Tuesday, September 20, 2022

How To Help Stress Incontinence

How Is It Treated

Kegel Exercises Can Help Stress Incontinence

Incontinence can have more than one cause, so your doctor will treat the main cause first. Surgery for stress incontinence is usually done only after other treatments have failed.

Other treatments you might try include:

  • Kegel exercises. These are also called pelvic floor exercises. They strengthen the pelvic muscles that control urination. You can do these exercises at any time without anyone knowing you’re doing them. Women who do Kegel exercises are more likely to improve, and even cure, their incontinence. These women had fewer leakage problems a day and said their quality of life was better.2
  • Medicines. These can be used to reduce how often you leak and can improve your quality of life. But medicines rarely cure stress incontinence.3
  • Pessaries. A pessary, which is a rubber device inserted into the vagina to support the bladder, may help prevent leaking. Pessaries have no serious side effects. They can be used at home, and they don’t limit other options. They work well in treating mild to moderate incontinence.
  • Electrical stimulation, which sends a mild electric current to nerves in the lower back or the pelvic muscles that are involved in urination. Electrical stimulation of the pelvic floor muscles may reduce how often you leak.4

Surgery For Stress Incontinence

If the less invasive treatments dont help you, your GP will refer you to a specialist to discuss surgery. The main types of surgery for stress incontinence include the following.

  • Colposuspension. In this procedure your surgeon will lift the neck of your bladder by stitching the top of your vagina to the back of your pubic bone. Most people will have open surgery for this procedure.
  • Sling procedure. In this procedure, your surgeon will place a piece of your own tissue under your urethra, and use it as a sling to support it.
  • Injections of bulking agents into the wall of the urethra. This narrows your urethra, helping you to hold urine in your bladder. The effects of this procedure may wear off over time and you may need to have further injections.
  • Artificial sphincters. If youve already had surgery for stress incontinence and this hasnt worked, you may be offered an artificial urinary sphincter.

Each procedure comes with risks and benefits. Its important to discuss these and any complications you might experience with your doctor before you agree to go ahead with the procedure.

Until recently, another treatment choice for some women was to have an operation using an artificial mesh, also known as a tape, to support your urethra. There are concerns about the safety of the procedure, so for now this type of operation has been suspended and is unlikely to be offered except in exceptional circumstances.

Treatments For Urinary Incontinence

Now its time to look at some of the most common ways to help improve and hopefully eliminate your urinary incontinence. A good approach is to divide treatment into 3 categories: simple, medical, and surgical.

Most of the time, you can begin with one or more simple approaches. More advanced or unresponsive cases may require medical intervention by a health care professional. A surgical solution may be appropriate for severe cases or people who have not benefited from more conservative and medical interventions.

Treatments for urinary incontinence can be very similar for women and men with some notable distinctions. Some treatments may require a specific diagnostic evaluation with things like urine and blood testing, measurements that show how your urine drains , Xrays, CT scans, and endoscopic visualization .

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  • HiJust trying to under stand what is happening to me.I had a in large prostate and had the operation on it, does it get large again.Thanks Richard

  • Why Do You Experience Urinary Incontinence When Running

    Why men tolerate stress incontinence for years before ...

    Experiencing urine leakage during running often occurs due to a problem with the pelvic floor muscles. Weakened pelvic floor muscles can be caused by a number of things such as the strain of pregnancy and childbirth, hormonal shifts and the force of gravity over time. Having weak pelvic floor muscles results in the individual being unable to prevent and control leakages. While some individuals suffer from a strength deficit, others possess plenty of pelvic power, however lack the full control or ability to release it.

    Excessive tension from injury or stress can keep the pelvic floor in a constant clench. Eventually, the muscles become tired and give away, causing lack of support and leakage control. The impact of too much pressure on the muscles can then contribute to stress incontinence. If your muscles have too much tension, you may experience frequent pain during intercourse or have difficulty inserting a tampon.

