Urinary Incontinence
What is Urinary Incontinence?
Incontinence affects twice as many women as men, which is believed to be due to pregnancy, childbirth and menopause. The good news is that urinary incontinence is not a normal part of aging, and it can be treated.
Four types of Urinary Incontinence
- Stress Urinary Incontinence (SUI)
- Bladder leakage that occurs when you put pressure on the muscles around your bladder, like when you cough, laugh, sneeze, lift something or exercise
- Urge Urinary Incontinence (UUI)
- Bladder leakage that happens in conjunction with a sudden, strong or frequent urge to urinate
- Mixed Incontinence (both SUI and UUI)
- Some people leak urine with activity (SUI) and often feel the urge to urinate (UUI). This is mixed incontinence.
- Overflow Incontinence
- With overflow incontinence, the body makes more urine than the bladder can hold or the bladder is full and cannot empty thereby causing it to leak urine.
Management
- You can help prevent urinary incontinence by keeping your bladder healthy with lifestyle changes.
- Avoid food and drinks that seem to increase your symptoms such as caffeine and acidic foods (alcohol, tomatoes, citrus)
- Keep hydrated to avoid your urine getting too concentrated, which can irritate your bladder
- Schedule regular bathroom visits with the goal of gradually increasing the length of time between trips
- Eat more fiber and avoid straining during bowel movements.
- Quit smoking. Persistent coughing from smoking can stress pelvic floor muscles.
- Maintain a healthy weight. Obesity puts extra pressure on your bladder and can make incontinence worse.
Treatments
Treatment for bladder leakage depends on the type of incontinence (urge or stress) and its cause. Treatments may include:
- Pelvic Floor Physical Therapy: These help men and women strengthen and control the muscles involved in urination. Kegels are one example of pelvic floor muscle exercises.
- Medicines: If you have urge incontinence, depending on what’s causing it, medicines may be able to help.
- Topical Estrogen (for women): In post-menopausal women, topical estrogen can restore the health of the bladder and vagina
- Pessary: A small device a provider puts into a woman’s vagina to help support her pelvic muscles and stop leaks.
- Electrical Stimulation and Neuromodulation sends small pulses of electricity to your pelvic muscles to make them tighter and stronger
- Injections of Botulinum Toxin (BOTOX®) into the bladder muscle to keep it from contracting too often.
- Surgery and Outpatient Procedures: Depending on the type of incontinence and its cause, surgery and outpatient procedures can treat urinary incontinence. The gold standard is a mid urethral sling, which is very successful in treating stress incontinence. Several types of slings are available, and we can help you determine which approach is best.
