Thursday, September 21, 2023

How To Treat Stress Incontinence

Maintain A Healthy Weight

Bulkamid Treats Stress Urinary Incontinence in Women – Dr. Mark Ellerkmann – Mercy

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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Urinary Incontinence In Women: What You Need To Know

  • Urinary incontinence is the accidental loss of urine.

  • Over 25 million adult Americans experience temporary or chronic urinary incontinence.

  • This condition can occur at any age, but it is more common in women over the age of 50.

  • There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.

  • Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.

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 1959.57 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 rate49 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 .

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What Is The Treatment For Urinary Incontinence

Specific treatment for urinary incontinence will be determined by your doctor based on:

  • Your age, overall health and medical history

  • Type of incontinence and extent of the disease

  • Your tolerance for specific medications, procedures or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Behavioral therapies:

  • Bladder training: Teaches people to resist the urge to void and gradually expand the intervals between voiding.

  • Toileting assistance: Uses routine or scheduled toileting, habit training schedules and prompted voiding to empty the bladder regularly to prevent leaking.

  • Diet modifications: Eliminating bladder irritants, such as caffeine, alcohol and citrus fruits.

  • Pelvic muscle rehabilitation :

  • Kegel exercises: Regular, daily exercising of pelvic muscles can improve, and even prevent, urinary incontinence.

  • Biofeedback: Used with Kegel exercises, biofeedback helps people gain awareness and control of their pelvic muscles.

  • Vaginal weight training: Small weights are held within the vagina by tightening the vaginal muscles.

  • Pelvic floor electrical stimulation: Mild electrical pulses stimulate muscle contractions.

  • Medication :

  • Pessary

  • Office procedure

  • Slings

  • Bladder suspension

  • Consult your doctor with questions regarding the management and treatment of urinary incontinence.

    Sling Surgery Restores A Patient to Active Life | Stephanie’s Story

    What Are The Types Of Urinary Incontinence

    Urinary Incontinence USMLE Types Stress Urge Overflow Female Bladder ...

    More than half of people with stress incontinence also have urge incontinence. Having both stress and urge incontinence is known as mixed incontinence. An overactive bladder causes urge incontinence. This type of urinary incontinence causes you to leak urine when you feel an urgent need to pee.

    Overflow incontinence is a different type of urinary incontinence. It causes you to leak urine because your bladder is too full or you cant completely empty it.

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    Fast Facts On Urinary Incontinence

    • Urinary incontinence is more common in females than in males.
    • There are a number of reasons why urinary incontinence can occur.
    • Obesity and smoking are both risk factors for urinary incontinence.

    Urinary incontinence is when a person cannot prevent urine from leaking out.

    It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.

    The chances of it happening increase with age.

    Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.

    Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.

    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.

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    Should I Drink Less Water Or Other Fluids If I Have Urinary Incontinence

    No. Many people with urinary incontinence think they need to drink less to reduce how much urine leaks out. But you need fluids, especially water, for good health.

    Women need 91 ounces of fluids a day from food and drinks.11 Getting enough fluids helps keep your kidneys and bladder healthy, prevents urinary tract infections, and prevents constipation, which may make urinary incontinence worse.

    After age 60, people are less likely to get enough water, putting them at risk for dehydration and conditions that make urinary incontinence worse.12

    What Are Kegel Exercises

    Natural Treatment for Stress Incontinence (try this BEFORE surgery!)

    Kegel exercises, also called Kegels or pelvic floor muscle training, are exercises for your pelvic floor muscles to help prevent or reduce stress urinary incontinence. Your pelvic floor muscles support your uterus, bladder, small intestine, and rectum.

    Four in 10 women improved their symptoms after trying Kegels.9 Kegels can be done daily and may be especially helpful during pregnancy. They can help prevent the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may also weaken with age and less physical activity.

    Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.

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    Surgery To Control Sui

    Making the decision to have surgery can be very personal. It is made in consultation with your surgeon based on the characteristics of your incontinence, your goals and your preferences.

    It helps to learn as much as you can before you decide to move forward with surgery. Explain your goals to your healthcare provider. Find out which type of surgery is recommended and how much it may reduce urine leaks to see if its worth doing. Learn what to expect during and after surgery. Also ask about risks and possible complications.

    Here are a few sample questions for your healthcare provider to help you make the best decision:

    • Which surgery is best for me? Why?
    • What are the risks with surgery?
    • Will surgery fix my SUI completely?
    • How long is the recovery?
    • Will I still have incontinence or other symptoms after surgery?
    • Will my insurance pay for surgery?
    • Should I do this now, or wait?

    Waiting to have SUI surgery wont harm you. Unlike some other medical conditions, delaying SUI surgery doesnt usually change the outcome.

    Surgery for SUI in women is usually very successful. While each of the most commonly performed surgeries are similar in terms of success rates, they have different risks. It is important to understand your options so you can feel confident about the decision you make. If you want to find out more about SUI surgery, ask your healthcare provider what kind may work best for you, why and for how long.

    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.

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    Demonstration Of Stress Incontinence: Cough Stress Test

    Stress urinary incontinence should be objectively demonstrated before any anti-incontinence surgery is performed 101113. Visualization of fluid loss from the urethra simultaneous with a cough is diagnostic of SUI. Delayed fluid loss is considered a negative cough stress test result and suggests cough-induced detrusor overactivity. The cough stress test can be performed with the patient in the supine position during the physical examination. However, if urine leakage is not observed, the cough stress test needs to be repeated with the patient standing and with a full bladder to maximize test sensitivity. Health care providers often ask patients to come to the office with a full bladder during an initial evaluation so that the cough stress test can be performed before bladder emptying 12.

