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Urinary Incontinence


urinary incontinenceUrinary Incontinence

Millions of women experience involuntary loss of urine called urinary incontinence. This treatable medical condition can be slightly bothersome or totally debilitating. For some women, the risk of public embarrassment keeps them from enjoying many activities with their family and friends.

If bladder control problems are keeping you from enjoying your life, you are not alone. This problem afflicts approximately 13 million adults in the United States with 85% of them being women. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. The good news is that you do not have to live with the pain or embarrassment. There is a whole realm of available treatments to help you reclaim control of your life.

The Types of Urinary Incontinence

Stress Coughing, laughing, sneezing, or other movements that put pressure on the bladder which cause urine to leak. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence.
Urge Loss of urine for no apparent reason after suddenly feeling the need or urge to urinate.
Overactive Bladder Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding more than seven times a day may be an indication of overactive bladder.
Functional Untimely urination because of physical disability, external obstacles, or problems in communicating that prevents a person from reaching a toilet.
Overflow Unexpected leakage of small amounts of urine because of a full bladder.
Mixed Stress and urge incontinence often occur together in women. Mixed incontinence may be the most common type of urine loss in women.

How is Incontinence Evaluated?

To diagnose the problem, Dr. Jeffrey Hantes will first ask about your symptoms and medical history. He will physically examine you for signs of medical conditions causing incontinence. In addition, weakness of the pelvic floor leading to incontinence may cause a condition called prolapse, where the vagina or bladder begins to protrude out of your body. This condition is also important to diagnose at the time of an evaluation.

Other tests Dr. Hantes may recommend include:

  • Bladder stress test – You cough vigorously as the doctor watches for loss of urine from the urinary opening.
  • Urinalysis and urine culture – Laboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes.
  • Ultrasound – This test uses sound waves to create an image of the kidneys, ureters, bladder, and urethra.
  • Cystoscopy – The doctor inserts a thin tube with a tiny camera in the urethra to see inside the urethra and bladder.
  • Urodynamics – Various techniques measure pressure in the bladder and the flow of urine.

How is Incontinence Treated?

Behavioral Remedies

Dr. Hantes may suggest making it a point to use the bathroom at regular timed intervals, a habit called timed voiding. As you gain control, you can extend the time between scheduled trips to the bathroom. Medicines for Overactive Bladder If you have an overactive bladder, Dr. Hantes may prescribe medication to block the nerve signals that cause frequent urination and urgency.

Pelvic Muscle Therapy

Pelvic Muscle Therapy can provide long-term gains as pelvic floor muscles are retrained, strength is improved and pain is eliminated. To relieve incontinence, exercises are introduced to target key muscles. During each exercise, biofeedback equipment monitors electrical impulses of the working muscles in order to educate patients and improve exercise effectiveness.

Neuromodulation

For urge incontinence not responding to behavioral treatments or drugs, stimulation of nerves to the bladder leaving the spine can be effective in some patients. Neuromodulation is the name of this FDA approved therapy. Dr. Hantes will need to test to determine if this device would be helpful to you.

Surgery for Stress Incontinence

In some women, the bladder can move out of its normal position, especially following childbirth. Surgeons have developed different techniques for supporting the bladder back to its normal position. The main types of surgery for incontinence are retropubic suspension and sling procedures.