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Female Incontinence

Incontinence is a problem of the urinary system where the bladder does not reliably store urine until it is convenient to urinate. Incontinence occurs when urine involuntarily leaks from the bladder out the urethra.

When coughing or sneezing causes a woman to expel small amounts of urine, it’s called stress incontinence. It is a very common condition affecting half of all women.

Causes of Female Incontinence

The most common type of urinary incontinence in women is stress incontinence or SUI. Referring to physical stress rather than mental or emotional stress, this condition is defined by the pelvic muscles becoming unable to sustain any kind of sudden additional stress—or pressure. When sudden extra pressure occurs, so does involuntary leakage.

Stress incontinence can be provoked by the following actions:

  • Coughing
  • Sneezing
  • Laughing
  • Exercising
  • Heavy lifting
  • Awkward movement (getting out of a car, for example)
  • Sexual intercourse

Many women experiencing stress incontinence suffer in silence. Feelings of embarrassment and self-consciousness overtake their emotional wellness and may lead to social isolation. In time, women suffering from SUI can begin to feel very distressed. Psychological problems associated with urinary incontinence include anxiety, depression, fear of intimacy, and relationship troubles.

Other Types of Incontinence

Some women experience incontinence based on secondary conditions.

Urge Incontinence is typically a symptom of overactive bladder and includes a strong urge to urinate much more frequently than normal. When urine is leaked, it is much more than a dribble.

Continuous Incontinence: This is rare situation and usually is the result of a complication of surgery causing an abnormal connection between the bladder and vagina.
Some women have multiple types of incontinence at the same time.

Quality of Life Issues

Urinary incontinence has a far-reaching effect on women’s lives impacting their professional, mental and social well-being. The secondary impacts can include:

  • Reduced sexual activity
  • Avoiding going out in public
  • Becoming isolated
  • Struggling with depression
  • The condition is linked to an increase in falls and fractures among elderly women.

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The doctor will take a urine sample to check for infection. A discussion of symptoms, urges, frequency and fluid intake are typical for the first visit.

  • A pelvic exam (including a Kegel exercise to test the strength of the muscles
  • A cough test (to assess the amount of urine leakage)

The doctor may also take measurements of the bladder to see how much urine is retained or visually examine the bladder with a procedure called cystoscopy.

Urinary incontinence treatment - Montreal urologist


There are many potential responses to female incontinence. The doctor will evaluate your situation and determine the best course of action. The list below shows some non-surgical therapies.

Treatment Type Description
Behavior Modification
  • Bladder training
  • Kegel exercises to strengthen bladder muscles
  • Smoking cessation
  • Weight loss
  • Biofeedback


Medication Topical estrogen (cream, patch or ring) scan help stimulate the vaginal muscle tissue
Neuromodulator Injections Injections of Neuromodulator into the bladder muscle may benefit women with incontinence due to overactive bladder. 
  • Urethral insert is a small disposable plug (similar to tampon) inserted into the urethra before commencing an activity that triggers incontinence. It blocks leakages.
  • Pessary is a ring that is inserted into the vagina. A pessary helps support the bladder, to prevent urine leakage.

Surgical Options

Surgery may be a consideration for women with severe symptoms affecting quality of life.

Sling Procedures: Using the body’s own tissue along with synthetic mesh, slings are placed under the urethra by making a small incision in the vagina. The sling supports the urethra at its connection point at the bladder.

Bladder Suspension: The procedure is used to resolve sagging of the bladder neck or urethra by sutures to surround tissue or bone.

Non-Invasive Treatments

Vaginal laser treatments, like the diVa Laser.

The diVa laser treatment is the newest evolution of laser vaginal therapy built on years of experience. diVa delivers two types of energy to aid in resurfacing the vaginal skin while also stimulating the re-growth of new collagen, blood vessels, and nerve endings below the surface of the vaginal walls.

The deeper layer is responsible for the dynamic elastic nature of the vagina, the lubricating, secreting capability of the vaginal skin, and the sensitivity of the vaginal canal. Restoring this deeper vaginal layer creates a significant change to dry, lax, painful tissue with long term results.

The treatment is quick and we can target specific regions to improve stress urinary incontinence or other localized issues – as well as the broader benefits in addressing dyspareunia or vaginal laxity.




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