Many Treatment Options for Incontinence



Millions of women experience urinary incontinence, or involuntary loss of urine, a condition that is more likely to occur as women get older. Incontinence can be slightly bothersome or totally debilitating. It keeps some women from enjoying many activities with their families and friends. Urine loss also can occur during sexual activity, causing tremendous emotional distress.

“Women experience urinary incontinence twice as often as men due to pregnancy and childbirth, menopause and the structure of the female urinary tract,” says Marie Fidela-Paraiso, M.D., of the Cleveland Clinic Pelvic Floor Disorders Center at Lakewood Hospital. “But both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.”

The Pelvic Floor Disorders Center provides individualized treatment with the latest procedures targeted at comprehensive evaluation and management of disorders from urinary and fecal incontinence to pelvic prolapse.

“Incontinence occurs because of problems with muscles and nerves that help to hold or release urine,” says Dr. Paraiso, a urogynecologist and reconstructive pelvic surgeon. “Urinary incontinence should not be considered a disease, but rather a symptom or sign of an underlying problem, which may include pelvic organ prolapse. It should not be considered a ‘normal part of aging’ but a condition that can be treated.”

Through the Cleveland Clinic Pelvic Floor Disorders Center at Lakewood Hospital, patients have access to Dr. Paraiso and her colleagues at Cleveland Clinic who specialize in treating vaginal prolapse, urinary incontinence, and neurogenic and overactive bladder.

Treatment options include a wide variety of non-operative and minimally invasive solutions.

“The challenge is identifying the origins of urinary incontinence,” says Dr. Paraiso. A detailed medical history and physical examination will offer information suggesting the cause of the incontinence. The Center also offers sophisticated diagnostic tools such as multichannel urodynamic testing and cystoscopy.

Treatment options may include physical therapy to strengthen the pelvic floor muscles, medications to reduce leakage, or devices or surgical procedures to help reposition and stabilize the bladder and urethra.

“These procedures have been shown to have high success rates,” says Dr. Paraiso, who is board-certified in obstetrics and gynecology. Her expertise includes laparoscopic and robotic-assisted laparoscopic surgery, incontinence, pelvic organ prolapse, vaginal surgery and neuromodulation.

Marie Fidela-Paraiso, M.D.

Dr. Paraiso works with Lakewood Hospital physical therapists who specialize in pelvic muscle physiotherapy.

For additional information, or to make an appointment with Dr. Paraiso at the Cleveland Clinic Pelvic Floor Disorders Center at Lakewood Hospital, please call 216.227.2508.

For additional information on physical therapy for incontinence, call 216.529.7173.