Urinary Incontinence

Urinary incontinence — the loss of bladder control — affects millions of Americans, often as a side effect of childbirth, surgery or aging. Houston Methodist’s urology services team offers patients sophisticated testing to determine the cause of incontinence, as well as leading-edge treatments to correct the problem.

Urinary incontinence can range from mild leakage to uncontrollable urine loss. The two main types of incontinence are:
  • Stress incontinence, which arises from weakness in the muscles that keep your bladder closed. You may notice leakage when you laugh, sneeze, cough or lift a heavy object
  • Urge incontinence, or overactive bladder, happens when your bladder muscles are overactive, frequently causing you to feel the urge to urinate, but giving you little warning to make it to the restroom in time

Incontinence is caused by many factors, including:
  • Age
  • Previous surgery involving the bladder or vagina in women
  • Previous surgery involving the bladder or prostate in men
  • Stretched and weakened pelvic muscles after childbirth
  • Side effects of medicine
  • Diabetes mellitus
  • A neurologic condition such as stroke, spinal cord injury or multiple sclerosis

Treatment of Incontinence
The most effective treatment depends on the type of incontinence, as well as its severity and cause. Your doctor’s treatment recommendation will be based on factors such as age and gender. Common treatments include:
  • Behavior modification
  • Physical therapy
  • Medicines
  • Surgery

Bladder retraining involves “teaching” your bladder to control urination urges through delayed urination, “double voiding” (waiting a few minutes after urination and trying again) and relaxation exercises.

Timed voiding involves scheduled urination, usually every two to four hours, rather than waiting for the urge to go.

Your doctor may recommend reducing or eliminating alcohol, caffeine or acidic foods from your diet to help you regain bladder control.

Your doctor also may recommend pelvic floor physical therapy to strengthen bladder muscles. Physical therapists help men and women with stress and urge incontinence. This therapy often works well when used with behavioral techniques and medicines.

Anticholinergics medicines can calm an overactive bladder and may be effective in controlling urge incontinence.

Topical low-dose estrogen, available in a vaginal cream, ring or patch, may reduce overactive bladder symptoms for women by relieving dryness and correcting the pH of the urethra and vaginal areas.

Your doctor may recommend surgery if non-surgical techniques fail, including:
  • Urethral bulking agent: This involves an injection into the urethra (opening of the bladder) to reduce the opening to prevent urine leakage. In many cases, the injection can be done in a clinic.
  • Sling procedure: Surgeons use strips of your body’s tissue or synthetic material to create a “sling” to support the urethra during actions such as coughing or sneezing. The sling supports the urethra, keeping it closed and preventing urine leakage. This procedure is performed in men and women.
  • Artificial Urinary Sphincter: This procedure is performed on men with weakened urinary sphincters because of prostate cancer treatments or other incontinence causes. The surgeon implants a doughnut-shaped, fluid-filled device around the neck of your bladder to keep the urinary sphincter closed until you're ready to urinate. You will press a valve that deflates the ring and allows urination.


Our physicians at Houston Methodist specialize in managing incontinence at the following convenient locations.