1. What is urinary incontinence?

  2. How common is urinary incontinence?

  3. What are the major causes for urinary incontinence?

  4. How do you evaluate patients with urinary incontinence?

  5. Is surgery the best treatment?

  6. How effective is the “nonsurgical treatment modality”?

  7. What is the success rate of various treatments?


  1. Urinary incontinence is involuntary loss of urine from the urethra or sometimes from the vagina.

  2. Urinary incontinence is common. Estimated 30 million women in the USA suffer from that problem.

  3. Urinary incontinence can result from either a bladder that is “too active” and pushes urine out. Or from urethra that is weak and cannot act as an effective sphincter. It is extremely important to differentiate between these two causes because treatment is very different. In fact, one of the major reasons for failure of operation for urinary incontinence is undiagnosed or existence of bladder overactivity.

  4. Evaluation should be focused on where and what is the primary problem, i.e., is the problem in the bladder or urethra? Successful treatment depends on adequate evaluation. Evaluation should include clinical examination, testing the nerves of the bladder area, looking at the bladder and urethra and urodynamic testing. These are all office procedures with minimal discomfort.

  5. Surgery is the answer only to some forms of urinary incontinence, i.e., when the problem is in the urethra. Surgery is not helpful if the problem is in the bladder functions and even in urethral weakness. Surgery is not the only answer to the problem.

  6. Nonsurgical treatment modalities may be helpful in 70% or more of women with incontinence. Nonsurgical modalities include medications, pelvic muscle training “Kegel exercises”, various devices, bladder training and electrical stimulation.

  7. When done appropriately and in the right indication, good results can be expected in more than 80% of patients.