Bladder control problems affect 37 million Americans. Most of them are women. The most common forms of this treatable condition include stress urinary incontinence (SUI) and overactive bladder (OAB).

There are three things you should know:

• Urinary incontinence is not an inevitable consequence of aging.
• Effective treatments are available.
• Surgery is not the only option.

Treatment depends on your symptoms. Urinary incontinence usually falls into two main types.

Stress urinary incontinence: Physical activity, such as coughing, sneezing, laughing, walking up stairs, running and jumping are common causes of leakage among women with SUI. Any activity that uses your abdominal muscles increases abdominal pressure, in turn creating stress or pressure on the bladder and urethra.

If the strong connective tissue that surrounds and supports the bladder and urethra weakens, the urethra loses its ability to maintain a seal and urine leaks. Many factors contribute to weakening of these tissues, including vaginal childbirth, heavy lifting, chronic constipation and chronic lung disease. SUI also may be genetic -- those affected with bladder control problems often say their mothers and sisters experienced the same symptoms.

Treatments for SUI have progressed substantially during the last 10 years. There are newer surgical options, but nonsurgical treatment often works for most patients. Pelvic floor muscle, or Kegel, exercises lead first-line treatments for SUI.

If you have trouble contracting your pelvic floor muscles, a program of biofeedback and electrical stimulation can help "rehabilitate" the pelvic floor. Topical estrogen in the form of a cream or suppository may provide significant improvement in stress incontinence, too.

Overactive bladder: Patients with this other common form of urinary incontinence may have sudden and strong urges to urinate that are difficult or impossible to put off. Two-thirds of women with OAB do not leak urine but experience "close calls," as well as needing to urinate frequently, even at night.

Medications that quiet bladder contractions can help. They may cause side effects such as dry mouth and eyes, but this usually is tolerable.

The most relief from symptoms usually comes from medications combined with pelvic floor muscle exercises, fluid restriction and a program of timed voiding known as "bladder retraining."

Take heart: in most cases, symptoms can be significantly improved. Your primary care physician can address your symptoms and, if appropriate, refer you to an incontinence specialist.

Treat Your Urinary Incontinence
Get out of the bathroom and on with your life.

Please call 1-888-4GW-DOCS for a physician referral and information about the GW Pelvic Floor Center for men and women.

To find out more about the Senior Advantage program, please call 202-715-4263 or visit www.gwhospital.com and click on Senior Advantage.

900 23rd St., NW, Washington, DC 20037 (202) 715-4000