Urogynecology, Incontinence

Although most of us don't normally think of the bladder and pelvis beyond reproductive years, there are a variety of ailments in these areas that reduce the quality of life for women as they age if not appropriately treated. Our highly trained specialists can address problems of urinary leakage and voiding issues, bladder infections, prolapse of the pelvic organs, sexual issues, pelvic pain and lower bowel dysfunction. Even young women, those with neurologic problems and those with issues surrounding childbirth are candidates for evaluation.

The Pelvic Care and Incontinence Center brings together the collaborative expertise of specialists from the Departments of Obstetrics and Gynecology, Urology, General Surgery and the Division of Gastroenterology to address issues involving the pelvic floor.

Contact Us

(801) 581-3834

(801) 581-5490

Bladder and pelvic conditions can lead to a number of problems that we are familiar with, even if we don’t know what treatment options are available. Here are some facts about these conditions:

  • When the tissue that supports the pelvic organs is stretched or damaged, the organ (bladder, uterus, rectum, intestine) can press against the wall of the vagina. This can cause a bulge.
  • Pelvic organ prolapse occurs in 15–30% of women. Childbearing and obesity increase this risk.
  • Urinary incontinence affects 18 million women and increases with age.
  • Bowel incontinence is closely associated with urinary loss.

There are a variety of treatment options for urinary incontinence and prolapsed available at our center. They range from appropriate lifestyle changes to minimally invasive procedures, such as pessaries and Botox injections, all the way to state-of-the-art surgical interventions. We also can perform the following tests: subtraction-and-video urodynamics, anal manometry, electrophysical testing and endoanal ultrasonography.

Learn more by taking these quizzes:

Urinary Incontinence

What is urinary incontinence (UI)?

Urinary incontinence (UI) is the loss of urine control, or the inability to hold your urine until you can reach a restroom. According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age. Women over age 50 are the most likely to develop UI. Urinary incontinence may be a temporary condition, resulting from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.

What causes urinary incontinence?

Incontinence is not an inevitable result of aging, but is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications, and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop incontinence either during pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles.

What are some of the different types of urinary incontinence?

The following are some of the different types of urinary incontinence:

  • Urge incontinence. The inability to hold urine long enough to reach a restroom. It is often found in people who have conditions, such as diabetes, stroke, dementia, Parkinson's disease, and multiple sclerosis, but may be an indication of other diseases or conditions that would also warrant medical attention.

  • Stress incontinence. The most common type of incontinence that involves the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.

  • Functional incontinence. Leakage due to a difficulty reaching a restroom in time because of physical conditions such as arthritis.

  • Overflow incontinence.  Leakage that occurs when the quantity of urine produced exceeds the bladder's capacity to hold it.

What are the symptoms of urinary incontinence?

The following are the most common symptoms of urinary incontinence. However, each individual may experience symptoms differently. Symptoms may include:

  • Inability to urinate

  • Pain related to filling the bladder and/or pain related to urination without a proven bladder infection

  • Progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying

  • An increased rate of urination without a proven bladder infection

  • Needing to rush to the restroom and/or losing urine if you do not get to restroom in time

  • Abnormal urination or changes in urination related to a nervous system

  • Abnormality, such as stroke, spinal cord injury, or multiple sclerosis that interferes with urination

  • Leakage of urine that prevents activities

  • Leakage of urine that began or continued after surgery

  • Leakage of urine that causes embarrassment

  • Frequent bladder infections

The symptoms of urinary incontinence may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

How is urinary incontinence diagnosed?

For people with urinary incontinence, it is important to consult a health care provider for a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples. In many cases, patients will then be referred to a urologist, a doctor who specializes in diseases of the urinary tract.

What is the treatment for urinary incontinence?

Specific treatment for urinary incontinence will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Behavioral therapies (to help people regain control of their bladder), including the following:

    • Bladder training. Teaches people to resist the urge to void and gradually expand the intervals between voiding.

    • Toileting assistance. Uses routine or scheduled toileting, habit training schedules, and prompted voiding to empty the bladder regularly to prevent leaking.

  • Pelvic muscle rehabilitation (to improve pelvic muscle tone and prevent leakage), including the following:

    • Kegel exercises. Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence. This is particularly helpful for younger women. Should be performed 30-80 times daily for at least 8 weeks.

