UAB Medicine

Incontinence, Geriatrics - Overview

It’s embarrassing. You could laugh or sneeze and lose control. Or just be walking along and feel something wrong. Many people who suffer from incontinence become afraid to leave home, especially those with fecal incontinence. However alone you might feel, this disorder is more common than you think. Over a lifetime, one in three women will experience incontinence, and one in six older men. And no one talks about it! However, at the UAB Continence Clinic, we know about the impact of incontinence on quality of life, and we do something about it.

Incontinence is highly treatable. The earlier treatment is sought, the better the result. Many therapies exist to help control both the bladder and the bowel.

We specialize in behavioral therapies. Pelvic floor muscle exercises, called Kegel exercises, strengthen the pelvic floor and help prevent bladder and bowel leakage. Bladder and bowel control strategies, including the “freeze and squeeze” technique developed by UAB researchers, add to the effectiveness of muscle strengthening. Dietary, fiber, and fluid management can be very helpful. With behavioral therapy, people often see results in less than a month.

At the UAB Continence Clinic, the first step is a thorough examination that can determine the best course of treatment.

  • Comprehensive clinical evaluation
  • Physical examination similar to that which women undergo during an annual exam and Pap smear
  • Urinalysis
  • Bladder ultrasound
  • Urodynamic testing, an evaluation to check the function of the lower urinary tract, which consists of the bladder, urethra, and the voluntary and involuntary sphincter muscles
  • Anorectal studies, including manometry and electromyography, to evaluate the anal sphincter, pelvic muscles, nerve function, and rectal function
Our team of physicians, nurse practitioners, and patient-care technicians offer a full spectrum of individualized treatments, including:
  • Behavioral therapy, including pelvic floor muscle therapy and bladder and bowel control strategies for urinary and bowel incontinence (biofeedback and electrical stimulation as needed)
  • Fluid, fiber, and dietary management
  • Medications
  • Trigger point release and pelvic floor relaxation training for voiding and defecatory dysfunction
  • Fitting of vaginal support device (pessary) for prolapse and stress urinary incontinence
  • Percutaneous posterior tibial nerve stimulation for urgency incontinence
  • In conjunction with our colleagues in Colorectal Surgery, Urogynecology, and Urology
    • Surgery for pelvic organ prolapse and stress incontinence, including new minimally invasive vaginal and laparoscopic approaches
    • Neurostimulation therapy for refractory urge urinary incontinence, bowel incontinence, and voiding dysfunction
    • Botox therapy for refractory urge urinary incontinence