Both urinary and bowel incontinence typically occur when the pelvic floor muscles become damaged or weakened over time, often as a result of multiple pregnancies, vaginal childbirth, obesity, or age- and hormone-related changes. Smoking can also increase the chances of developing incontinence, and women who have had hysterectomies or some other types of pelvic surgery can also be at an increased risk. Sometimes, incontinence can be caused by traumatic injury or by conditions that affect the nerves and muscles, like multiple sclerosis.
Urinary incontinence is usually divided into three primary types:
Diagnosis of incontinence involves determining the type of incontinence that's occurring as well as the underlying cause of symptoms. The diagnostic process begins with a complete medical history to look for risk factors for incontinence followed by blood tests and diagnostic imaging using ultrasound, CT scans or similar procedures to evaluate the structure and function of the bladder and other structures. Minimally-invasive diagnostic evaluations also may be performed to assess the structure of the bladder, how well the bladder retains urine, how much fluid the bladder can hold, the strength of the bladder muscles, and other factors that can cause or contribute to incontinence.
Once accepted as part of the “natural” course of aging, today there are state-of-the-art methods to treat urinary incontinence so women feel more comfortable and more confident. Medications can be helpful in mild to moderate incontinence, especially if combined with pelvic floor muscle exercises. When conservative approaches aren't enough, minimally-invasive surgery including highly-accurate robot-assisted da Vinci® surgery can be performed to repair or strengthen muscles and other structures to reduce or eliminate incontinence symptoms. The approach used will depend on the cause of incontinence and other factors.
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