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    Transvaginal Needle Suspension Procedures

    Transvaginal needle suspension techniques evolved as a minimally invasive alternative to the retropubic procedures for SUI due to urethral hypermobility. The original transvaginal needle suspension was first described by Armand Pereyra, MD, in 1959. Since then, however, many modifications of this procedure have been reported. The common feature of each of these modifications is that the anterior abdominal wall fascia is not incised and the suspending sutures are passed through the retropubic space from the vagina to the anterior abdominal wall with a specialized long ligature passer.

    Advantages to the transvaginal approach include the avoidance of a large, transfascial abdominal incision shorter operative times less postoperative discomfort shorter hospital stay and the ability to repair coexisting vaginal pathology through the same or slightly extended incision. Disadvantages include a potentially lower long-term cure rate poor intraoperative visualization risk of injury to the bladder and urethra during blind passage of the needles through the retropubic space risk of significant bleeding in the retropubic space with poor operative access from the vaginal incisions and, lastly, infection or erosion of a foreign body if suture buttresses are utilized .

    Why Do I Have Stress Incontinence In The First Place

    To understand how to stop stress incontinence its helpful to first understand a little bit about the most common causes of mild to moderate stress incontinence:

  • Weakness of pelvic floor muscles resulting in inadequate closure of urethral sphincters.
  • Damage of fascia or ligaments following pelvic trauma such as childbirth.
  • Sub-optimal communication between the nerves and muscles responsible for managing pressure change in the pelvis and abdomen .
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    Male Stress Urinary Incontinence

    Before we get into the details on Stress Urinary Incontinence a quick review of the male plumbing system is in order. As you may recall from biology class, the kidneys main job is to filter out waste from the blood. Once it does so, it mixes this waste with water and sends it to the bladder. The bladder holds the urine until its time to pee. While the bladder muscle squeezes, the sphincter relaxes, allowing the urine to be released. Any sort of physical stress on the system can cause urine to be released unintentionally. Thats SUI.

    What Causes Female Urinary Stress Incontinence

    Stop Stress Urinary Incontinence With 5 Easy Exercises

    Female urinary stress incontinence occurs when your pelvic muscles weaken. These muscles form a bowl that lines your pelvis. They support your bladder and control the release of your urine. As you age these pelvic muscles grow weak. Childbirth, pelvic surgery, and injury to your pelvis can weaken the muscles. Increased age and a history of pregnancy are also big risk factors.

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    Surgical Procedures For When Enough Is Enough

    If you have chronic or severe urinary incontinence, you may ultimately require surgery to correct the problem. This is usually reserved as a treatment of last resort to correct incontinence that has not responded to previous medical treatments or serious medical conditions such as prostate cancer.

    1. Surgery to help stress incontinence in women is often aimed at repairing tissues that provide bladder support. Pregnancy is a common cause of dropped bladder. For less severe stress incontinence cases, a sling procedure may be used to reposition the urethra.

    2. Surgery is also available to help men with urge and overflow incontinence due to prostate problems. Transurethral resection of the prostate removes tissue pressing on the urethra and allows the urine to flow more freely. Prostate cancer may require the removal of the prostate , primarily to treat the cancer as well as improve urine flow.

    Here is a video on urinary incontinence from Mercyhealth by Urogynecologist Dr. Sonya Ephraim.

    Some General Lifestyle Measures Which May Help

    • Your GP may refer you to the local continence adviser. Continence advisors can give advice on treatments, especially pelvic floor exercises. If incontinence remains a problem, they can also give lots of advice on how to cope. Examples include the supply of various appliances and aids such as incontinence pads, etc.
    • Getting to the toilet. Make this as easy as possible. If you have difficulty getting about, consider special adaptations like a handrail or a raised seat in your toilet. Sometimes a commode in the bedroom makes life much easier.
    • Obesity. Stress incontinence is more common in women who are obese. Weight loss is advised in those who are overweight or obese. It has been shown that losing a modest amount of weight can improve urinary incontinence in overweight and obese women. Even just 5-10% weight loss can help symptoms.
    • Smoking can cause cough which can aggravate symptoms of incontinence. It would help not to smoke.

