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:
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.
Consult your doctor with questions regarding the management and treatment of urinary incontinence.
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There Are Two Primary Categories Of Medications Used To Treat Urge Incontinence Including:
- Anticholinergics These medications help relax your bladder, and can be helpful for urge incontinence and overactive bladder. There are a few side effects to be aware of, including dry mouth and eyes, constipation and difficulty completely emptying your bladder.
- Beta 3 agonist This category of medications relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It also may increase the amount you are able to urinate at one time instead of small amounts more frequently. This is a newer category of medications, and your insurance provider may require that you try other conservative or medication options first.
Your health care provider will help you determine which is right for you and your condition.
How Common Is Stress Incontinence
Stress incontinence is the most common type of urinary incontinence. It most often affects the urinary system in people assigned female at birth . As many as 1 in 3 people who were AFAB will experience stress urinary incontinence at some point. Its less common for the condition to affect men, but it does happen.
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Treatment For Mixed Incontinence
Treatment for mixed incontinence will require a combination of approaches used to relieve both stress incontinence and urge incontinence. There is no single treatment that works for everyone. The treatments you and your doctor choose will depend on the severity of your incontinence as well as your lifestyle and preferences.
These treatments may include:
Behavior Modification: If your diary shows a pattern of urination, your doctor may recommend that you use the bathroom at regular intervals to minimize leaking. Doing Kegel exercises regularly can help strengthen muscles that are involved in urine control. To learn how to do Kegel exercises, go to the bathroom and urinate. Halfway through, try to stop the stream of urine. This will help you identify the muscles you need to contract for Kegel exercises. Once you identify the muscles, do not practice while urinating. Do the exercises for about five minutes a day as you go about your day. After a few weeks to a month you should start to notice some improvement.
Medications: For the urge incontinence component of mixed incontinence, doctors may prescribe a medication called an anticholinergic to help relax bladder muscles to prevent spasms. Alternatively, your doctor may change a medication you are taking, such as high blood pressure medications that increase urine output and can contribute to incontinence.
EurasiaHealth Knowledge Network web site: “Urinary Incontinence.”
Childbirth.org: “Kegel Exercises”
Stress Vs Urgency Incontinence
Incontinence refers to the inability to hold your urine until youre ready to use the restroom. This condition can lead to leaks and sometimes the full loss of control over the contents of your bladder.
There are two main types of incontinence: stress urinary incontinence and urgency urinary incontinence. Some women have a combination of both types, called mixed urinary incontinence.
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Can Urge Incontinence Be Prevented
Urge incontinence can’t be prevented in every case, but there are some general things you can do that may reduce the chance of it happening. These include:
- Maintaining a healthy lifestyle and weight
- Reducing alcohol intake
- Strengthening your pelvic floor through pelvic floor exercises
- Staying active
Surgery And Procedures For Urinary Incontinence
If other treatments for urinary incontinence are unsuccessful or unsuitable, surgery or other procedures may be recommended.
Before making a decision, discuss the risks and benefits with a specialist, as well as any possible alternative treatments.
If you are a woman and plan to have children, this will affect your decision, because the physical strain of pregnancy and childbirth can sometimes cause surgical treatments to fail. Therefore, you may wish to wait until you no longer want to have any more children before having surgery.
The various surgical treatments for urinary incontinence are outlined below.
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What Causes Urge Incontinence Vs Stress Incontinence
Stress and urge incontinence have different causes.
With stress incontinence, weak muscles are a factor. The pelvic floor muscles support the bladder, while the urethral sphincter controls the release of urine from the bladder by opening and closing when required.
Both of these muscle groups can weaken over time, often due to life events such as childbirth or high impact sports. When these muscles are weak, movements that put pressure on the bladder can squeeze urine from the bladder, leading to involuntary leaks.
With urge incontinence, the muscles surrounding the bladder are also implicated. However, in this case, the bladder muscles are too active. They can suddenly contract too strongly, overpowering the urethral sphincter and allowing urine to flow out.
