Understanding Urinary Incontinence
Practical, evidence-based options for stress, urge, and mixed leakage—without shame.
Leakage with coughing, sneezing, workouts, or sudden urges can feel frustrating and isolating. The good news: many people improve with simple, non-surgical strategies. At Westside Women's Health, we start with a clear diagnosis and build a stepwise plan that fits your routines and goals.
Fast Facts About Incontinence
Common types are stress, urge (overactive bladder), and mixed
First-line care often improves symptoms without surgery
Pelvic floor physical therapy can strengthen support and control
Postmenopausal vaginal estrogen may help urgency and comfort after evaluation
Common Symptoms
- Leakage with coughing, sneezing, laughing, or exercise (stress)
- Sudden, hard-to-hold urge to urinate; frequent trips (urge)
- Nocturia (waking at night to urinate)
- Mixed pattern: both stress and urge features
- Vaginal dryness or discomfort after menopause
Why It Matters
Incontinence affects confidence, social plans, exercise, and sleep—but it's treatable. Identifying the pattern (stress vs. urge vs. mixed) guides targeted steps that reduce leaks and pad use, often without procedures.
Diagnosis & Evaluation
We review a bladder diary, triggers, fluid/caffeine intake, and medications. A focused exam may include a cough stress test and pelvic floor assessment. Urinalysis rules out infection; selected patients may need post-void residual measurement or specialist testing. Clarifying the type leads to the right plan.
Stress vs. Urge Incontinence
Stress Incontinence
- Leaks with pressure: cough, sneeze, laugh, jumping
- Often due to pelvic floor support or urethral closure issues
- Improves with pelvic floor PT, pessary, or in some cases urethral bulking/sling
Urge Incontinence (OAB)
- Sudden, intense urge; can't reach toilet in time
- Frequency, urgency, nocturia are common
- Improves with bladder training, fluid/caffeine timing, meds, and vaginal estrogen after menopause
Treatment Options
We start with conservative care: pelvic floor physical therapy (targeted beyond DIY Kegels), bladder training, fluid spacing, and reducing bladder irritants (caffeine, carbonation, artificial sweeteners). A well-fitted pessary can support stress leakage. For postmenopausal patients, local vaginal estrogen may improve urgency and comfort after evaluation. When needed, medications for overactive bladder can reduce urgency and frequency. Office procedures include urethral bulking for stress incontinence; surgery options (e.g., midurethral sling) are considered if conservative steps fall short. Your plan is personalized and stepwise.
What to Bring to Your Appointment
- ✓3–7 day bladder diary (times, volumes, leaks, triggers)
- ✓List of medications/supplements (include diuretics, antihypertensives)
- ✓Pad usage per day and activity triggers
- ✓Goals (e.g., run without leaks, sleep through night)
Frequently Asked Questions
1Will I need surgery?
Not usually. Many improve with pelvic floor PT, bladder training, fluid/caffeine timing, and, after menopause, local vaginal estrogen. Procedures or surgery are options if first-line steps don't meet your goals.
2Do Kegels actually work?
Targeted pelvic floor therapy—often more precise than self-directed Kegels—can strengthen support and coordination. A pelvic floor physical therapist teaches correct technique and a plan you can sustain.
3Which lifestyle changes help the most?
Spacing fluids, reducing bladder irritants, timed voiding, managing constipation, and maintaining a healthy weight can all reduce leaks. A bladder diary helps pinpoint the changes with the biggest payoff.
4Can vaginal estrogen help?
Local vaginal estrogen can improve urgency, frequency, and vaginal comfort in many postmenopausal patients after clinical evaluation. It is low dose and acts locally with minimal systemic absorption.
5When should I see a specialist?
Consider urogynecology/urology referral for persistent symptoms despite first-line care, significant pelvic organ prolapse, prior pelvic surgery, blood in urine, recurrent UTIs, or unclear diagnosis.
Leak Less, Live More
From pelvic floor therapy to simple daily tweaks—and procedures when needed—we'll tailor a plan to reduce leaks and restore confidence.
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