Urinary Incontinence

Urinary incontinence is the uncontrolled loss of urine and affects one out of seven adults. Twenty-five million Americans, including fifty percent of nursing home patients, twenty-six percent of women between the ages of thirty and fifty-nine, and thirty percent of all adults over sixty are affected by chronic incontinence. Nineteen percent of women are forced to discontinue an activity such as extended walking, lifting or housework. Lifestyle changes limiting travel and socialization can be forced by urinary incontinence. It was estimated that in 1995, 13.2 billion dollars were spent on the medical consequences due to incontinence. These consequences include prolonged hospitalization, excessive nursing home admissions, costly orthopedic injuries caused by elderly patients falling while trying to get to a bathroom quickly, and skin breakdown leading to decubitus ulcers. It is estimated at 1.2 billion dollars per year are spent on absorbent pads alone. Urinary incontinence is a vase problem affecting a broad range of patients, both young and old. Individuals with this problem are clearly not alone.

Clinically, this problem is defined as stress incontinence, urge incontinence, mixed urge and stress or total incontinence. Briefly, stress incontinence is a loss of urine due to increasing abdominal pressure caused by coughing, sneezing or lifting. Urge incontinence occurs when the need to urinate is too great an cannot be voluntarily suppressed. Total incontinence is the loss of urine without any warning or reason. The problem may be a consequence of neurologic disease such as multiple sclerosis or injury such as a stroke. It may also be secondary to previous surgery such as prostate cancer surgery. It is not the normal process of aging, and does not need to be "put up with." Whatever the cause, it is treatable and improvement can take place in the minority of patients. Surgery is often not required and should not dissuade individuals from seeking help.

We at Delaware Valley Urology are well trained in the diagnosis, management and treatment of urinary incontinence. While we prefer to manage patients conservatively, we have the facilities to perform advanced bladder function testing. With more complicated situations which might require surgical treatment, we have expertise in performing several urethral suspension operations, cystocele repairs, collagen injection and urinary sphincter insertion.