Urinary Incontinence – You Are Not Alone

Do you have trouble controlling your bladder? Do you sometimes lose urine when you cough or sneeze, on the way to the bathroom, or when you lift something heavy? Have you experienced bed-wetting? You are not alone. Approximately 13 million adults in the United States suffer from urinary incontinence. Urinary incontinence is a $26 billion dollar industry affecting twice as many women as men.

Incontinence can affect persons at any age

Incontinence can affect persons at any age, however women over 50 are the most common sufferers and younger women who have just given birth. Approximately 50% of older adults are currently institutionalized due to urinary incontinence. On average, one in four adult women have experienced urinary incontinence at some point in their life. There are many causes of incontinence. Some of these causes include pregnancy, childbirth, and hormone changes during the menopausal years.

Incontinence is very common, but not a condition that should be ignored. Eight out of ten times continence can be improved through exercise, biofeedback or surgical intervention.

Normal bladder function

Urinary and bladder control is dependent on activities coordinated between the smooth muscle tissue of the urethra and bladder, skeletal muscle, voluntary inhibition, and the autonomic nervous system. The kidneys filter and cleanse the blood to produce urine, which is stored in the bladder. Nerves in the bladder tell the brain when the bladder is filled with urine resulting in the urge to urinate. Once on the toilet, your brain signals the urethra sphincter muscles to relax while signaling the bladder muscles to contract, thus releasing urine.

Types of Incontinence

There are four major types of incontinence:

1. Stress incontinence
   Urine leaks due to sudden pressure on your lower stomach muscles, (i.e. coughing, sneezing, laughing, heaving lifting, exercise), usually as the result of weakened pelvic muscles.


2. Urge incontinence
   Urine leaks because of the sudden urge to urinate, before you can reach the toilet.


3. Overflow incontinence
   Urine leaks because the bladder is overfilled but doesn’t send the signal to the brain to urinate.


4. Functional incontinence
   Urine leaks not due to a urinary condition but due to a physical disability or mobility issue slowing down a person’s ability to get to the toilet in time.

What can be done?

No one should have to accept living with urinary incontinence. There are several diagnostic and treatment options offered by California Pacific’s Comprehensive Pelvic Medicine and Continence Center that can help you.

Diagnostic Tools

• Urodynamics Testing — Lower urinary tract functional testing helps determine the cause of incontinence and provides guidance for developing an effective treatment plan.


• Ano-rectal Manometry — Diagnostic testing measures the sphincter muscle tone and contraction.


• Physical Therapy Evaluation — Individualized assessment to determine the most appropriate treatment plan that may include one of the following therapies.

Treatment Therapies

• Biofeedback — therapeutic technique measuring strength and duration of pelvic muscle contractions utilizing sensory feedback to reinforce proper muscle performance.


• Pelvic Floor Stimulation — controlled bladder and pelvic nerve and muscle stimulation.


• Bladder and Bowel Retraining — behavioral modification techniques to help improve or restore normal bladder control and bowel function.

Comprehensive Pelvic Medicine and Continence Center

The Comprehensive Pelvic Medicine and Continence Center at California Pacific Medical Center is located on our California Campus at:

3700 California St.
5 North, Room 515
San Francisco, California 94118

Please see our Comprehensive Pelvic Medicine & Continence Center Web page.