Treatment of urinary incontinence by obstetrician-gynecologist Vitaliy Grigoryevich Kostenko in Dnipro.

Patients present with complaints of involuntary urine leakage during physical activity, frequent urges, or difficulty controlling urination.

The doctor conducts a thorough assessment, reviews the symptoms and medical history, and, if necessary, orders additional tests to clarify the cause.

The patient receives a clear plan of action: recommendations for current measures, the necessary examinations, and monitoring of changes in the condition.

The doctor pays particular attention to the differential diagnosis of the causes and to observing the progression of the condition, which helps to adjust treatment in a timely manner and prevent complications.

When to See a Doctor

Urinary incontinence can present in different ways and significantly affect quality of life. Sometimes symptoms appear for the first time, and sometimes they gradually worsen or recur. It is important to pay attention to changes and not ignore them. You should make an appointment with an obstetrician-gynecologist if, with urinary incontinence, you notice:

• Constant urine leakage during physical activity or coughing
• Frequent uncontrollable urges to urinate
• A feeling of incomplete bladder emptying
• Urine leakage at night that interferes with sleep
• Worsening symptoms after a change in lifestyle or after childbirth
• Repeated episodes of loss of bladder control
• Symptoms that interfere with work, rest, or normal daily activities
• No effect from self-care measures or previously prescribed treatment
• Discomfort or pain during urination
• Symptoms that appear for the first time after stress or trauma
• The need to adjust treatment in the presence of other medical conditions
• Worsening symptoms after pregnancy or surgical procedures

Seeing a specialist will help determine the exact causes of your symptoms. Only a doctor can order the necessary examinations and choose the right plan of action. This is especially important in cases of recurrent or worsening urinary incontinence to help avoid possible complications and improve quality of life.

Emergency Situations or When You Need to See a Doctor Urgently

• Sudden onset of severe pain in the lower abdomen or pelvic area
• A sharp increase in incontinence accompanied by bloody discharge
• Altered consciousness or severe dizziness along with symptoms
• A combination of high fever with painful or difficult urination

If you have these symptoms, do not wait for a scheduled appointment and seek urgent medical care. Our clinic offers a doctor-on-call home visit service for a quick response.

Causes and Risk Factors of Urinary Incontinence

This section will help you understand the possible causes underlying urinary incontinence and the factors that increase the likelihood of it developing or worsening. It is important to remember that determining the exact cause requires a doctor’s evaluation and additional tests.

Main causes / mechanisms (briefly)

• Weakening of the pelvic floor muscles that support the bladder and urethra
• Disruption of the nervous regulation of urination
• Increased intra-abdominal pressure during physical exertion or coughing
• Chronic inflammatory processes in the urinary tract
• Consequences of childbirth and surgical procedures in the pelvic area

Risk factors

• Age-related changes and hormonal imbalance
• Pregnancy and childbirth, especially when complicated
• Obesity and excessive physical strain on the pelvic floor
• Chronic constipation and the factors that cause it
• Smoking, which worsens the condition of blood vessels and tissues
• Associated chronic diseases, including diabetes mellitus
• Lack of physical activity and weakness of the pelvic floor muscles
• Frequent urinary tract infections

Reversible causes that should be ruled out

• Acute infectious inflammation of the bladder
• Taking certain medications that affect urination
• Excessive fluid intake or an unbalanced daily routine
• Temporary dysfunction after surgical procedures

Urinary incontinence is a symptom that requires careful attention and diagnosis in order to determine the cause and choose appropriate measures.

Diagnosis

The goal of diagnosing urinary incontinence is to understand the possible causes of the symptoms and determine the next steps for further evaluation or treatment. The doctor will conduct a thorough assessment, taking into account each patient’s individual characteristics.

Diagnostic approach

• Collecting a detailed medical history, including an assessment of complaints and past illnesses
• Performing a physical examination with an emphasis on pelvic floor condition and overall health
• Carrying out basic laboratory and functional tests when indicated
• Ordering additional instrumental examinations if necessary
• Discussing the results and developing a preliminary evaluation and treatment plan
• Adjusting the plan depending on progress and response to therapy

Typical tests when indicated

These may include:

• Urinalysis and urine culture for microorganisms
• Ultrasound examination of the pelvic organs
• Urodynamic tests to assess bladder function
• Cystoscopy (examination of the bladder using optical equipment)
• Neurological examination if nerve-related disorders are suspected

What to bring to the appointment

• Previous examination and test results
• A list of medications you are currently taking
• A symptom diary describing the frequency and circumstances of incontinence
• Information about any existing medical conditions and previous treatment

A thorough diagnosis of urinary incontinence is the first step in creating an effective care plan tailored to your needs.

