Hope for Urinary Incontinence Sufferers The loss of bladder control, or urinary incontinence, is a common and often embarrassing problem that affects millions of people in the United States — many of whom suffer in silence, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Fortunately, treatment is available, and it’s simpler than you might think.
Although common, urinary incontinence is not a normal part of aging or, in women, an inevitable consequence of childbirth or changes after menopause. It is a medical condition with many possible causes—and just as many solutions.
“Urinary incontinence can affect people of all ages for any number of reasons,” says Brian Feagins, M.D., urologist on the medical staff at Presbyterian Hospital of Dallas. “The incidence increases with age in both sexes. However, it can happen to otherwise healthy teenagers. Genetics may also play a part in the development of incontinence.”
Treatment is determined by the type of incontinence and severity of the condition, as well as what best fits the patient’s lifestyle.
Several types of urinary incontinence are recognized by medical professionals, and, as defined by the NIDDK, three common types include:
• Stress incontinence occurs when urine leaks out during exercise, coughing, sneezing or other movements that place pressure on the bladder. It can be treated with pelvic floor exercises and biofeedback. If neither works, surgery can be done to insert a sling to support the urethra or, to correct a vaginal wall prolapse (bulging or sinking). Advances in the treatment of stress incontinence have made sling procedures minimally invasive, requiring little recuperation.
• Urge incontinence is the sudden, uncontrollable need to go to the bathroom. It often affects those who have had a stroke or nerve damage, or those with diabetes or diseases of the nervous system. It also can be a sign of a bladder infection. Most often, urge incontinence occurs without any obvious cause. Urge incontinence may be treated with medications that decrease abnormal bladder contractions, biofeedback, pelvic neuromodulation (implants to control bladder nerve function) or Botox injections of
• Overflow Incontinence results when the bladder cannot be completely emptied and small amounts of urine continually leak out. This is the most common type of urinary incontinence in men. Overflow incontinence is treated with medications called alpha-blockers that relax the neck of the bladder to let it drain. Also, men can be given medications to decrease prostate size. If these are not effective, transurethral resection of the prostate (TURP) can relieve obstruction. If women are obstructed, urethral dilation or revision of previous surgery can relieve symptoms.
“It’s important to seek attention from physicians when you have these issues,” says Dr. Feagins. “You don’t have to live with incontinence.” (Summer 2008)