Having a leaky bladder is a common and embarrassing problem.  This is especially true for woman after childbirth, after menopause or even you younger physically fit woman without having childbirth.  There are many types of urinary incontinence and the treatments should specific toward the type of incontinence. Most common type of is called genuine stress urinary incontinence.  This is caused from changed in position of the bladder due to childbirth, prolong weight bearing or simply from gravity.  One often notices leakage with actions that would increase one’s abdominal pressure such as coughing, laughing and physical exercise.  If symptom is mild, one can often use a tampon during exercise to increase pressure at the bladder neck (lower portion of the bladder where bladder meet the urethra). Treatment options often include Kegels, pessaries, pelvic weights and surgery.   Recently, published literature have demonstrated non-invasive radio frequency energy treatments (ThermiVa) for mild to moderate stress urinary incontinence. Second type of urinary leakage is due to overactive bladder called Detrusor Instability.  Symptoms include frequent urination with small quantity of urine during the day and evening.  This can be made worse with caffeine and tea. Many will achieve improvement with bladder drills combined with short course of medication to relax the bladder.  In postmenopausal woman, usage of estrogen or the new class of topical anti-aging peptides can help.  Surgery will not improve this condition. Third type of urinary leakage is due to lost of elasticity of urethra.  Cause can be due to age, radiation or without known cause.  Characteristic symptom noted by leakage independent of position or action.   Surgery and injection of fillers have been traditionally being the treatment of choice.  In future, usage of novel radiofrequency or topical peptides may offer options. Last type of urinary incontinence is classified as Mixed Urinary Incontinence.  It can be a mixture of any of the three mentioned above.  By performing careful history, exam and special testings called urodynamics, your gynecologist or urogynecologist   can diagnose and offer you treatment options so you do not have to be embarrassed with this common condition.