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Johns Hopkins Health - Holding Back Incontinence

Spring 2010
Issue No. 8

Holding Back Incontinence

Date: April 23, 2010

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Women don’t need to struggle with embarrassing urine leakage

Just because you’re getting older doesn’t mean you have to live with the frustration of urinary incontinence. And the condition isn’t necessarily a reality of getting older, says urogynecologist Victoria Handa, M.D.

“Suggesting that urinary incontinence is a normal part of aging,” she explains, “is like saying that cancer always happens when you get old.” That’s just not true.

It is fact, though, that urinary incontinence affects primarily women—about half of them will have some form of incontinence in their lifetimes.

It’s no laughing matter.

“It’s more than just a medical problem,” Handa says. “It’s also a quality-of-life issue, and all of those feelings and frustrations that go along with that.”

Fortunately, urinary incontinence can be managed. Doing that means first identifying what type you have. There are two main patterns, Handa explains: stress incontinence and urge incontinence.

Stress incontinence, the more common type, usually begins between the ages of 40 and 50. It’s a leakage of urine that occurs with physical activities that put pressure on the bladder, such as coughing, lifting or jumping. Treatment involves stabilizing the “pelvic floor” to support the bladder. Options include Kegel exercises, inserting a vaginal device called a pessary to support the urethra, and minimally invasive surgery.

In contrast, urge incontinence is an inability to get to the bathroom in time to prevent urine leakage. This condition is more commonly called overactive bladder. Women with urge incontinence usually have frequent urination and sometimes feel as if their bladder is not completely empty. Treatment may include medication or behavioral therapy, or a combination.

But you won’t get help if you don’t ask, Handa says. “The first step is to overcome any embarrassment you may have and talk to your doctor.” That conversation might start with your primary care physician. But you can also talk to your gynecologist or urologist or another specialist with expertise in female pelvic medicine.

  • 25 million Americans are affected by urinary incontinence
  • 80% of those who suffer from incontinence are women
  • 1 in 5 older men suffers from incontinence

Free Seminar
Fixing the Leaky Bladder
Tuesday, May 25, 6 p.m., at Johns Hopkins Bayview Medical Center
Learn about the causes of and latest treatments for urinary incontinence in women and men. Refreshments will be served. Visit to register

You can overcome incontinence. This prevalent condition has effective treatment options. Go to or call 877-546-1872 to explore solutions.