Linda A Kiley, MD

Urogynecology & Functional Medicine
Palm Beach Gardens, FL

Women may not talk about it, but overactive bladder and accidental urine loss are common problems, especially for women over 40. A women’s health and urogynecology expert, Linda Kiley, MD, at the Palm Beach Center for Pelvic Health, in Palm Beach Gardens, Florida, offers a number of treatment options for women with urinary incontinence, including physical therapy, Botox, Interstim, medication, and surgical procedures (both office and outpatient) to reduce urine loss. For an evaluation and treatment, call today to schedule an appointment.

Urinary Incontinence Q & A

What is urinary incontinence?

Urinary incontinence is the unintentional loss of urine. There are two types of urinary incontinence that most often affect women: stress incontinence and urge incontinence.

Stress incontinence

This type of incontinence occurs because your muscles aren’t able to hold in the urine, leading to leakage. If you leak with a sneeze, laughing, or during exercise, you may be experiencing stress incontinence.

Urge incontinence

This occurs with an overactive bladder muscle, which creates difficulty holding your urine when you have the urge to empty your bladder.  Overactive bladder may not always cause urine loss but results in a sensation of frequent urges to urinate.  If you aren’t able to “hold it” as you used to, or if you start to lose urine as you walk in the door or enter the driveway, you may have urge incontinence.

Many women have mixed incontinence, which means you have both stress and urge incontinence.

What are my treatment options for urge incontinence?

Dr. Linda Kiley uses a combination of treatments to help you gain control of your urge incontinence.  Behavior modification and physical therapy are usually the first steps in treating urge incontinence.

Behavior modification may include:

  • Eliminating food and drinks that irritate the bladder, such as spicy food, carbonated beverages, caffeine, and artificial sweeteners
  • Bladder training
  • Limiting fluid intake to no more than 60 ounces per day, and particularly reducing fluid intake at night

If these steps fail to improve symptoms adequately, other treatments may be recommended such as medication, Urgent PC, Interstim® trial, or Botox therapy.


Neuromodulation is a device that stimulates the bladder nerves to reduce impulses to urinate and improve your ability to control bladder function.  Prior to implanting the device, a trial is performed to determine whether it is a good choice for your symptoms.


Botox injections temporarily weaken the bladder muscle to reduce spasms leading to urine loss or urgency. Botox treatments may last 3 to 9 months and can be performed in the office under local anesthesia.

Urgent PC

Urgent PC is similar to Interstim®, but a small acupuncture-type needle is placed in the ankle for 30 minutes once a week for 12 weeks.

The team will work with you to individualize your treatment plan.

What are my treatment options for stress incontinence?

We always recommend working with a pelvic physical therapist first, as there is a significant likelihood that this will improve or resolve the problem.  If physical therapy does not adequately alleviate the leakage, then Dr. Kiley is able to offer several modalities to reduce leakage caused by stress incontinence.

For mild to moderate leakage, vaginal laser therapy (MonaLisaTouch®) may be helpful.

For a minimally invasive option done in the office under local anesthetic, urethral bulking may be performed using Macroplastique, which tightens the urethra without incisions.  The advantage of the procedure is that there is essentially no “down time”.

For moderate to severe leakage, if the above options are not adequate, the team may offer minimally invasive surgical treatment, which may be done in an outpatient surgicenter.

For treatment for your urinary incontinence, call us at 561-701-2841 to schedule an appointment.