What is Urinary Incontinence?

Urinary incontinence is an accidental loss of urine. The pelvic health specialists at Virginia Mason Franciscan Health pinpoint the source and deliver personalized treatments that halt symptoms so you can get back to your busy life.

Since 2010, Virginia Mason Medical Center has achieved and maintained National Association for Continence Center of Excellence accreditation by the Surgical Review Corporation. We are the only program in the Pacific Northwest with this designation.

Our high-quality care has also earned some locations prestigious recognition. We maintain center of excellence designation for urethral bulking and sacral nerve stimulation. These urinary incontinence procedures give you more control over bladder function.

We’re one of the region’s largest referral centers for incontinence and other pelvic health concerns. Our specialists promptly identify the cause of bladder leaks and deliver treatments that consistently lead to excellent outcomes. Even if previous incontinence treatments haven’t been successful, our team can help you. Meet our team.

Highlights of our program include: 

• Team-based care: Highly regarded urogynecologists, gastroenterologists and colorectal surgeons collaborate to address difficult-to-treat cases. The extended team includes radiologists, gastroenterologists, nutritionists, psychologists and pelvic floor physical therapists. Our health system is one of the few in the Puget Sound area with this capability.

• Conservative approach: Nonsurgical pelvic floor treatments, such as pelvic floor physical therapy, enable many patients to achieve their treatment goals. You may also benefit from medications, bladder training or simple changes to daily habits.

• Advanced options: Our team uses the latest evidence-based methods, including minimally invasive robot-assisted surgery for pelvic floor disorders. Eligible patients may receive innovative treatments available through clinical trials.

There are several types, including: 

• Stress incontinence: This type occurs when coughing, sneezing, laughing or exercising puts stress on the bladder.
• Urge incontinence: You may lose bladder control after a sudden, strong urge to urinate. Urge incontinence often occurs as a result of overactive bladder.
• Overflow incontinence: These leaks occur due to urine buildups after not fully emptying your bladder.
• Functional incontinence: A disability or cognitive issue can cause loss of bladder control.

Urinary incontinence occurs when muscles that keep urine in the bladder contract or relax unexpectedly. It is often a symptom of some other medical issue, such as: 

• Chronic bladder inflammation (interstitial cystitis)
• Damage from pregnancy, childbirth or previous pelvic surgery
• Hormonal changes that occur with menopause 
• Weak pelvic floor (group of muscles that support the bladder, bowel and uterus)

The primary symptom is involuntary bladder leaks that may occur:

• While you are sleeping
• After experiencing a sudden, strong urge to urinate 
• While lifting, bending, coughing, laughing or exercising 
• Without warning

A thorough exam and specialized testing, such as video urodynamic studies, may be necessary to pinpoint the precise source of your symptoms. Read more about diagnostic testing for pelvic floor disorders.

Incontinence evaluations may include: 

• Medical history and exam: First, we ask about your symptoms and how they impact your daily life. Then, we perform a pelvic exam similar to when you visit a gynecologist. 
• Cystoscopy: This procedure evaluates the inside of the bladder. Many patients undergo cystoscopy during an office visit. 
• Urodynamic testing: These tests assess the body's ability to store and release urine. Some locations offer video urodynamic studies, which show bladder function in real time.

Your personalized incontinence treatment plan may include pelvic floor physical therapy. You may also benefit from medications or bladder training. 

We deliver some treatments, such as urethral bulking for stress incontinence, using in-office cystoscopy. The doctor injects a material that helps the tube that carries urine from the body (urethra) form a tight seal. For urge incontinence, we can use cystoscopy to inject botulinum toxin into bladder muscles. This medication relaxes the muscles, which decreases urgency.

Our trusted urogynecologists, gastroenterologists and colorectal surgeons treat complex forms of urinary incontinence and maintain exceptional results. We typically use minimally invasive techniques to deliver your care. These methods are gentler on your body so that you can recover quickly. Find out more about incontinence procedures and surgery.

Our multidisciplinary team cares for patients across the Puget Sound area and beyond. Contact us to learn more or to schedule an appointment.