Urinary Incontinence
Incontinence affects twice as many women as men, and while younger people experience the condition, it is more common among older individuals. About one in ten people 65 and older have this problem. Approximately 11 million women are affected by urinary incontinence, but less than 10 percent seek medical treatment. Many of these women could be helped and successfully treated with simple procedures, medication or rehabilitation.
Persons affected by urinary incontinence are unable to control urination and therefore experience mild leaking to uncontrollable wetting. Urinary incontinence is a symptom of an underlying medical condition -- not a disease or illness itself. Incontinence can occur as a result of pregnancy or childbirth, injury to the pelvic region or spinal cord, neurologic disease, infection or degenerative changes associated with aging.
Depending on the cause, incontinence can be temporary or permanent. In addition to physical consequences, the problem carries with it significant emotional and psychological components -- often causing patients to feel ashamed and less confident in social situations.
Because it is a sign of a health disorder, incontinence should never be ignored.
Treatment
For today's patients, more options than ever are available to alleviate or eliminate urine leakage. About 80 percent of individuals affected by the condition can be cured or improved. The proper treatment, or combination of treatments, depend on the type of incontinence you are experiencing, its severity and your lifestyle.
Options range from doing simple exercises and diet modification (drinking more water and avoiding caffeine, alcohol, high-acid foods, and spicy foods), to surgical solutions.
Bladder training, including Kegel exercises, delaying urination and urinating on a schedule. Under this plan, the patient is able to stretch the time between bathroom trips, increase the amount of urine the bladder can hold and improve control
Electrical stimulation. Gentle pulses given through the vagina or anus stimulate the nerves that control the bladder and sphincter muscles. This option offers much the same effect as exercises.
Biofeedback. Keeping a diary or using an electronic device to track bladder activity can help you gain greater control.
Medications. For persons with an overactive bladder, two types of drugs can have a positive affect on the nerves and muscles of the urinary tract: anticholinergics, which work to relax the bladder muscles and prevent bladder spasms, and anti-depressants, also relax the bladder muscle.
Devices. A pessary is a stiff ring used to reposition the urethra. Other devices include a disposable patch or a urethral plug (similar to a tampon).
Implant injection. Material is injected into the area around the urethra to add bulk and close the urethra.
Surgery. Procedures may involve a number of solutions:
- Reposition and secure the bladder to a more normal position. If there is a lack of support to other pelvic organs, more involved surgery may be necessary.
- Insert an artificial sphincter
- Divert the path of urine
- Increase the capacity of the bladder (hydro-distention
- Limit nerve impulses to the bladder control muscles (denervation)
- Modulate the nerve to the bladder or penis
- Remove a blockage in the urinary tract
Resources at Cedars-Sinai
