Urinary Incontinence: New Solutions for an Old Problem

by Jose Maceda, M.D.

Crozer-Keystone Health System Urogynecologist

Most women dismiss these problems as “part of the aging process” and something they just have to tolerate. Some try to mitigate the symptoms by wearing sanitary pads all day, emptying the bladder every half hour, and cutting back on fluids. Others stop exercising because they leak with exertion, or they complain that the problem interferes with their recreational time or the way they interact in the workplace. Many women say they’ve had the problem for years and are too embarrassed to discuss it with their physician.

If your overall quality of life is suffering and this condition is interfering with lifestyle, recreational activities and/or relationships with others, it’s time to talk with your primary care physician or gynecologist and ask if you should see a urogynecologist. Urogynecology is a relatively new, highly specialized field of medicine -- so new that many primary care physicians are not fully aware of the scope of services available to their patients.

A urogynecologist specializes in treating pelvic floor disorders that may affect women at any stage of their lives, not just as they get older. The term “pelvic floor” refers to the group of muscles that form a sling or hammock across the opening of a woman’s pelvis. These muscles, together with their surrounding tissues, keep all of the pelvic organs in place so that the organs can function correctly. A pelvic floor disorder occurs when the pelvic muscles and connective tissue in the pelvis weaken or are injured as a result of childbirth, aging or illness. 

Urinary incontinence is a pelvic floor disorder that may involve a loss of bladder control due to activity such as lifting, exercise and excessive coughing. Many women also suffer from an overactive bladder which causes an urgent need to urinate frequently.

Treatment Options

During the past decade, huge advances in treatment for pelvic floor disorders have occurred and, today, women are offered more effective options than ever before.

One option is physical therapy specially designed for pelvic floor rehabilitation. Physical therapists who deal with urogynecological issues such as urinary incontinence are specially trained, and it is important to seek them out. Locally, the Crozer-Keystone Health System has a team of female physical therapists who provide care for such problems. Treatment may include an individualized plan of exercise, biofeedback and dietary recommendations. Physical therapy typically lasts from four to six weeks.

Treatment for urinary incontinence may also include minimally invasive surgical procedures. Overall, the method of treatment will depend largely on the reasons for the incontinence.

When considering treatment options, it’s important to see a urogynecologist who takes the time to educate patients about the problem and who is willing to partner with each individual patient to determine the most effective treatment to help relieve the pain, discomfort and embarrassment associated with urinary incontinence and other pelvic floor disorders.

If you think you have urinary incontinence, don’t just tolerate it. Find out more about your treatment options from a urogynecologist.

Jose Maceda, M.D., is chief of the Division of Female Pelvic Medicine and Reconstructive Surgery at Crozer-Chester Medical Center and medical director of Crozer’s Urogynecology and Pelvic Floor Disorders Program. His practice, Delaware Valley Urogynecology, has four locations – Springfield, Upland, Glen Mills and Drexel Hill – and can be reached at (610) 338-1810.