    How To Treat Stress Incontinence

    Stress Urinary Incontinence

    Stress incontinence has various treatments, and they include using medicines, like over-the-counter , anti-spasmodic and even anti-depressants. These are used to control the symptoms of the condition and prevent the person from experiencing further discomfort. Physical therapy is also recommended for patients with stress incontinence. Exercise and dietary changes may also help reduce the levels of stress incontinence that occurs in a persons life. These measures, however, should be coupled with other forms of therapy to achieve optimum results.

    Over-the-counter medications are safe for use by anyone. Some contain ingredients that may interact with other medicines or cause unpleasant side effects. These should not be used by pregnant women or individuals who have kidney or heart disease as these ingredients can result in side effects.

    Before using any OTC medication to treat stress incontinence, you should consult your doctor to ensure that the treatment is safe for the individual in question.

    There are many ways to manage stress incontinence. It is best to find the underlying cause for the condition and deal with it accordingly. Using special pillows and the addition of special ointments can help a person to manage their stress incontinence.

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    What Is The Process Of Urinary Tract And How It Normally Works

    The urinary tract issue incorporates two kidneys. It supports two ureters, the urethra, a bladder, and a sphincter. The bladder is set up by a sash in the pelvic floor. The overall SUI system cooperates with the kidney and eliminates squander, explicitly urine from our bodies.

    The kidneys make the proper amount of urine. The kidneys clean our blood and expel waste and excess water . They likewise fill in as our body channel to control electrolytes, liquid equilibrium, pH, and pulse. Urine channels down through slim cylinders called ureters into the bladder. Further, we will discuss how the urinary tract will work?

    • The ureters will quickly move the urine and assign it from the kidneys to the bladder.
    • The bladder is an inflatable-like organ. It stores urine. The bladder muscles contract happens, when were prepared to deliver urine.
    • It has sphincter fibers to keep the urethra closed and keep urine from spilling out till youre prepared to deliver urine. The sphincter muscle loosens up when the bladder agreements and urine happens.
    • The pelvic floor incorporates a sling that works similar to a lounger of muscles and sash that upholds the bladder, rectum, and uterus.

    Treatments For Stress Incontinence In Women

    Urinary incontinence is the loss of bladder control, a condition that affects 13 million women in the United States. Stress incontinence, the most common type in women, is when leakage occurs during activities that put pressure on the bladder, such as coughing, sneezing, laughing, lifting, or running. These accidents happen when the muscles that contract to hold urine in are too weak to handle sudden pressure on the bladder during stressful activities.

    Though stress incontinence affects people of all ages, races, and both sexes, it is twice as common in women as in men, and affects one in three women at some point in their lifetime. It is more common in women because pregnancy, childbirth, and menopause may weaken the pelvic floor muscles. The condition is especially common in older women post-menopause because the pelvic floor muscles tend to weaken with age, especially when hormone levels drop.

    If stress incontinence is affecting your lifestyle, there are treatments that can lessen the problem or eliminate it entirely. There are many effective treatments, and surgery should be considered only as a last resort.

    Pelvic floor muscle exercises, which you can perform yourself at no cost, is the treatment that has been shown to have the most consistent success to help women achieve bladder control. The fact that it is free is probably the reason it is not more widely used: nobody is advertising it because they cant make money.

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    What Are Stress Incontinence Treatments For Women

    Stress incontinence treatments for women include:

    • Vaginal estrogen creams, gels, rings or patches that strengthen vaginal muscles and tissues after menopause.
    • Insertable vaginal pessary devices that support the bladder and urethra.
    • Urethral injections to temporarily bulk up the urethral muscle and keep the sphincter closed.
    • Surgery to place a sling made of your tissue, donor tissue or surgical mesh under the urethra to support it.

    Common Treatment Options For Male Stress Incontinence

    Stress incontinence treatment at Vikalp physiotherapy clinic noida

    Have you ever experienced sharing a funny moment with your friends, and then, amid the raucous laughter, you feel yourself pee a little? Losing control over your bladder can be embarrassing, and youre not alone in this experience. Stress incontinence is the unintentional loss of urine due to exertion or excessive pressure on the bladder. It is a common problem that occurs due to insufficient support of the muscles surrounding the urethra, the tube that carries urine from your bladder.

    Stress incontinence can happen when you engage in physical activities, and sometimes coughs and sneezes are sufficient to cause accidental urination. Fortunately, there are various methods for treating stress incontinence, ranging from conservative to surgical modalities.

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    Why Do You Experience Urinary Incontinence When Running

    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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    Exercises To Help Prevent Bladder Incontinence

    Kegel exercises are one type of workout you can do anywhere, anytime. When youâre doing Kegel exercises properly, they are invisible to others. The most important thing to understand is that Kegel exercises only involve the pelvic muscles, not the stomach or chest muscles. You should feel like youâre clenching up and in, not pushing down and out like a bowel movement.

    Finding Your Kegel Muscles

    The first step to properly exercising your pelvic muscles is to feel them in your body.

    Step 1: While sitting down or standing up, feel the sensation of urinating.

    Step 2: Imagine the sensation of stopping your urine stream before your bladder is empty.

    Step 3: Notice which muscles tense when you imagine this sensation. These are your pelvic muscles. The way they tensed in this exercise is the beginning of most Kegel exercises.

    Note: donât actually do this when urinating. Regularly stopping your urine before your bladder is empty can damage your bladder and even result in bladder infections. If this exercise isnât helpful, you can also imagine the sensation of avoiding passing gas or squeezing a tampon if you have a vagina.

    Sitting Fast-Twitch Exercise

    You have two important kinds of muscle tissue, known as fast-twitch and slow-twitch muscles. You have both in every part of your body, including your pelvic muscles. Fast-twitch muscles react quickly, and can help you avoid stress incontinence such as a urine leak while laughing.

    Step 3: Release almost immediately.

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