Treatment

Treatment for urinary incontinence is aimed at improving bladder control and enhancing the patient’s quality of life. The treatment plan is selected individually, taking into account the specific condition and associated factors.

Goals of therapy

• Reduce symptom severity and the number of incontinence episodes
• Address the causes contributing to the problem
• Restore normal bladder and pelvic floor function
• Prevent complications and worsening of the condition

Main treatment approaches

• Therapy is individualized and may combine medications, pelvic floor muscle exercises, and other non-drug approaches
• It may include lifestyle changes and recommendations for a bladder voiding schedule
• If indicated, the doctor may prescribe additional procedures or minimally invasive interventions
• Physiotherapy and rehabilitation may help strengthen muscles and reduce symptoms
• A comprehensive approach is discussed when necessary, taking comorbidities into account

What the doctor does

• Selects and adjusts treatment depending on the patient’s response
• Takes into account comorbid conditions and possible drug interactions
• Monitors the occurrence and severity of possible side effects
• Explains how treatment effectiveness is assessed and what the next steps will be
• Refers the patient to relevant specialists if comprehensive follow-up is needed

What to expect: plan and follow-up

• Symptom progress is assessed regularly and as indicated
• The treatment plan may be adjusted if effectiveness is insufficient or the condition changes
• Follow-up visits are important for monitoring and timely therapy adjustment
• Individual treatment timelines and stages depend on your health condition

You can learn more about treatment options during a consultation with Dr. Vitaliy G. Kostenko.

Prevention

Prevention plays an important role in reducing the risk of developing and progressing urinary incontinence. The preventive plan is selected individually, taking into account the patient’s health status and lifestyle.

Main measures for primary prevention

• Weight control to reduce the load on the pelvic floor muscles
• Regular physical activity aimed at strengthening the pelvic muscles
• Avoiding prolonged straining during constipation and discomfort
• Quitting or reducing smoking to improve the condition of blood vessels and tissues
• Managing chronic conditions that may affect bladder function

Screening and secondary prevention / regular monitoring

• Regular examinations by a gynecologist or urologist, as recommended and when indicated
• Monitoring symptoms and timely assessment of changes in condition
• Discussing the need for examinations to clarify the causes of symptoms

Practical tips

• Monitor your fluid intake; avoid both excessive fluid intake and dehydration
• Discuss with your doctor the possibility of adjusting medications if you have comorbidities
• Avoid heavy lifting and excessive physical exertion without consulting a doctor
• Keep a symptom diary to track changes and identify worsening factors
• Follow personal hygiene rules to reduce the risk of inflammation

Preventive measures help maintain health and quality of life in cases of urinary incontinence; however, any questions are best discussed with a doctor on an individual basis.

Important to know

Urinary incontinence is a condition that requires careful attention and timely evaluation. It is important to remember that eliminating symptoms without understanding the cause does not always lead to improvement. Early consultation helps choose the right approach and reduce the risk of possible complications. Sometimes, achieving results requires follow-up over time and adjustment of the treatment plan. The course of the condition is influenced by various factors, including physical activity, stress, sleep quality, and the presence of concomitant diseases.

• Identifying the cause of incontinence is more important than merely suppressing symptoms
• Early assessment makes it possible to choose effective methods and reduce the risk of complications
• Successful control often requires regular monitoring and treatment adjustment
• Factors such as stress and physical activity can affect symptom severity
• Self-treatment can blur the clinical picture and delay the establishment of the correct plan
• A comprehensive approach helps take into account all aspects of the patient’s health and the specifics of the condition

Seeing a doctor for urinary incontinence makes it possible to receive a full evaluation of the condition and develop an appropriate treatment plan. For a more detailed introduction to this topic, we recommend visiting the general page, which describes the causes, diagnostic methods, and available options for help in detail.

