Urinary Incontinence

What is Urinary Incontinence?

Urinary Incontinence is a common life-limiting condition among women of all ages. One in every two women has it. While there is nothing to be embarrassed about it, it is completely treatable.

Types of Incontinence

There are several types of incontinence, but stress incontinence and urge incontinence are the two most common.

Stress Incontinence

This occurs when excess pressure is placed on the bladder, such as when you sneeze, cough, or exert yourself lifting an object. Stress incontinence is particularly common if you’re experiencing vaginal atrophy, known to occur during menopause or after childbirth.

Common causes of Stress Incontinence:

  • Pregnancy/Childbirth (multiplicity)
  • Age
  • Obesity (BMI>40, 66%)
  • Chronic cough
  • Prolapse
  • Constipation
  • Smoking
  • Genetics

Urge Incontinence

If you find yourself unable to control your bladder, such as during sleep or after experiencing sensations of a sudden urge to urinate, you may be suffering from urge incontinence, also called Overactive Bladder (OAB).

Common causes of OAB:

  • Menopause / Vaginal Atrophy
  • Neurological disorders
  • Drug side effects
  • Bladder Infection, Stone, Tumor
  • Prior Surgeries
  • Chronic Diseases
  • Excessive Caffeine and Alcohol
  • Unknown

As the premier specialist is treating Incontinence, Dr. Kothandaraman selects the most appropriate treatment options for the patient. It all starts with a full physical exam, evaluating the past medical and social history. Then as needed, it is followed by in-house testing called Urodynamics testing.


This refers to a series of diagnostic tests that evaluate the function of the bladder and urethra. The tests provide important information in order for Dr. Kothandaraman to accurately diagnose and treat your bladder problems appropriately.

Patient Guide for Urodynamics Testing

A Bladder Diary is kept by the patient to keep track of their incontinence episodes. This diary will also help the doctor in accurately diagnosing your symptoms.

Download your Bladder Diary

Based on these findings, she then applies one or more of the following treatment options for the best and complete outcome, allowing you, the patient to resume your normal un-interrupted life:

  1. Lifestyle changes like bladder training, double voiding, scheduled trips, fluid and diet management, pelvic floor exercises, and physical therapy.
  2. Medications
  3. Topical creams like Estrogen and Hormone Replacement Therapy
  4. Medical Inserts like pessary, urethral inserts.
  5. Bio-feedback – The Urostym® is a full clinic-based non-surgical pelvic floor rehabilitation system that provides effective treatment for urinary incontinence (stress, urge, mixed).

Watch a video on Urostym

  1. Nerve Stimulators. Dr. Kothandaraman uses Urgent PC that delivers percutaneous tibial nerve stimulation (PTNS) to treat patients with overactive bladder and the associated symptoms of urinary urgency, urinary frequency, and urge incontinence.
  2. Surgical Procedures like Bladder neck suspension, prolapse surgery, Vaginal Hysterectomy, Anterior Colporrhaphy, Posterior Colporrhaphy
  3. Vaginal Laser Therapy. Dr. Kothandaraman uses Monalisa Touch, an FDA-approved, non-surgical procedure to treat Vaginal atrophy and Incontinence.
  4. Tempsure Vitalia. It’s a non-invasive, non-hormonal, and chemical-free solution for Incontinence and women’s Wellness.

Urinary Incontinence Therapy Located in Arcadia, CA

If you’re suffering from urinary incontinence, you’re not alone. Prema Kothandaraman MD — practicing in Arcadia, California — is a board-certified OB/GYN who specializes in urogynecology and the treatment of urinary incontinence. Call the office to schedule your consultation or book your appointment online.


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