These abnormal muscle contractions can occur for a variety of reasons. In some cases, an underlying condition such as diabetes, multiple sclerosis, or Parkinsons disease is to blame. In other cases, spinal cord damage or bladder irritation cause the contractions.
It is not always possible to identify the cause of urge incontinence.
Stress and urge incontinence have different causes, but a number of the available treatments are the same.
Common first-line treatments include behavioural therapies such as education on lifestyle changes, pelvic floor exercises, bladder training and timed voiding, electrical stimulation.
What Are The Risk Factors For Stress Incontinence
Anyone can have urinary incontinence, but the problem affects twice as many people AFAB as people assigned male at birth . Its estimated half of women over age 65 have stress urinary incontinence. But urinary incontinence is not a normal part of aging. Its a sign of a problem that can get better with appropriate treatment.
Risk factors for stress incontinence include:
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What Are Some Of The Different Types Of Urinary Incontinence
The following are some of the different types of urinary incontinence:
Urgency incontinence: This is the inability to hold urine long enough to reach a restroom. It can be associated with having to urinate often and feeling a strong, sudden urge to urinate. It can be a separate condition, but it may also be an indication of other diseases or conditions that would also warrant medical attention.
Stress incontinence: This is the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects or performing other body movements that put pressure on the bladder.
Functional incontinence: This is urine leakage due to a difficulty reaching a restroom in time because of physical conditions, such as arthritis, injury or other disabilities.
Overflow incontinence. Leakage occurs when the quantity of urine produced exceeds the bladders capacity to hold it.
Absorbent Pads Or Diapers
Absorbent products may be used to manage any form of incontinence. However, these products are NOT A TREATMENT for incontinence for some individuals, urinary incontinence products are a temporary strategy until they address and resolve the underlying cause of their incontinence. Most people find the use of pads, diapers and bladder supports to be extremely inconvenient, expensive and impacts their quality of life.
Risks when using absorbent products include irritation around the groin area and an increased risk of urinary tract infections.
Product options include:
- Always Discreet®
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Treatment Options To Manage Types Of Urinary Incontinence
Incontinence treatments often depend on the type of urinary incontinence a person suffers from and how severe the condition is. In some situations, pelvic floor exercises called Kegel can help strengthen the urinary sphincter and thus the pelvic muscles to help prevent the urine from leaking out. There is also a technique known as bladder training. Someone who bladder-trains is aiming to bring urge under control. One way to do this is to schedule certain times for washroom breaks and stick to those times. After a while, the bladder gets accustomed to emptying at specific times and the random, frequent urges start to subside. Some urologists also suggest double-voiding, which means going to the toilet, then waiting for a couple minutes and going again.
In some instances, medications are prescribed for urinary incontinence. This can include medications that calm overactive bladder or lessen the urge sensation. Topical estrogen has also been used to help reinforce tissues in the vaginal area, which has potential to lessen symptoms. When stress incontinence is the diagnosis, sometimes antidepressants will be prescribed.
What Are Kegel Exercises
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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What Should I Do After My Surgery To Treat Stress Urinary Incontinence
- Continue with annual check-ups and follow-up care, notifying your health care provider if complications develop, such as persistent vaginal bleeding or discharge, pelvic or groin pain, or pain during sexual intercourse. There is no need to take additional action if you are satisfied with your surgery and are not having complications or symptoms.
- If you have complications or other symptoms:
- Discuss complications and treatment options with your health care provider. Only your health care provider can give you personalized medical advice.
- Consider getting a second opinion from a surgeon who specializes in female pelvic reconstruction if you are not satisfied with your discussion with your health care provider.
What Are Stress Incontinence Treatments For Men
Men are most likely to develop incontinence after prostate cancer surgery. Stress incontinence treatments for men include:
- Condom catheters cover the penis and have a catheter at the tip to drain urine into a bag. This would catch the leakage but not prevent it.
