Female Incontinence

Get your life back with compassionate expert care for urinary and fecal incontinence from University of Iowa Health Care

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Incontinence is leakage of urine (urinary incontinence or accidents) or feces/stool (fecal incontinence, also called accidental bowel leakage).

If you're dealing with incontinence, you know how much it limits your ability to socialize, travel, and enjoy everyday activities. It can even affect your sleep.

University of Iowa Health Care urogynecologists and other experts provide compassionate, comprehensive care.

They're international leaders in the field. In fact, one of our physicians developed a questionnaire that's used worldwide to diagnose urinary incontinence in women.

Our team treats urinary and fecal incontinence with the widest range of therapies available.

From behavioral counseling to surgical procedures, you have many choices that will improve your quality of life.

Most of the time, we can offer you a treatment plan after one consultation in our offices. If that's the case, you'll see results without having to come back for additional testing.

Incontinence symptoms and diagnosis

Incontinence can be caused by many factors, including pelvic organ prolapse and muscle or nerve damage from pregnancy and childbirth.

The first step in creating a treatment plan is a physical examination and a conversation with your provider about your symptoms.

This can often provide enough information to diagnose the type of incontinence you have.

Urinary incontinence

There are three main types of urinary incontinence:

Stress urinary incontinence is leakage during activities like coughing, sneezing, lifting, or exercise. It can happen to women of all ages, but it's most common in younger women.
Urgency incontinence is leakage with a sudden, unexpected need to urinate. It can be related to another condition, known as overactive bladder, that causes a frequent need to urinate.
Mixed incontinence is a combination of the two types. Many women have both.

Fecal incontinence

Types of fecal incontinence include:

Urgency incontinence, when the feeling that you need to have a bowel movement comes on too quickly.
Passive incontinence, when you don't realize that you need to have a bowel movement.

You can also experience fecal incontinence if you have another bowel issue, like diarrhea or excessive gas.

Incontinence treatment from UI Health Care

Treating your urinary or fecal incontinence is a highly personalized process.

It depends on what's causing your symptoms, how severe they are, and what kind of therapy you'd like to pursue.

Your care team will work with you to make a treatment plan that fits your lifestyle and your goals.

Because UI Health Care specialists are continually researching new ways to treat incontinence, you may be able to be a part of a clinical trial of the latest therapies.

Your treatment plan could include one or more of the following approaches.

Lifestyle changes and education

If your symptoms are mild, you may be able to treat them with some behavioral changes.

These include:

Managing your intake of food and liquids
Losing weight if you need to
Treating constipation
Avoiding heavy lifting or other straining

Medications

Sometimes we can treat fecal incontinence with anti-diarrhea medications, fiber supplements, or laxatives.

For urinary incontinence, medications can calm the bladder muscles or increase the amount of urine the bladder can hold.

Pelvic floor physical therapy

Often, we can treat urinary or fecal incontinence caused by muscle damage with pelvic floor physical therapy.

UI Health Care is home to Iowa's largest team of pelvic floor physical therapists. Our specially trained experts can help you regain muscle control to relieve your symptoms.

Vaginal devices

Special devices can help many women with urinary incontinence. These include pessaries.

A pessary is a flexible silicone device inserted into the vagina to support organs that can prolapse and cause incontinence.

In-office procedures

Your provider can offer procedures to treat incontinence right in the office. They'll use local anesthesia to keep you comfortable.

These procedures include:

Injections for stress urinary incontinence include bulking agents. These are injected behind the urethral wall so the urethra can better resist the pressure of a full bladder. Injections of Botox, which calm the nerves to the bladder, are an option for urgency-related urinary incontinence.
Sacral neuromodulation, or nerve stimulation, can treat both urinary and fecal incontinence. It delivers a mild electrical pulse through a small device implanted under the skin near your tailbone. This stimulates the pelvic muscles or the nerves in the lower back. This procedure can also be performed as outpatient surgery.
Tibial nerve stimulation is a treatment for overactive bladder. It works by sending signals to help relax the bladder, allowing you to hold more urine and get more "warning time." This is a weekly in-office procedure with minimal side effects and risks.

Surgery

If you have moderate to severe incontinence, a minimally invasive surgical procedure might be an option.

Minimally invasive surgeries are performed using special tools inserted through small incisions. This means less pain and faster recovery.

A common procedure for urinary incontinence is the placement of a sling. Through a small incision, your provider places a strip of synthetic material or your own tissue to support the urethra and prevent urine leakage.