Urinary incontinence is a condition where there is loss of control in managing the flow of urine fromyour body.
Approximately 17 million women in the U.S. encounter urinary incontinence in their lifetime. Thiscondition can occur in women between the ages of 18 and 60 and beyond and is usually a result of theurethra not being closed tightly to keep urine in the bladder. Symptoms vary from:
an inability to prevent leaking urine when exercising or other involuntary actions such as coughing or sneezing
an overwhelming urge to urinate that often causes them to urinate before getting to a bathroom.
Pelvic floor strengthening exercises: Called Kegel exercises, these exercises commonly are intended to strengthen weak muscles surrounding the bladder.
Behavioral or Lifestyle modifications: Behavior modifications, often called Bladder training, is used to train one’s bladder and sphincter muscles by decreasing fluid intake and by prompting or scheduling voiding. Lifestyle modifications can involve altering your diet to reduce bladder stimulants or irritants.
Medications: There are a number of medications used to treat incontinence caused by the urge to continually void. Where incontinence is stress related, there are no medications used to treat this. For incontinence caused by a combination of both urge and stress, drug therapy may be helpful in treating the urge component.
Biofeedback: is a simple technique that provides patients with information about a particular function of their body. In Urology, biofeedback therapy can be used for patients who have pelvic muscle dysfunction, leading them to experience symptoms such as urgency, frequency, incontinence, pelvic pain, or difficulty emptying their bladder. With the aid of biofeedback, a patient can retrain the pelvic muscles in order to reduce or resolve their symptoms.
Electrical Stimulation Therapy: is a form of treatment that improves urinary and bowel control by strengthening and toning the pelvic floor muscles and decreasing bladder irritability and contractility. By stimulating the pelvic floor muscles that regulate continence, you can strengthen them and achieve better or complete control over your urinary or bowel control issues. This therapy also can relax and prevent bladder activity or unwanted bladder contractions that cause urinary frequency, urgency, and urge incontinence.
Estrogen Therapy: This is a vaginal cream or tablet that is utilized to help strengthen and restore the health of the vaginal tissues in women who have had atrophy of these tissues related to aging, having had a total hysterectomy, or those who are postmenopausal.
Bulking Agents: Bulking agents, such as collagen, are injected directly into the urethral lining to firm and bulk up the urethral lining so that the urethra can close more tightly.
Utilization of devices: Called a Pessary, this device is designed to apply pressure to help reposition the urethra permitting it to close tightly. It features a stiff ring that is inserted into the vagina to exert pressure press against the wall of the vagina and urethra.
Sacral Nerve Stimulation therapy: called InterStim. This is an implant device that is like a pacemaker for your bladder that facilitates communication between the brain and the bladder and can potentially relieve symptoms of overactive bladder, including urge incontinence, urinary retention and may improve fecal incontinence.
Surgical intervention: There are a number of surgical approaches to strengthen, support, elevate and/or restore the urethra and bladder. These are employed when other treatments are not working and include:
-Retropubic Suspensions - Surgical procedures (Burch procedure) intended to restore the urethra and neck of the bladder to a higher anatomical position.
-Slings - Procedures used to treat that treats hypermobility in which a sling is used to support the urethra when there is increased abdominal pressure.
-Bone-fixed slings - treat incontinence by supporting the urethra with a graft material attached to the pubic bone.
-Self-fixated slings - can be used to support the urethra and are secured in place by friction and tissue ingrowth, and require no sutures or screws.
In association to Incontinence, if Pelvic Organ Prolapse exists, surgical correction of the issue depending on the type and degree of prolapse is an option.
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