- Male sling procedure to place a surgical mesh sling that supports the urethral bulb .
- Surgery to place an artificial sphincter device that keeps the urethra closed until you press a pump to open the device to pee.
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Urinary Incontinence In Older Adults
Urinary incontinence means a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. But incontinence can often be stopped or controlled.
What happens in the body to cause bladder control problems? Located in the lower abdomen, the bladder is a hollow organ that is part of the urinary system, which also includes the kidneys, ureters, and urethra. During urination, muscles in the bladder tighten to move urine into the tube-shaped urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder dont work the way they should, urine can leak, resulting in urinary incontinence.
Incontinence can happen for many reasons, including urinary tract infections, vaginal infection or irritation, or constipation. Some medications can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:
Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:
- Prostatitis, a painful inflammation of the prostate gland
- Injury or damage to nerves or muscles from surgery
- An enlarged prostate gland, which can lead to benign prostate hyperplasia, a condition in which the prostate grows as men age
If You Have Had Little Luck With Other Incontinence Interventions You May Need To Consider These Interventional Therapies:
- BotoxInjections of Botox into the bladder muscle may benefit you if you have an overactive bladder. Botox generally is prescribed only if medications or conservative treatments haven’t been successful.
- InterStim therapy With this therapy, a small device the size of a pacemaker is placed under the skin in your hip area. A lead wire is connected to the device and sends electrical impulses to the sacral nerves, which control bladder contraction and function.
- Percutaneous tibial nerve stimulation This therapy is designed to stimulate the nerves responsible for bladder control using the tibial nerve in your lower leg. During the procedure, a small, slim needle electrode is inserted near your tibial nerve and connected to a battery-powered stimulator. The impulses travel to the tibial nerve and then to the sacral nerve, which controls bladder control and function.
Watch this video to learn more about urinary incontinence treatments including sacral neuromodulation therapy:
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How Does The Urinary System Work
The urinary system consists of the kidneys, ureters, the bladder and urethra. The kidneys filter the blood to remove waste products and produce urine. The urine flows from the kidneys down through the ureters to the bladder. A ring of muscle squeezes shut to keep urine in the bladder and relaxes when we need to wee. The urine passes through another tube called the urethra to the outside when urinating .
Posterior Tibial Nerve Stimulation
Your posterior tibial nerve runs down your leg to your ankle. It contains nerve fibres that start from the same place as nerves that run to your bladder and pelvic floor. It is thought that stimulating the tibial nerve will affect these other nerves and help control bladder symptoms, such as the urge to pass urine.
During the procedure, a very thin needle is inserted through the skin of your ankle and a mild electric current is sent through it, causing a tingling feeling and causing your foot to move. You may need 12 sessions of stimulation, each lasting around half an hour, one week apart.
Some studies have shown that this treatment can offer relief from OAB and urge incontinence for some people, although there is not yet enough evidence to recommend tibial nerve stimulation as a routine treatment.
Tibial nerve stimulation is only recommended in a few cases where urge incontinence has not improved with medication and you don’t want to have botulinum toxin A injections or sacral nerve stimulation.
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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.
Stress Vs Urge Incontinence What Causes Each Type
Many people are unaware of what causes stress vs. urge incontinence. Different conditions and circumstances are responsible for each type.
Weakened pelvic floor muscles are the ultimate cause of stress incontinence. Muscles become weak due to childbirth, age and menopause. There are circumstances that aggravate stress incontinence, including obesity, smoking, high-impact activities like running and aerobics, and conditions that cause a chronic cough.
On the other hand, conditions that affect the bladders normal function cause urge incontinence, which is an important distinction between stress vs. urge incontinence. Here are the conditions that cause urge incontinence.
- Bladder stones
- A blockage in the bladder
- Conditions that affect the brain or nervous system such as multiple sclerosis
- Injuries that affect the spinal cord
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