Urinary incontinence is the loss of bladder control. Leaking urine is a common problem for women, and it can happen to anyone but is more common with age. For some, symptoms are so severe that they significantly restrict their activities to avoid embarrassing accidents. Most bladder control problems happen when muscles are too weak or too active.

If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh, jump or lift a heavy object. This is stress incontinence.  If bladder muscles become too active, there may be a strong urge to go to the bathroom even when the bladder is not full. This is urge incontinence or overactive bladder.  There are other causes of incontinence, such as nerve damage from certain medical conditions or radiation damage from cancer treatment.

Treatment depends on the type of bladder problem and a woman’s personal preference. Treatments may include simple exercises, medicines, special devices prescribed a provider, or surgery. Many of these treatments are available at Selah.

Free resource guide for patients interested in learning more about Stress Urinary Incontinence.

Overactive bladder is a condition in which the bladder muscle contracts frequently, triggering the sensation of the urge to urinate. This can be caused or worsened by various bladder irritants in the diet, by aging, by nerve dysfunction, or unknown causes.

Sometimes it also results in involuntary leakage of urine. This is a condition that is more common in women than men. It is also treatable, with options ranging from dietary changes, bladder retraining therapy, physical therapy, medications, or nerve stimulator treatments.

Interstitial cystitis is a chronic painful bladder condition thought to be caused by a type of autoimmune inflammation. Symptoms include bladder and pelvic pain or pressure and a frequent urge to urinate. Symptoms are often mistaken for recurrent urinary tract infections (UTI) or endometriosis. Sometimes women will experience chronic pelvic pain and pain with sex that has not responded to typical treatments for reproductive tract problems.

Effective treatment often needs to be multifaceted, including nutritional changes, medications, instillations (direct bladder treatments done in the office setting), physical therapy, and biofeedback.

Often women come to us feeling hopeless about their long-standing symptoms, but we have witnessed so many of them achieving pain-free living through this type of treatment approach.

Weakness in the pelvic muscle floor can lead to prolapse. Symptoms include vaginal bulging or pressure, difficulty emptying the bladder completely or experiencing frequent urinary tract infections, and difficulty passing bowel movements (sometimes requiring pressure in the vagina from a finger in order to pass).

Prolapse treatments can vary from special pelvic exercises or physical therapy, to pessary use or surgical reconstruction.

https://www.acog.org/Patients/Patient-Education-Videos/Pelvic-Organ-Prolapse

A pessary is a silicone device that is helpful as a conservative treatment for vaginal prolapse. These come in various sizes and shapes, and can be fitted by a medical provider to hold up prolapsing areas of the vagina.

For some women, whether by personal preference or medical necessity, this proves to be a better treatment than surgery.

Selah providers are skilled at helping patients choose the right pessary and providing the maintenance care required for it several times a year.

Dyspareunia, or pain with sexual intercourse, is unfortunately common among women. The causes that can contribute to discomfort include sexual arousal disorders, vaginal atrophy (common after menopause), effects of prior sexual trauma, pelvic muscle dysfunction and spasm, and structural abnormalities of the female reproductive system, such as uterine fibroids, endometriosis, or ovarian cysts.

Since the causes are so varied, it is important to seek evaluation with an experienced gynecology provider. This may include hormonal lab testing, physical exam, and ultrasound imaging.

Most women can experience complete relief with the proper treatment for the specific cause. These treatments can range from topical or oral medication to physical therapy, laser therapy, or counseling. It is also not unusual for us to recommend more than one treatment modality to fully resolve the cause(s).