Women’s Health – Urinary Incontinence
Leaking urine is common, but it is not something you have to “just live with.” Urinary incontinence affects women and men of all ages and can disrupt work, sleep, exercise, travel, and intimacy.
At Riverstone Urology in Cypress, Dr. Russell Libby evaluates urinary incontinence with a simple goal. Understand the cause, match it to the right treatment, and help you get back to daily life with more control and fewer accidents.
What Is Urinary Incontinence?
Urinary incontinence means any involuntary leakage of urine. It ranges from a few drops with a hard cough to sudden, large accidents that are hard to predict.
There Are Several Main Types:
- Stress incontinence: Leaking with coughing, laughing, sneezing, lifting, or exercise. This often relates to weak pelvic floor muscles or urethral support, especially in women after childbirth or surgery, and sometimes in men after prostate surgery.
- Urge incontinence, overactive bladder: Strong, sudden urges to urinate with little warning and frequent trips to the bathroom, sometimes with leakage before you reach the toilet.
- Mixed incontinence: A combination of stress and urge symptoms. One type usually bothers you more.
- Overflow incontinence: Leakage from a bladder that never empties well, often from blockage or weak bladder muscle.
- Functional incontinence: Leaking because of trouble getting to the bathroom in time due to mobility, vision, or thinking problems.
Dr. Libby focuses on which type you have, because treatment depends on the pattern, not only on the word “incontinence.”
Symptoms
People With Urinary Incontinence Often Notice:
- Leaking with cough, laugh, sneeze, or exertion
- Sudden, hard to control urges to urinate
- Going to the bathroom very often during the day
- Waking up multiple times at night to urinate
- Not making it to the toilet in time
- Using pads or protective garments for leaks
- Planning outings around bathroom access
Many people feel embarrassed and stay quiet for years. Incontinence is a medical problem, not a personal failure. You deserve an honest conversation and a plan.
Common Causes And Risk Factors
Urinary Incontinence Often Builds From Several Factors, Including:
- Pregnancy and vaginal childbirth
- Menopause and lower estrogen levels
- Prostate enlargement or prostate surgery in men
- Pelvic organ prolapse in women
- Obesity and chronic cough or constipation
- Nerve or brain conditions such as stroke, Parkinson’s disease, or spinal cord injury
- Diabetes and long standing high blood sugar
- Certain medicines, such as diuretics, sedatives, or some antidepressants
- Prior pelvic surgery or radiation
Dr. Libby looks for these underlying drivers so treatment goes beyond pads and quick fixes.
When To See Dr. Libby
You Should Schedule A Visit If:
- You leak urine often enough to use pads or change clothes
- You wake up more than twice a night to urinate
- Bathroom urges interrupt work, travel, or relationships
- You avoid exercise, intimacy, or social events because of leakage
- You have sudden incontinence with weakness, numbness, confusion, or back pain, which needs urgent attention
Incontinence is not a normal part of aging. It is common and treatable.
How Dr. Libby Evaluates Urinary Incontinence
Evaluation At Riverstone Urology Follows National Guidelines But Stays Practical.
Focused History
Dr. Libby asks about:
- When leaks happen and how often
- How much you leak, a few drops or more
- Fluid intake, caffeine, and alcohol habits
- Pregnancies, pelvic surgeries, or prostate procedures
- Bowel habits and constipation
- Medicines, medical conditions, and mobility
You may be asked to complete a bladder diary at home, writing down what you drink, when you urinate, and when leaks occur.
Physical Exam
- Abdominal and pelvic exam for women to check pelvic floor support and prolapse
- Genital and prostate exam for men
- Basic neurologic checks when needed
Initial Tests
- Urinalysis to rule out infection or blood in the urine
- Bladder scan or simple ultrasound to check how well you empty
- In some cases, urodynamics or cystoscopy if diagnosis is unclear or surgery is being planned
The goal is to match your symptoms with a clear type of incontinence and rule out red flags that need urgent attention.
Treatment Options At Riverstone Urology
Most Patients See Significant Improvement With A Stepwise Plan. Treatment Builds From Conservative Options To More Advanced Therapies As Needed.
Lifestyle And Bladder Habits
These changes often help across all incontinence types:
- Adjusting fluid intake, avoiding both extremes
- Cutting back on caffeine, artificial sweeteners, and bladder irritants
- Treating constipation and chronic cough
- Timing voids to avoid “emergency” situations
- Weight loss when extra weight increases pelvic pressure
Guided bladder training, where you slowly lengthen the time between bathroom trips, helps retrain bladder and brain for urge incontinence.
Pelvic Floor Therapy
For many women, and for some men after prostate treatment, pelvic floor muscle training is a cornerstone of care.
- Kegel exercises taught correctly
- Biofeedback or pelvic floor physical therapy when needed
- Focus on both strengthening and relaxation, not constant squeezing
Strong, well coordinated pelvic floor muscles support the urethra and improve stress and mixed incontinence.
Medicines
For urge incontinence and overactive bladder, medicines can calm bladder muscle overactivity when lifestyle and pelvic floor work are not enough.
Options include:
- Antimuscarinic medicines
- Beta-3 agonists, which often have fewer cognitive side effects
Dr. Libby reviews benefits and side effects in plain language and tailors choices to your other health conditions.
Office And Minimally Invasive Procedures
If conservative options do not give adequate relief, Riverstone Urology offers advanced therapies, such as:
- Intravesical Botox for overactive bladder, which relaxes bladder muscle and reduces urgency leaks
- Nerve stimulation therapies to modulate bladder signaling, where appropriate
- Bulking agents at the urethra for selected stress incontinence cases
These options can reduce leaks without major surgery in the right patients.
Surgical Options
For more severe or persistent incontinence, surgery offers durable relief, especially for stress incontinence. Examples include:
Mid-urethral sling procedures for women with stress incontinence
Other sling or suspension procedures tailored to anatomy
Male sling or artificial urinary sphincter in men with significant stress incontinence after prostate surgery
Dr. Libby explains what each surgery does, expected recovery, and realistic outcomes so you can make an informed choice.
Urinary Incontinence And Overall Health
Incontinence Affects More Than Laundry And Pad Costs. Research Links Untreated Incontinence To:
- Higher risk of falls, especially at night
- Sleep disruption and daytime fatigue
- Anxiety, depression, and social isolation
- Lower physical activity and weight gain
By treating leakage, you improve both comfort and long term health. Part of Dr. Libby’s approach is to look at mobility, sleep, and mental health, not only pad counts.
Urinary Incontinence Care At Riverstone Urology
At Riverstone Urology in Cypress, serving the greater Northwest Houston area, Dr. Libby offers:
- Compassionate, judgment free evaluation of bladder symptoms
- Clear identification of incontinence type and contributing factors
- Stepwise treatment, from lifestyle and pelvic floor therapy to advanced options
- Coordination with pelvic floor physical therapists and other specialists when needed
If leaking urine affects your daily life, sleep, exercise, or confidence, schedule a visit with Riverstone Urology. A straightforward conversation and a practical plan can help you move from coping with accidents to regaining control.