Stop the Leak

Stop the Leak
Urinary Incontinence Has Minimally Invasive Treatment Options

Urinary incontinence can be an embarrassing condition that interferes with a woman’s quality of life. It’s also quite common, affecting 30 to 50 percent of women at some point during their lives, according to Jeff Welgoss, MD, Medical Director of Urogynecology at Inova Fairfax Hospital.

While it occurs across a variety of age groups, urinary incontinence becomes increasingly common as women get older. “It’s not uncommon to see people who have been leaking urine for 10–15 years before they come in and get checked out, so we end up doing procedures to compensate for their weakened floor muscles,” says Dr. Welgoss. Women who receive treatment during the mild and earlier stages of incontinence are possibly more likely to avoid surgery, he notes.


Jeff Welgoss, MD

Jeff Welgoss, MD, will discuss the causes and treatment options for female pelvic floor disorders, including stress and urge incontinence. This FREE lecture will take place on Tuesday, Oct. 16, at 7 p.m. at Reston Community Center, Lake Anne Gallery, 1609–A Washington Plaza, Reston, VA. To register, call 1-855-694-6682 (1-855-My-Inova) or click here.

Two types of incontinence are
stress incontinence — leaking
urine with coughing and sneezing
— and urge incontinence —
feeling the need to urinate but
not being able to make it to the
bathroom fast enough. Urge
incontinence can be treated with
nonsurgical methods, such as
pelvic floor or Kegel exercises;
avoidance of bladder irritants,
such as caffeinated beverages;
and medications. InterStim
therapy is also a treatment
option, which involves the
implantation of a device that
stimulates the sacral nerves so
that the bladder and its related
muscles can function properly.
An in-office therapy called tibial nerve stimulation, where a nerve in the lower leg is stimulated, can also be effective.

For stress incontinence, a minimally invasive surgery is performed to place a mesh hammock under the urethra. “Basically, it creates a backstop for the urethra so when the patient coughs or sneezes, the urethra moves down onto the mesh, and that closes off the urethra when the muscles don’t,” Dr. Welgoss says. The recovery from this procedure is minimal. “People go home the same day — within a couple of hours — and they are driving and back to working physically non-strenuous jobs in a couple of days,” he says.

Common but not Normal

Pelvic floor disorders are the conditions women experience when their pelvic muscles and tissues weaken, which can result in the shifting of pelvic organs and cause uncomfortable symptoms. Some women are more at risk for developing pelvic floor disorders. Risk increases for women who:

Have had children
Have gone through menopause
Are overweight
Genetically have weaker, more stretchy tissue
Have undergone certain pelvic surgeries
Experience constipation or other chronic increases in
abdominal pressure

For women in their 20s and 30s, pelvic floor conditions, such as urinary incontinence, may occur shortly after vaginal delivery. “During this time, moms are busy with babies and are not necessarily thinking about themselves. They leak [urine], and they think, ‘Oh, it’s there, and it’s no big deal,’” Dr. Welgoss says.

“It’s important to be aware that these things exist and realize that it’s not normal to leak urine because you just had a baby,” he continues. “It’s common, but it’s never normal.”

You're Not Alone
Learn more about treatment for incontinence and other pelvic floor disorders by clicking here. Click on “Gynecology” on the left-hand side of the home page.