Self-help before the appointment: what you can and cannot do

Before your visit with Dr. Vitaliy Grigoryevich Kostenko, you can take a number of safe steps to help ease your condition and prepare for the appointment. If your symptoms worsen or alarming signs appear, be sure to contact a specialist.

What you can do before the appointment

• Write down when and how the symptoms began, including the circumstances and possible triggers
• Keep a symptom diary: note the intensity, time of day, and possible factors
• Bring a list of all medications and vitamins you are taking to the appointment
• Reduce physical activity and get enough rest so as not to worsen incontinence
• Drink enough water while avoiding dehydration
• Measure and record your body temperature and pulse if possible
• Pay attention to any changes in your general condition and mood
• Try to avoid stressful situations that may aggravate the condition
• Maintain good hygiene to help prevent inflammation
• Prepare questions for the doctor so you can fully discuss your symptoms

What you should not do before the appointment

• Do not stop or change any previously prescribed medications without consulting your doctor
• Do not start taking new medications or dietary supplements without your doctor’s approval
• Do not rely on unverified folk remedies or treatment methods
• Do not ignore worsening symptoms or the appearance of new alarming signs
• Do not try to diagnose yourself based on the internet or test results
• Do not increase or decrease your fluid intake without specialist recommendations
• Do not subject yourself to excessive physical exertion or stress
• Do not delay seeing a doctor if incontinence or discomfort worsens
• Do not try to manage the symptoms without professional supervision
• Do not follow someone else’s treatment experience without individual approval from your doctor

If signs of an emergency appear, seek medical help from Dr. Vitaliy Grigoryevich Kostenko immediately.

How I can help as a doctor with urinary incontinence

During a urinary incontinence consultation, I can help you in the following ways: together we will look into the causes of your symptoms, assess how severe the problem is, and determine the best plan of action. It is important to take all aspects of your health into account in order to choose the most appropriate treatment and management strategy.

• I will review your symptoms and medical history to identify possible causes of incontinence
• I will assess the severity of your symptoms and the risks related to your condition
• I will review your current medications and evaluate how well you tolerated previously used treatments
• I will create a plan for the next steps: tests if indicated, treatment strategy, and follow-up
• I take into account accompanying medical conditions and medications when choosing treatment
• I will give recommendations on lifestyle and daily habits that can help support treatment results
• I will discuss with you how to monitor your condition and what to look for before follow-up visits
• I will carry out an initial assessment of the causes using a differential approach without unnecessary complexity
• I will adjust the treatment plan if it is not effective enough or if side effects appear

Medical care for urinary incontinence is a comprehensive process that includes diagnosis, treatment selection, and ongoing monitoring. This approach makes it possible to adapt treatment to changes in your condition and minimize the risk of complications. If you have already tried treatment without success, the consultation can include a review of previous prescriptions and suggestions for adjusting the plan.

What questions can you ask a doctor about urinary incontinence?

At an appointment for urinary incontinence, you can discuss the following issues with Vitaliy Grigorievich Kostenko:

• Complaints about frequent urine leakage during physical activity or at rest
• Discomfort caused by frequent urges to urinate
• Situations where incontinence interferes with work, rest, or sleep
• Worsening or recurrence of symptoms after treatment or on their own
• Questions about associated conditions, such as cystitis or hormonal changes
• The need for a second opinion or an assessment of the effectiveness of previous treatment
• Discussion of treatment duration and the need for regular follow-up

If sudden severe pain, bloody discharge, or loss of consciousness occurs, emergency care is needed—do not wait for a scheduled appointment.

What questions can you ask the doctor during the consultation?

• What is happening to me, and what could it be?
• Why did this start now?
• How can I tell whether this is related to incontinence and not another problem?
• What examinations are needed in my case?
• Which tests and studies are truly necessary?
• How should I prepare properly for the examinations and the appointment?
• What treatment options are available, and how do they differ?
• Can this condition be fully treated, or does it require ongoing monitoring?
• Why isn’t the prescribed treatment working, and what should I do?
• Is it possible to manage without medication or surgery?
• How long does treatment take, and how often do I need follow-up visits?
• What signs indicate improvement or worsening of the condition?
• What should I do if symptoms suddenly worsen or flare up?

During the consultation, the doctor will thoroughly review your complaints, select the necessary examinations, and suggest a treatment plan tailored to your individual needs. If emergency symptoms appear, it is important to seek specialized medical help immediately.

