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Urinary Incontinence in Women


Many women experience urinary incontinence, an embarrassing bladder control problem that you don't have to struggle with anymore. 

"Though urine leakage is common in women," says Leslie Rickey, MPH, MD, a Yale Medicine urologist, "it should absolutely not be considered a normal or inevitable part of aging. Many women will try to self-manage their symptoms with pads or limiting their fluid intake. However, this does not stop the problem from getting worse. Women should know there are many treatments for urine leakage, and they should feel empowered to seek out information on their options instead of feeling isolated and alone."

Many women don’t realize there are effective treatments available to regain bladder control. Even mild leakage symptoms should be addressed as there is potential for the condition to worsen over time.

Urinary incontinence affects women of all ages, and the condition is two times more common in women than men. Our clinicians at the Yale Medicine Department of Urology recognize that bladder issues can significantly impact quality of life. Each patient seeking treatment will receive a personalized plan that takes into account symptoms, lifestyle and treatment goals.

“There are many different treatment options for urine leakage, and we are here to help you determine which treatment options are right for you,” says Nancy Ringel, MD, MS, who specializes in treating pelvic floor disorders. “My patients report huge improvements in their quality of life after seeking treatment—they say they wish they had come in sooner

What is urinary incontinence?

Urinary incontinence is the involuntary loss of urine or urine leakage.

There are three types of this condition:

  • Urgency incontinenceUrine leakage is associated with urinary urgency and failure to get to the bathroom in time.
  • Stress incontinence: The patient experiences urine leakage with activity, such as coughing, laughing or sneezing.
  • Mixed incontinence: Many patients experience a combination of stress incontinence and urge incontinence.

What are the underlying causes of urinary incontinence for women?

The most common causes of UI are pregnancy, pelvic floor trauma after vaginal birth, menopause, obesity, urinary tract infections, cognitive impairment, chronic coughing or constipation.

How is urinary incontinence treated?

Depending on the cause and severity of the condition, both surgical and nonsurgical treatment options are available to patients.

First-line treatments include muscle strengthening exercises, lifestyle changes, medication or a referral to a specialized pelvic floor physical therapist. Office procedures, such as injectable therapy or minimally invasive outpatient procedures are also available.

Patients who still suffer from bladder issues after multiple treatment options have failed might be eligible for a clinical trial.

How successful is treatment for urinary incontinence in women?

Incontinence is usually a highly treatable condition. Half of patients with this condition may see improvement with behavioral changes and pelvic floor exercises alone.

There are also many options and alternate therapies for women who need further treatment.

What are the best treatment options for stress incontinence?

Pelvic floor muscle strengthening is often recommended for stress incontinence. Another option is an “incontinence ring.” This device is placed into the vagina and can prevent leakage during exercise or other activity.

Surgical treatments are more common for stress incontinence and could include an office procedure to “bulk up” the opening of the bladder. They may also include an outpatient surgery that helps support the urinary tube and prevents loss of urine during coughing, sneezing or exercise.

What are the best treatment options for mixed incontinence?

Mixed incontinence usually requires treatment of both stress and urgency incontinence. For this reason, a nonsurgical option is recommended first. Often both types of incontinence will improve without surgical intervention. More difficult cases require careful evaluation to help determine the best course of treatment.

What makes Yale Medicine's approach to treating urinary incontinence unique?

Our physicians are dedicated to listening to patients and helping them get back to their previous quality of life. 

Urinary incontinence is not a problem that simply has to be endured, Dr. Rickey says. Yale Medicine urologists strive to guide each patient towards a treatment plan that matches their lifestyle and personal goals.

“We care about making sure that each patient feels informed about their options,” Dr. Ringel says. “We want you to feel empowered to take control of your life, and we’re here to help you find ways to do that safely and effectively.”