Urinary Incontinence; Urgency, Retention and Voiding Problems

Types of urinary problems:

Problems with the urinary system include:

Urinary incontinence- the inability to control urine

Urinary urgency- the involuntary loss of urine associated with a sudden urge to void

Urinary retention- the inability to completely empty the bladder

Voiding problems- any abnormality associated with the bladder including an inability or difficulty starting to void and inability to sense bladder fullness


What causes urinary difficulty?

There can be many causes of problems with urination including constipation, trauma, difficult childbirth, surgery, bladder prolapse, diabetes, radiation therapy or back injury. 


How are urinary problems diagnosed?

Patients should undergo a thorough history and physical examination and you may be referred to a specialist (urologist, urogynecologist).  Diagnosis is often determined from history and exam only but you may require specialized testing called urodynamics.


How are urinary difficulties treated?

There are many treatments available determined by the diagnosis.  Medication is often helpful as well as physical therapy or biofeedback therapy. These are both aimed at strengthening the muscles in the pelvic floor as well as helping the muscles relax appropriately to empty the bladder.  A pessary may be recommended for female patients.  Treatment of underlying constipation may be suggested.  Sacral nerve stimulation is another treatment option for problems that fail to respond to other treatments.