How the consultation takes place

A doctor’s consultation is a detailed review of your complaints, an assessment of your condition, and the development of a plan for next steps. The scope of examinations is determined individually, based on indications, in order to understand the specifics of your health as accurately as possible. You should not expect a precise diagnosis at the very first appointment — this is usually the first step in a comprehensive process.

1. Clarification of complaints and the purpose of the visit — the doctor finds out what exactly is bothering you, when the symptoms appeared, how they affect daily life, and what the patient expects from the appointment.
2. Medical history taking, including an assessment of risk factors related to urinary incontinence and overall health.
3. Review of previous treatment and examinations, if any; it is recommended to bring all available test results, scans, and a list of medications you are taking.
4. Examination and additional tests as indicated — this may include an assessment of the pelvic floor muscles and functional tests aimed at evaluating bladder function.
5. Preliminary assessment with discussion of likely causes and important conditions to rule out; no final conclusions are made at the first appointment.
6. If needed, the examination plan may include urinalysis, pelvic ultrasound, and other procedures as indicated.
7. Formulation of a treatment and management plan — the doctor explains the general approach, taking into account the patient’s individual characteristics.
8. Discussion of follow-up and next steps — when to return for a follow-up appointment and how to monitor changes in the condition.

If this is your first visit, the consultation will focus especially on clarifying symptoms and identifying possible causes. If previous treatment has not been effective, more time is devoted to analyzing the reasons for the lack of improvement and adjusting the treatment plan.

This approach helps create a clear and patient-friendly plan, taking into account all important details and the specifics of each individual case.

Preparing for Your Appointment

To make your consultation with an obstetrician-gynecologist as effective as possible and receive the most accurate examination and treatment plan, it is important to prepare properly for the appointment.

• Bring a list of all current medications (names, dosages, and how you take them).
• Bring the results of previous examinations, including tests, ultrasounds, and any other available documents.
• Write down your main complaints: when the symptoms started, and what makes the condition worse or better.
• Do not stop taking prescribed medications without consulting your doctor.
• Come without makeup and creams applied to the area for the gynecological examination, if one is planned.
• If needed, ask when booking whether you need to come on an empty stomach.
• Prepare questions and points you would like to discuss with the doctor.
• If you have any comorbidities, prepare information about them.
• Follow any additional instructions from the clinic, if provided.

If you still have any doubts about how to prepare, it is better to уточнить this at the registration desk when booking to avoid misunderstandings and save time during the appointment. Do not change your medication schedule on your own.

About the Doctor

Vitaliy Grigoryevich Kostenko is an obstetrician-gynecologist of the highest qualification category with over 20 years of experience. He often works with patients seeking help for urinary incontinence, including first-time visits, recurring symptoms, and cases where previous treatment has not helped.

The doctor pays special attention to a thorough analysis of the causes and to ongoing monitoring of patients’ conditions. This systematic approach makes it possible to identify risk factors and adjust treatment to improve quality of life.

During the consultation, you will receive a clear explanation of your situation and recommendations for the next steps.

Why patients choose Dr. Vitaly Grigoryevich Kostenko

When treating urinary incontinence, it is important not only to prescribe treatment, but also to carefully analyze the causes and monitor the patient over time. Vitaly Grigoryevich Kostenko builds a step-by-step treatment process that takes into account all health characteristics and responses to therapy. The doctor considers previous examinations and prescriptions in order to avoid unnecessary procedures and adjust treatment based on actual findings. This approach ensures that each step is clear and helps minimize the risk of complications.

• A clear action plan with staged monitoring of results to assess effectiveness
• Tests are performed only when indicated, to avoid unnecessary examinations
• Consideration of comorbidities and drug interactions to ensure treatment safety
• Monitoring of symptom dynamics and timely treatment adjustment when necessary
• Review of previous prescriptions, assessment of treatment tolerance and side effects
• Explanation of treatment goals and options in plain language without excessive medical terminology
• Focus on preventing flare-ups and complications to maintain stable patient condition
• Experience managing complex and chronic cases with an individualized approach to each situation

This systematic and attentive approach helps patients feel confident throughout treatment and receive appropriate care for their specific situation. The ability to come for a consultation with already completed examinations simplifies the process and helps move toward results more quickly.