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    How To Treat Stress Incontinence

    1. Behavior Therapies

    These therapies can help reduce stress incontinence episodes. Your doctor may suggest some of the following treatments:

    • Exercises for the pelvic floor muscles: Doing kegel exercises will strengthen the pelvic floor muscles as well as the urinary sphincter. Your physical therapist or doctor can help you correctly do these exercises and the effectiveness of this treatment depends on how regularly you perform the exercises.
    • Consuming fluids: In some cases, your doctor will suggest that you time your fluid consumption or limit it throughout the day. On a related note, he may also recommend avoiding alcoholic or caffeinated beverages until you can tell how the dietary irritants affect your bladder.
    • Lifestyle changes: Many healthy lifestyle changes, such as treating chronic coughs, losing excess weight, and quitting smoking can improve symptoms and reduce your risk of stress incontinence.
    • Scheduling toilet breaks: In cases of mixed incontinence, your doctor may suggest creating a toileting schedule, known as bladder retraining. By voiding your bladder more frequently, you can reduce the severity or number of incontinence episodes.

    2. Devices

    There are specific devices which have been designed for women and can help you control stress incontinence. These include:

    3. Surgery

    Surgical interventions will help improve the sphincter’s closure or support the neck of the bladder. Some of the surgical options include the following:

    4. Home and Lifestyle Remedies

    Maintain A Healthy Weight

    Pin on Women

    Staying a healthy weight can make an enormous difference, reducing pressure on the bladder. A study in 2009 found that losing weight reduces incontinence in individuals who are overweight or obese. In a trial funded by the National Institutes of Health, moderate weight loss in a group of heavy women who undertook a diet and exercise program cut the frequency of incontinence episodes by nearly a half. After six months, women in one of the groups had lost an average of 17 pounds and had 47% fewer incontinence episodes. Healthcare experts assert that losing just 5% to 10% of your weight can result in a marked improvement in people with bladder leakage issues. Losing weight should be on of your first lines of defence when it comes to a solution for urinary incontinence.

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    Who Develops Urinary Incontinence

    Stress incontinence is far more common among women than men. It can occur at any age. But the chances of developing stress incontinence increases with pregnancy and as you age.

    According to the American Academy of Physicians , about 50 percent of women between the ages of 40 to 60, and nearly 75 percent of women over the age of 75, have some form of urinary incontinence . The actual figures may be even higher, since the condition is underreported and under diagnosed, according to the AAP. It estimates that about one-half of the women who experience UI do not report it to their doctors.

    Certain factors can increase the risk of female urinary stress incontinence, or can aggravate symptoms if you already have it.

    Pelvic Floor Training To Treat Stress Incontinence

    Now for the main event. Supervised pelvic floor muscle training is the recommended first-line treatment for mild to moderate cases of stress incontinence.

    A 2018 meta-analysis of clinical studies found that women who performed pelvic floor muscle training were eight times more likely to report being cured of their stress incontinence symptoms than women who did not participate in active treatment .

    Why is it so effective? Training not only increases pelvic and inner core muscle strength and endurance, it also reinforces optimal neuromuscular communication to improve the ability and timing of both conscious and subconscious muscle activation. As a result, whether your underlying cause is muscular weakness, trauma or injury to the area, or a neuromuscular activation issue, training can improve or eliminate your symptoms by:

  • Improving the strength of urethral closure.
  • Improving muscular support of the pelvis and reducing downward pressure on the neck of the bladder.
  • Encouraging the natural and automatic coordination of pelvic floor and other core muscles to effectively manage intraabdominal pressure during physical activity.
  • There are two general classes of pelvic floor muscle training: supervised, and unsupervised.

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    What Causes Bladder Leaks

    There are two main types of urinary incontinence:

    Stress incontinence

    If you have this type, activities that raise the pressure inside your abdomen cause urine to leak through the ring of muscle in your bladder that normally holds it in. Coughing, sneezing, jumping and lifting heavy objects could lead to a leak.

