Women's Continence Program

Bladder leakage, or urinary incontinence, affects one out of every 10 women of all ages, and one out of five women over age 40. Even though urinary incontinence is such a common health problem among women, surveys show that most women wait, on average, seven to nine years before seeking treatment for the condition. Many are embarrassed about the problem and some think it's just a "normal" part of being a woman or of aging. If you experience incontinence, you are not alone. There's no need to be embarrassed about seeking treatment and you do not need to learn to live with it. There are many treatment options available to you.

Simple, First-Step Treatment

Shawnee Mission Medical Center's Women's Continence Program was designed to provide simple, non-invasive treatment for the management, and oftentimes resolution, of bladder leakage. This program emphasizes changing urinary behaviors and exercising pelvic muscles. These methods have been designated by the U.S. Agency for Health Care Policy & Research (AHCPR) as being the preferred "first-step" treatment for urinary incontinence. The program is staffed by female physical therapists specially trained in the nerve, muscle and organ process of urinary control, who are sensitive to the issues surrounding incontinence.

The Women's Continence Program provides treatment primarily for stress, urge and mixed incontinence problems (see information below). However, many other types of urinary leakage exist. A discussion and exam with your physician will assess whether the program can help your particular condition.

A woman enters the program by medical prescription from her primary care or specialist physician. Participation in the Women's Continence Program may be combined with prescription drugs or other treatment options. Some women benefit from participating in the program either before or after surgical procedures for incontinence. Each woman's treatment plan is customized to meet her individual medical and personal needs.

The Program Includes:

• Evaluation of urinating habits and fluid intake
• Guidelines to reduce an irritable bladder
• Techniques of bladder training by timed voiding and urge deferral, if needed
• Computerized testing of pelvic muscles to determine strength, endurance and coordination.

Women of any age who are concerned about bladder leakage limiting their lifestyle are encouraged to seek the advice of their health care practitioner regarding these and other treatment options for incontinence.

Types of Incontinence

• Stress. The most common form of leakage, stress incontinence occurs during normal activities such as coughing, sneezing, laughing or exercising. These activities place downward pressure on the bladder and weakened pelvic muscles cannot control the force. There may be actual changes in anatomy with this condition, such as a dropped bladder or a sagging urethra.
• Urge. Urge incontinence is another common form of bladder leakage. Also called overactive bladder or detrusor instability, this type occurs when there is poor coordination between nerves, bladder and muscles. The detrusor muscle of the bladder becomes irritated, signaling the brain and consciousness with a strong urge to urinate. These urges can occur even if the bladder is not full. The bladder muscle squeezes urine out before pelvic muscles can prevent this from occurring. Most leakage episodes in this form of incontinence occur on the way to the bathroom. Urinary frequency (going more than every two to four hours) and nocturia (frequent urination at night) are also characteristics of this condition.
• Mixed. Some women suffer from mixed incontinence, a combination of the stress and urge leakage patterns.