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urinary voiding dysfunction


Urinary incontinence — the loss of bladder control — is a common and potentially embarrassing problem and most women believe that they have to live with it; however, that is not the case and we are here to help restore your quality of life. To learn how we help our patients combat incontinence, please see our incontinence therapies page.


Urinary incontinence is the inability to control the release of urine from your bladder. It can vary in severity. Some women experience only minor leaking, while other have a total loss of bladder control.

Types of incontinence

Stress incontinence

This is loss of urine when you exert pressure — stress — on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Stress incontinence occurs when the sphincter muscle of the bladder is weakened. In women, physical changes resulting from pregnancy, childbirth and menopause can cause stress incontinence.

Urge incontinence

This is a sudden, intense urge to urinate, followed by an involuntary loss of urine. Your bladder muscle
contracts, and may give you a warning of only a few seconds to a minute to reach a toilet. With urge incontinence, you may need to urinate often, including throughout the night. Urge incontinence may be caused by urinary tract infections, bladder irritants, bowel problems, Parkinson’s disease, Alzheimer´s disease, stroke, injury, or nervous system damage associated with multiple sclerosis. If there’sno known cause, urge incontinence is also called overactive bladder.

Overflow incontinence

If you frequently or constantly dribble urine, you may have overflow incontinence, which is an inability to empty your bladder. Sometimes you may feel as if you never completely empty your bladder. When you try to urinate, you may produce only a weak stream of urine. This type of incontinence may occur in people with a damaged bladder, blocked urethra, or nerve damage from diabetes.

Mixed incontinence

If you experience symptoms of more than one type of urinary incontinence, such as stress incontinence and urge incontinence, you have mixed incontinence. This type of incontinence may require multiple levels of treatment.

Functional incontinence

Many older adults, especially people in nursing homes, experience incontinence simply because a physical or mental impairment keeps them from making it to the toilet in time. For example, a person with severe arthritis may not be able to unbutton his or her pants quickly enough. This is called functional incontinence.

Gross total incontinence

This term is sometimes used to describe continuous leaking of urine, day and night, or the periodic uncontrollable leaking of large volumes of urine. In such cases, the bladder has no storage capacity. Some people have this type of incontinence because they were born with an anatomical defect. This type of incontinence can be caused by injuries to the spinal cord or urinary system, or by an abnormal opening (fistula) between the bladder and an adjacent structure, such as the vagina.


Overactive Bladder

Overactive Bladder (OAB) is condition in which the patient experiences two or all three of the following conditions: urinary urgency, urge incontinence or urinary frequency which is defined as urination more than seven times a day or more than twice at night.


The major symptom of OAB is a “gotta go” feeling—the sudden, strong urge to urinate that you can’t control. You may also worry that you will not be able to get to a bathroom in time. You may or may not leak urine after feeling this urge.
If you live with OAB, you may also experience:


Nocturia and Enuresis


Nocturia is experienced when an individual awakes more than one or two times during the night to urinate. This can disrupt sleep patterns, and cause other health related complications.

Enuresis results when an individual does not wake up before the bladder muscle contracts releasing the urine, commonly known as bed-wetting. Although more common in children, it can be seen in adulthood. There are many causes for this problem including medication side effects, sleep disorders, and even some urinary obstruction disorders.


Urinary Tract Infection

A urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract. The main causative agent is Escherichia coli. Although urine contains a variety of fluids, salts, and waste products, it usually does not have bacteria in it. When bacteria get into the bladder or kidney and multiply in the urine, they cause a UTI. The most common type of UTI is a bladder infection which is also often called cystitis. Another kind of UTI is a kidney infection, known as pyelonephritis, and is much more serious. Although they cause discomfort, urinary tract infections can usually be quickly and easily treated with a short course of antibiotics.


Not everyone with a UTI has symptoms, but most people get at least some symptoms. It is not unusual to feel bad all over — tired, shaky, washed out — and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone, and some men may experience a fullness in the rectum. Normally, a UTI does not cause fever if it is in the bladder or urethra; however, a fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.

Common UTI symptoms include:


Interstitial Cystitis

Interstitial cystitis (IC) is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. It is also known as painful bladder syndrome, or PBS.


The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate, a frequent need to urinate, or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women’s symptoms often get worse during menstruation. They may sometimes experience pain during vaginal intercourse.