Bladder leakage in women: you don’t have to plan around it
Leaking with a sneeze, skipping the gym, wearing a pad every day just in case: bladder leakage is common, and many women never mention it, even to their doctor. It’s common, but it isn’t normal, and it’s treatable. Dr. Dev Mally of Advanced Urology explains.
Questions in this guide
- What kind of leakage do I have?
- How do you find the cause?
- What helps stress leakage?
- What helps urge leakage?
- What if prolapse is part of it?
- Can I see a female provider?
- What about risks?
What kind of leakage do I have?
There are two main types. Stress leakage happens when pressure pushes on the bladder, such as a cough, a laugh or lifting something heavy; it usually comes from weakened support after childbirth, with age or after menopause. Urge leakage is the sudden I-have-to-go-now feeling where you don’t make it in time, which is overactive bladder. Many women have both, and treatment depends on which bothers you most.
How do you find the cause?
A urine test checks for infection or blood. A quick ultrasound bladder scan shows whether you empty all the way. A pelvic exam checks for prolapse, where the bladder drops, which can cause leakage or trouble emptying. Sometimes we’ll ask you to keep a short bladder diary at home.
What helps stress leakage?
Pelvic floor exercises, which build up the muscles supporting the bladder, are where many women begin. We also offer magnetic pelvic floor stimulation: you sit fully clothed in a chair for a series of short sessions while magnetic pulses make those muscles contract. It may help selected patients, alongside exercises. If that isn’t enough, a bulking injection adds volume around the urethra to help it close; it’s quick but may need repeating. A sling is a narrow strip placed under the urethra to support it, like a hammock. Mesh slings for stress leakage are different from mesh placed through the vagina for prolapse repair that was taken off the market. Sling risks include trouble emptying, pain, and the sling material wearing through the tissue, which may need another procedure. Advanced Urology performs these in its outpatient surgery centers.
What helps urge leakage?
We start with habits: less caffeine, alcohol and fizzy drinks, spacing out fluids, and bladder training. For selected women after menopause with related vaginal and urinary symptoms, low-dose vaginal estrogen may help. Next come bladder medicines. Depending on your symptoms, preferences and response, further options include bladder Botox, InterStim, which works on the nerves that control the bladder, and Altaviva, a small implant near the ankle.
What if prolapse is part of it?
We can repair that too, so the whole picture is treated, not just one symptom.
Can I see a female provider?
Yes. Our team includes more than 25 female providers, if you’d feel more comfortable. Same-day appointments are often available.
What about risks?
Each treatment, and any anesthesia, carries risks and benefits, and there are always alternatives. We’ll weigh yours with you.
Watch a short video
Two short videos from Advanced Urology on leaks and overactive bladder, including one from Dr. Vik Sabarwal, who sees patients in Snellville.
This guide is educational, not medical advice. Every treatment and procedure has risks and benefits; your care team will review yours. More on this topic: Advanced Urology condition page.