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Mayo Clinic on Incontinence

Strategies and treatments for improving bowel and bladder control

Published by Mayo Clinic Press
Distributed by Simon & Schuster

For those living with incontinence, an overactive bladder can make day-to-day life unmanageable. Mayo Clinic on Incontinence is a modern-day guide to the new medications, therapies, treatment plans, and surgical options available to those living with incontinence.

If you’re suffering from unwanted symptoms of incontinence—like an uncontrollable bladder and bowel problems—you’re not alone. Millions of Americans struggle daily with issues related to urinary or fecal incontinence, and the effects can be invasive and debilitating. And while many believe incontinence is an age-related issue, the condition prevents patients of all ages from enjoying an active and carefree lifestyle.

What most Americans don’t know is that incontinence can be improved and, in some cases, even cured. Simple changes to everyday behaviors can ease symptoms of incontinence, while medications and minimally invasive procedures, like injections, can bring long-lasting relief to patients. And in more serious cases, surgical procedures can assist in relieving and often curing problems related to the condition.

Penned by two of Mayo Clinic’s leading urogynecologists, Mayo Clinic on Incontinence outlines the common causes of incontinence and provides tailored treatment advice for patients of all demographics. Readers will also find tools for enhanced living with incontinence, including tips to reduce the risk of developing incontinence, minimize issues while out in public, and boost overall sexual health and wellness.

With more than 10,000 patients treated for incontinence by the Mayo Clinic each year, this book provides a source of hope from the experts who are leading the efforts to treat and cure incontinence.

Table of Contents

Part 1: Urinary incontinence


Chapter 1 Understanding urinary incontinence

A common problem

Your urinary system

Types of urinary incontinence

Reasons to hope

Chapter 2 Causes of incontinence

Temporary causes

Persistent causes

The next step

Chapter 3 Evaluation and testing

Before your appointment

What to expect

Specific tests

Determining your treatment

Chapter 4 Conservative treatments

Lifestyle changes

Behavior therapies

Medical devices

Your role

Chapter 5 Medications and injections



Chapter 6 Surgery



Other procedures

Chapter 7 Concerns specific to different groups




Older adults

Chapter 8 Living well with incontinence

Reducing your risk

Modifying your environment

Getting out and about

Sexuality and incontinence

Keeping a positive outlook

Seeking help


Part 2: Fecal incontinence

Chapter 9 Understanding fecal incontinence

How your bowels work

Bowel problems and incontinence


A hopeful outlook

Chapter 10 Evaluation and testing

Choosing a doctor

Evaluating fecal incontinence

Tests for fecal incontinence

Test results

Chapter 11 Treating fecal incontinence

Conservative treatments



Hope for the future


Additional resources

Paul D. Pettit, M.D., is a gynecologic surgeon at Mayo Clinic in Jacksonville, Florida, who specializes in urinary incontinence, fecal incontinence, bowel and bladder fistulas, and genital and rectal prolapse. Along with co-author Dr. Anita Chen, he works at the Mayo Clinic College of Medicine as an Assistant Professor of Gynecology. Dr. Pettit is certified in obstetrics and gynecology and female pelvic medicine and reconstructive surgery by the American Board of Obstetrics and Gynecology. In addition to founding the International Society of Pelvic Neuromodulation, Dr. Pettit is also an active member of the American Urogynecologic Society and the Society of Gynecologic Surgeons. Now the director of Mayo Clinic’s Gynecologic Continence Program, Dr. Pettit has been helping patients find relief from urinary incontinence, bowel and bladder fistulas, and other urogynecological conditions for more than 40 years.

Anita H. Chen. M.D. is a board-certified urogynecologist at Mayo Clinic in Jacksonville, Florida. In addition to working as an Assistant Professor of Obstetrics and Gynecology at Mayo Clinic’s Alix School of Medicine, Dr. Chen also serves as the Associate Fellowship Director of Fellowship in Minimally Invasive Gynecology Surgery, where she mentors medical students, residents, and fellows in their research. Among other expertise, Dr. Chen specializes in the surgical treatment of stress incontinence, refractory overactive bladder treatment, and urethral diverticulum. Awarded the Castle Connolly Regional Top Doctor award, Dr. Chen is frequently recognized for her expertise in both the OR and the classroom.