Case Studies

Initial consultation for urinary incontinence

A middle-aged female patient presented with complaints of occasional urine leakage during physical exertion and frequent urges to urinate. It was important to rule out acute inflammatory processes and assess the condition of the pelvic floor. A detailed medical history was taken, an examination was performed, and tests were ordered as indicated to clarify the cause. Over the course of several weeks, symptoms decreased after appropriate non-pharmacological recommendations and lifestyle adjustments were introduced. Further follow-up included monitoring progress and, if necessary, refining the treatment plan.

Treatment adjustment due to insufficient effect

A young woman with a history of urinary incontinence treatment that had not led to improvement sought a second opinion. The physician carefully reviewed the previous prescriptions and assessed treatment tolerance, identifying possible factors contributing to reduced effectiveness. After revising the treatment approach and ordering additional examinations, gradual improvement was noted during follow-up visits. The plan included regular monitoring and treatment adjustment if symptoms changed.

Chronic course with comorbid conditions

An elderly patient with chronic urinary incontinence and several comorbid diagnoses sought comprehensive care. It was necessary to take into account the features of her existing conditions and possible drug interactions. The physician arranged a thorough diagnostic evaluation and selected an appropriate management strategy based on the overall clinical picture. Over time, the condition remained stable without deterioration. The plan included long-term follow-up and preventive measures.

Symptom flare-up and prevention plan

The patient presented with a sudden worsening of urinary incontinence and discomfort, requiring prompt assessment of severity and exclusion of acute conditions. An urgent evaluation was performed and a plan was initiated to stabilize symptoms. After the complaints subsided, an individualized plan for preventing flare-ups was developed. Regular follow-up is in place to enable timely treatment adjustments and maintain quality of life.

Recurrent symptoms with no response to self-management

A middle-aged woman experienced recurrent episodes of incontinence that did not resolve on their own. During the appointment, an in-depth review of her symptoms and the factors contributing to worsening was conducted. The necessary tests were ordered to determine the cause. Based on the examination results, a comprehensive management approach was chosen, which made it possible to reduce the frequency of episodes during the follow-up period. Ongoing monitoring and treatment adaptation are planned.

How long does the consultation last?

A consultation usually takes 30 to 60 minutes; please уточните the exact duration when booking.

How should I prepare for the appointment?

It is recommended to write down your main complaints and questions, and bring a list of the medications you are taking.

What should I bring to the appointment?

Please bring results of previous examinations, test results, scans/images, and a list of your medications.

Do I need to come on an empty stomach?

Usually no, unless otherwise specified when booking.

How many visits are usually required?

It depends on the complexity of the situation and the chosen treatment approach; usually several visits are needed.

When can I expect the first results of treatment?

Results depend on individual factors and the type of therapy.

What should I do if my condition worsens before the appointment?

If your condition worsens or new symptoms appear, contact a doctor or seek emergency help.

Can treatment be combined with my current medications?

Compatibility and any changes in treatment should be discussed only with a doctor; do not change medications on your own.

Is an online consultation available?

Yes, an online consultation is possible if the necessary information is available and your condition is stable.

Can I come with tests/examinations already done?

Yes, please bring all available results for a complete review and assessment.

Do I need to come back for follow-up visits, and how often?

Follow-up visits depend on how your condition changes and on the treatment plan; this is discussed individually.

Can I get a second opinion?

Yes, the doctor is ready to review your results and provide an alternative perspective on the situation.

What should I do if symptoms return after improvement?

Contact a doctor to assess the situation and adjust the monitoring and treatment plan.

What examinations are needed for urinary incontinence?

The required examinations are selected individually after the initial consultation.

Can treatment be carried out without examinations?

Examinations help clarify the cause and choose effective treatment; the decision is made by the doctor.

Are there any restrictions on food and medications before the visit?

Usually there are no restrictions, but please уточняйте individually when booking.

How quickly will the doctor determine the treatment plan?

The plan is formed after assessing symptoms and examination results; sometimes time is needed.

Can I seek help for chronic symptoms?

Yes, the doctor treats patients with symptoms of different durations and severity.

What should I do if I cannot tolerate the prescribed medications?

Inform the doctor so the therapy can be adjusted and alternative options can be chosen.