    Going through childbirth, smoking or being overweight can raise the risk of stress incontinence for women, Wright says. Stress incontinence in men is rare, and when it arises, its often due to prostate cancer treatment, such as radiation or surgery.

    Urge incontinence

    With this type, your brain, spinal cord and bladder dont work together properly to allow you to hold and release urine at the right time. Your bladder may suddenly empty itself without warning. Or you may feel like you need to urinate frequently, a problem called overactive bladder.

    Some diseases that affect the nervous system, such as multiple sclerosis or stroke, can cause this kind of incontinence, says Wright. In men, an enlarged prostate may be the culprit. But in many cases, doctors dont know what causes urge incontinence.

    It is possible to have both types of incontinence at the same time.

    TRY IT: Keep Records

    Your doctor will want to know as much as possible about your bladder leakswhen they occur, how much urine comes out, and what youre doing when leaks happen. Consider keeping a diary of when you urinate and when you have leaks, recommends Wright.

    What Matters Most To You

    Preventing Stress Incontinence and Prolapse

    Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

    Reasons to have surgery

    Reasons not to have surgery

    I’ve tried Kegel exercises, but they haven’t worked for me.

    I think that Kegels might work for me.

    I don’t want to wear absorbent pads or try a pessary to avoid leakage.

    I don’t mind wearing pads or trying a pessary.

    I’ve tried medicines, but they don’t work for me.

    I think that medicines might work for me.

    Stress incontinence lowers my quality of life.

    My quality of life is not too bad.

    I think surgery can help me.

    I don’t want to have surgery for any reason.

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    How Is Urinary Incontinence Treated

    The kind of treatment you have will depend on:

    • the type of urinary incontinence you have
    • how severe it is
    • your age, health and medical history.

    Your doctor may refer you to a womens health physiotherapist or a doctor who specialises in womens pelvic floor problems . They may recommend one or more of these treatment options:

    • Lifestyle changes such as losing weight, quitting smoking, eating more fibre, drinking more water or lifting less.
    • Medication to help relax the bladder muscles, which play an important role in urge incontinence.
    • Physiotherapy to strengthen the pelvic floor, which supports your bladder. A physiotherapist can design a special pelvic exercise program for you.
    • Surgery to support or hold up your bladder or urethra . Surgery is usually only considered if medication or physiotherapy have not been successful.
    • The success of treatment can vary. While treatment may not cure your incontinence, it can still help you live more comfortably with it.

    How To Manage Stress Incontinence When Running

    Although experiencing leaks whilst running may feel embarrassing, you should know that you are not alone in experiencing the condition. These accidents are often symptoms of the most common cause of incontinence: Stress Incontinence.

    Stress incontinence is a condition where urine leaks from your bladder when it is under pressure from for example running, lifting heavy objects, or through activities such as coughing and laughing.

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    Unsupervised Pelvic Floor Training

    As we saw above, unsupervised pelvic floor muscle training is not the recommended best approach for treating stress incontinence, but for some women it can still be very effective.

    Importantly, if you do not see an improvement in your symptoms, or your symptoms worsen, I would recommend you take a break from your home exercise efforts and seek out the guidance of a pelvic health physiotherapist. If you suffer from mild to moderate stress incontinence there is still an excellent chance that appropriate cueing and strengthening can significantly reduce or eliminate your symptoms.

    Here are some of pelvic floor strengthening tools pulled directly from the toolbox of pelvic floor physiotherapists that can help you stop stress incontinence:


    How to stop stress incontinence with Kegels:

  • Perform the Kegel exercise two times per day. Do not do this while going to the bathroom.
  • Get in a comfortable sitting or lying position and make sure you can locate your pelvic floor . Depending on your position you may find that you have more or less difficulty performing a full pelvic floor contraction. Experiment to find a position that works optimally. For example, being in a pelvic tucked under position with too much body weight into your buttocks may make it difficult for you to contract the front of your pelvic floor, while tipping the pelvis forward a bit to achieve a more neutral spine, may help.

    Vaginal weights
    Vaginal contraction trainers


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