- Incontinence affects all ages, both sexes, and people of every social and economic level.
- An estimated 12 million Americans have some problem controlling urination.
- It is treatable and generally does not require surgery.
Urinary incontinence: what is it?
Answer the following questions:
- Do you leak urine with coughing, sneezing, lifting?
- Do you leak urine before you make it to the bathroom?
- Do you need to wear protective undergarments for urine leakage?
If you answered yes to one or more, you know what incontinence is!
Causes of urinary incontinence
- Urinary tract or vaginal infections
- Effects of medicine
- Weakness of certain muscles
- Blocked urethra due to an enlarged prostate
- Diseases and disorders involving nerves and/or muscles
- Some types of surgery
Types of incontinence
- Stress incontinence: Leak urine with exercise, cough, sneeze.
- Urge Incontinence: loss of urine as soon as they sense need to use toilet. "Can't get there quickly enough"
- Mixed incontinence: combination of the above
- Overflow incontinence: feeling of incomplete emptying, lose small amounts day and night
Urinary incontinence: what to do?
- Is the problem bothersome?
- Does it alter your quality of life?
- If so: Tell your doctor, he or she can help!
How to diagnose incontinence
- Urinalysis to examine for presence of infection, blood, or other abnormalities
- Post-void residual measurement to see if any urine remains after an attempt has been made to completely empty the bladder
- Ultrasound to determine the size and shape of the kidneys, bladder, and prostate
- Cystoscopy using a thin telescope, allows the physician to see inside the bladder
- Stress test examines bladder and sphincter muscle function
- Urodynamics specialist test to see how bladder is working
Treatment for urinary incontinence
- Behavioral Therapy. Special exercises and training to strengthen the sphincter muscles.
- Medicine is prescribed to relax the bladder or tighten the sphincter muscles.
- For men: operation to relieve the blockage caused by an enlarged prostate.
- For women: operation to restore the support of the pelvic floor muscles, or to reconstruct or compress the sphincter.
- An artificial urinary sphincter can replace a damaged or absent sphincter muscle.
- Absorbent products and devices.
- Timed voiding: gradually increases the interval between voids
- Kegel exercises: for both urge and stress, improves ability of pelvic muscles to control leakage
- Biofeedback: extension of Kegels. Helps patients focus on pelvic floor muscles
- Electrical stimulation: electrical stimulation of pelvic floor muscles. Carried out with biofeedback
- Extracorporeal magnetic innervation:
- The Neotonus Chair, electromagnetic stimulation of the pelvic floor muscles
- Medications: drugs are available to inhibit bladder contractions in urge incontinence. Drugs are also available to tighten or relax the bladder neck
- Catheterization: If the bladder does not empty, patients may evacuate their bladders by catheterizing themselves
- Successful procedures available if simple measures don't work e.g.
- Slings and suspension procedures
- If you undergo surgery using GYNECARE TVT Tension-free Support for Incontinence, your surgeon will restore the normal position of the urethra by weaving a "sling" of mesh tape beneath it.
- After surgery, the tape will support the urethra during a sudden movement such as a cough or sneeze. This allows the urethra to remain closed and prevents the involuntary loss of urine.
- Peri-urethral bulking agents
- Artificial sphincters
- Artificial Urinary Sphincter prosthesis is a small, inflatable device. The cuff is filled with fluid and gently squeezes the urethra closed to keep urine in the bladder.
- Pelvic floor stimulators
- Slings and suspension procedures
Urodynamics, incontinence and reconstructive urologist
Jennifer G. Rothschild, M.D., M.A./M.P.H.
Help is available
- Consult your physician.
- Incontinence is a treatable condition.
- For more information, call the UC Davis Urologic Surgery Clinic at (916) 734-2222 or (800) 770-6930.