There are many factors that can cause or contribute to both urinary incontinence and fecal incontinence in women. Incontinence becomes more common with age as hormone levels decline, but one of the primary causes of incontinence is weakness in the pelvic floor muscles, an interconnected band of strong connective tissues and muscles that helps hold the pelvic organs in place. If the pelvic floor becomes weakened or injured, it may no longer be able to support the pelvic organs, and one or more organs may drop out of its normal position and press into the vagina, causing a condition called pelvic organ prolapse. Weakening of the sphincter muscles can also contribute to incontinence, as can nerve injury, some underlying chronic medical conditions and even long-term use of some medications. Women who have had multiple vaginal deliveries can also be more prone to urinary incontinence. The first step in treating incontinence is to have a thorough exam and testing to determine the underlying cause.
Bladder leakage is the most common symptoms of urinary incontinence, but other symptoms can also occur depending on the type of incontinence:
In addition to a physical exam, a pelvic exam and a review of the patient’s specific symptoms, there are several tests that can be performed to assess the muscle strength and capacity of the bladder and to check for other possible causes of bladder leakage like an infection. Minimally-invasive exams of the bladder can also be performed in the office. The testing that’s performed will depend on the patient’s symptoms and other factors.
Lifestyle and dietary changes, medication, and even BOTOX® injections can be used to treat many types of incontinence symptoms. More severe issues may require surgery to repair damaged muscles or to correct other issues.