Incontinence

There will always be that list of problems people don’t want to talk about. One of those problems is urinary incontinence, or the involuntary release of urine. Or what most people describe as having “accidents”.

Most people are reluctant to discuss incontinence issues because they believe it is normal; a normal part of aging or a normal side effect of pregnancy and childbirth. However, that thinking is wrong! Incontinence, while extremely common, can be treated.

 

According to the National Association for Incontinence, upwards of 25 million American adults suffer from some form of urinary incontinence. And of those, 75-80% are women. Whether it’s leaking urine during exercise, sneezing or laughing, or a sudden uncontrollable need to go that results in wet pads or pants, urinary incontinence is a problem that plagues many people. They may resort to adult diapers, plan their day around access to bathrooms, or give up activities they love, or work they need, as a result.

There are four main types on Incontinence:

1. Stress incontinence – occurs when urine leaks from the bladder when you laugh, cough, sneeze or do any other activity that places stress on the abdomen.

2. Urge incontinence – the leakage of urine associated with a great urgency or desire to urinate, which cannot be suppressed.

For example, it kicks in when (even if you’ve been fine up until that moment) you get close to a toilet and suddenly find you can’t make it all the way.

3. Overflow incontinence – happens when someone has difficulty passing urine, which causes the bladder to be permanently full.

As the kidneys continue to produce urine, the excess spills out through the urethra – almost like a dam that’s overflowing.

4. Total incontinence – is the continuous leakage of all the urine. It’s most often caused by an abnormal communication between the bladder and the vagina.

While urinary incontinence is highly treatable, it’s important to understand what type of incontinence you have and your symptoms often help your doctor to diagnosis your specific type. Luckily, our very own Dr. Aaron Sudbury is board certified in urogynecology and is highly trained in the diagnosis and treatment of urinary incontinence.

Often diagnosis starts with a thorough history and physical exam. This is followed by a series of tests including the following:

  • Urinalysis – A sample of your urine is checked for signs of infection, traces of blood or other abnormalities.
  • Bladder Diary – You will be asked to track your fluid intake, how often you urinate, the amount of urine you produce, your symptoms and/or accidents for several days.
  • Urodynamic Testing – A study that assesses how the bladder and urethra are performing their job of storing and releasing urine.
  • Post-Void Residual Ultrasound – Done in the office, this test evaluates the amount of urine in you feel the urge to urinate versus after voiding.
  • Cystoscopy – This is a procedure that allows your doctor to examine the lining of your bladder and the tube that carries urine out of your body (urethra). A hollow tube (cystoscope) equipped with a lens is inserted into your urethra and slowly advanced into your bladder

cystoscopy

Once it is determined what type of incontinence is causing your symptoms, a variety of treatments are at your fingertips. Your doctor may recommend any of the following options:

  • Bladder Training: to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet.
  • Fluid and Diet Management:  You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.
  • Pelvic Floor Physical Therapy: Pelvic PT is a non-surgical, painless method of retraining the pelvic floor muscles that help control bladder, bowel and sexual function. Strengthening your pelvic floor muscles will help you to support your bladder, reducing the likelihood of leaking.
  • Medications: There a number of medications that are commonly used to treat incontinence. Your doctor may prescribe these to alleviate your symptoms.
  • Interstim Therapy: The implanted InterStim™ II system electrically stimulates the sacral nerve which is thought to normalize neural communication between the bladder and brain.

interstim

  • Tibial Nerve Stimulation: This therapy stimulates the tibial nerve, which is located in your leg. The tibial nerve connects to nerves responsible for bladder function.

NURO

  • Surgery: If other treatments are not working, your doctor may recommend surgery. There are several surgical procedures that can treat the problems that cause urinary incontinence, including sling procedure, bladder neck suspension and prolapse surgeries.

If you are suffering from urinary incontinence, you are not alone! And the first step to treatment is an appointment with your provider.

If you have any questions or would like to schedule an appointment to discuss incontinence issues with Dr. Sudbury, give us a call today!

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