life. Leakage can range from small spurts to larger amounts. The condition can be embarrassing, but with proper diagnosis it can be treated.

While it affects men and women of all ages and levels of health, pregnancy, childbirth, menopause, and the structure of the female anatomy are a few reasons why women experience urinary incontinence more often than men do.

The most common types are:

  • Stress incontinence: Laughing, lifting, coughing, sneezing, or any activity that suddenly increases abdominal pressure, making it difficult to hold back urine. This is common after pregnancy, pelvic surgery, and during menopause.

  • Urge incontinence: A sudden uncontrollable urge to urinate often associated with urinary tract infections, certain medications, stress, spinal cord injuries, multiple sclerosis, and neurological diseases.

  • Bowel dysfunctions: Constipation due to pelvic floor muscle spasms and fecal incontinence after childbirth or anorectal surgery.

Diagnosis

MedStar Health offers a full range of services for diagnosing incontinence, including:

  • Urodynamic testing assesses how well your bladder and muscles store and release urine

  • Anorectal manometry measures the pressure and electrical activity of the anal sphincter and the rectum

  • Pudendal nerve testing measures the delay between an electrical impulse and the muscle contraction

Treatment

Once a diagnosis has been made, there are a variety of treatments available, including behavior modification, medication, and non-surgical therapies, including:

  • Physical therapy, including pelvic floor muscle exercises

  • Functional electrical stimulation, which stimulates the muscles of the pelvic floor

  • Biofeedback training, which uses a monitoring device to feedback on the effectiveness of the pelvic floor muscle contraction

  • Bladder training

  • Kegel exercises

  • Functional electrical stimulation, which stimulates the muscles of the pelvic floor

  • Pessary insertion

  • Constipation treatment

  • Treatment for frequent coughing

  • Treatment with medication

Most patients can experience improvement without surgery, but it may be necessary for more extreme cases. Advances in technology have resulted in successful outpatient surgical treatments that require minimal incisions and result in less pain and quicker recoveries.

Our providers

Dr Iglesia poses for a photo in front of a DaVinci robotic surgery machine at MedStar Health.

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MedStar Franklin Square Medical Center

9000 Franklin Square Dr.
Baltimore, MD 21237

MedStar Good Samaritan Hospital

5601 Loch Raven Blvd.
Baltimore, MD 21239

MedStar Georgetown University Hospital

3800 Reservoir Rd. NW
Washington, DC, 20007

MedStar Montgomery Medical Center

18101 Prince Philip Dr.
Olney, MD 20832

MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Southern Maryland Hospital Center

7503 Surratts Rd.
Clinton, MD 20735

MedStar St Mary's Hospital

25500 Point Lookout Rd.
Leonardtown, MD 20650

MedStar Health: Medical Center at Lafayette Centre

1133 21st St., NW
Building 2
Washington, DC, 20036

MedStar Health: Medical Center at Mitchellville

12158 Central Ave.
Mitchellville, MD 20721