    • Biofeedback. Used in conjunction with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.

    • Vaginal weight training. Small weights are held within the vagina by tightening the vaginal muscles. Should be performed for 15 minutes, twice daily, for four to six weeks.

    • Pelvic floor electrical stimulation. Mild electrical pulses stimulate muscle contractions; should be performed in conjunction with Kegel exercises.

  • Medication (including specific drugs for incontinence as well as estrogen therapy, which may be helpful in conjunction with other treatments for postmenopausal women with UI)

  • Surgery (if the incontinence is related to structural problems such as an abnormally positioned bladder or a blockage)

  • Diet modifications (i.e., eliminating caffeine in coffee, soda, and tea, and/or eliminating alcohol)

How is urinary incontinence managed?

Specifically designed absorbent underclothing, which is no more bulky than normal underwear and can be worn easily under everyday clothing, is available. Also, incontinence may be managed by inserting a catheter into the urethra and collecting the urine into a container. Consult your doctor with your questions regarding the management and treatment of urinary incontinence.

Jan E. Baker, N.P.

Jan E. Baker, MS, APRN is a research/clinical Nurse Practitioner at the University of Utah. She has 20 years experience in the non-surgical treatments of urinary incontinence and pelvic organ prolapse. She also has 20 years of experience performing specialized bladder testing procedures. She recently received ... Read More

Specialties:

Bowel Dysfunction, Chronic Urinary Tract Infections, Family Nurse Practitioner, Female Incontinence, Incontinence, Non-Surgical Management of Prolapse and Incontinence, OB/GYN Nurse Practitioner, Pelvic Dysfunction/Incontinence, Pelvic Organ Prolapse, Prolapse, Urogynecology, Non-surgical

Locations:

OB-Gyn Avenues Clinic (801) 587-1950
South Jordan Health Center (801) 587-1950
University Hospital (801) 587-1950

Yvonne Hsu, M.D.

Dr. Hsu is a board certified, fellowship trained Urogynecologist, and is responsible for both clinical services, research, and education conducted at outreach sites in the intermountain region. She also directs Intermountain Healthcare’s Urogynecology Clinics, seeing patients within their system. ... Read More

Specialties:

Female Incontinence, Incontinence, Pelvic Dysfunction/Incontinence, Pelvic Organ Prolapse, Prolapse, Robotic Assisted Pelvic Reconstruction Surgery, Urogyn & Pelvic Reconstructive Surgery

Locations:

OB-Gyn Avenues Clinic (801) 587-1950
University Hospital (801) 587-1950

Peggy A. Norton, M.D.

Peggy A. Norton, MD, is a board certified, fellowship trained Urogynecologist, who treats women with urinary incontinence and pelvic organ prolapse. She is Chief of Urogynecology and Pelvic Reconstructive Surgery and Medical Director of the Pelvic Floor Center, a multidisciplinary center where women can be seen... Read More

Specialties:

Female Incontinence, Incontinence, Pelvic Dysfunction/Incontinence, Pelvic Organ Prolapse, Prolapse, Urogyn & Pelvic Reconstructive Surgery

Locations:

University Hospital (801) 587-1950

Ingrid E. Nygaard, M.D., M.S.

Ingrid Nygaard, MD is a board certified, fellowship trained Urogynecologist. After practicing in the area of Urogynecology and Pelvic Reconstructive Surgery at the University of Iowa for 15 years, she joined the faculty at the University of Utah in 2006. Her clinical practice focuses on the care of women with ... Read More

Specialties:

Epidemiology, Incontinence, Pelvic Organ Prolapse, Prolapse, Urogyn & Pelvic Reconstructive Surgery

Locations:

University Hospital (801) 587-1950

University of Utah Campus

University Hospital
Urology Department
3rd Floor, Room 3A 100
50 N Medical Drive
Salt Lake City, UT 84132
Map
Appointments
(801) 581-3565
or
(801) 581-5490

Community Clinics

South Jordan Health Center 5126 W. Daybreak Parkway
South Jordan UT, 84095
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Appointments
(801) 213-4500
OBGYN Avenues Clinic Medical Plaza 2, 370 9th Avenue, Suite 101
Salt Lake City, UT 84103
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Appointments
(801) 236-7803
clinics & locations