Incontinence: Treatment Options

Incontinence: Treatment Options

What is incontinence?

Incontinence is the accidental release of urine and can occur when you cough, sneeze, laugh or exercise. Incontinence can also occur when you have a sudden urge to go to the bathroom but cannot get there in time. The two most common types of incontinence are stress and urge.

How common is urinary incontinence?

Urinary incontinence and bladder function disorders are a common yet often debilitating condition for millions of people in the United States. Women experience incontinence twice as often as men as a result of pregnancy, childbirth, hysterectomy, and menopause. Though women may develop incontinence during their lifetime, it is not a normal condition associated with aging. Many people with incontinence are embarrassed or fearful of mentioning the problem to a family member or primary care provider. Fortunately, there are many treatment options available to women of all ages.

What is the difference between stress and urge incontinence?

Stress incontinence is caused by childbirth, weight gain, or other conditions in which the bladder is no longer properly supported by the pelvic floor muscles. As a result, the bladder drops. The added pressure when you cough, laugh, or sneeze causes urine to leak. Urge incontinence is loss of urine that follows the sensation of an urge to urinate caused by bladder spasms. Some women have no warning before they accidentally leak urine. Overactive bladder is a type of urge incontinence.

How is incontinence diagnosed?

The first step to successful treatment is accurate diagnosis. A thorough assessment of your symptoms, physical exam, urine test, and check of bladder emptying are the starting point for the evaluation. Urodynamics is a diagnostic procedure that is done for patients with lower urinary tract symptoms. This procedure uses a small catheter to measure pressure and volume. Urodynamics assesses how the bladder performs its job of storing and releasing urine and can be used for determining the best method of treatment.

How is incontinence treated?

Weeks offers non-surgical and surgical treatment options for patients suffering from urinary incontinence. One of the treatments offered is pelvic floor rehabilitation. The treatment consists of eight visits where the patient has biofeedback monitoring to evaluate strength and endurance of the pelvic muscles. Counseling is provided on how to ensure patients are isolating the pelvic muscles versus the abdominal muscles. There are also several medications to treat the problem.

In some cases, stress incontinence can be treated by an outpatient procedure that inserts a sling to hold the urethra and bladder neck in place, offering support that can dramatically improve a patient’s quality of life. For patients suffering from severe urinary frequency and associated urinary incontinence, a bladder “pacemaker” may be an option. Called Interstim Therapy, the pacemaker is implanted during an outpatient procedure. A non-surgical procedure is also available (Urgent P.C.) to help with bladder over activity.

By Gina Bedell, ARNP-FNP-BC, MSN

Gina Bedell specializes in urology and family planning and sees patients in the both the North Strafford and Lancaster Physicians Offices. For more information or for an appointment, please call 603-788-5095.