About half of adult women say they have had urine leakage at one time or another. Many women report it is a daily problem. Embarrassment and shame can prevent them from seeking help. Many mistakenly believe that nothing can be done to correct it.
Luckily, that is not the case! In fact, there is a range of treatment options available to help women conquer this concern. If you have bladder issues, you are not alone. As many as 18 million women of all ages face the inability to predict when and where urination will occur. This common disorder is known as urinary incontinence.
Urinary incontinence affects everyone differently. You may have urinary incontinence if you experience any of the following:
If you are experience any of these issues, you should talk with your doctor about urinary incontinence and discuss your treatment options.
Bladder control is a complex process that involves the brain, spinal cord, and muscles of the bladder and pelvis. Loss of bladder control can be caused by problems with any of these components.
Incontinence can be caused by a variety of problems. Some of the causes include normal changes in muscles because of aging, birth defects, pelvic surgery, injuries to the pelvic region or the spinal cord, neurological diseases such as multiple sclerosis and Parkinson’s disease, dementia, degenerative changes associated with aging such as difficulty walking and memory loss, and pregnancy and childbirth.
Although urinary incontinence problems are most common in post-menopausal women, they can affect women of any age. Aging, pregnancy and childbirth are common causes of several types of urinary incontinence, including:
Because incontinence can be caused by a variety of issues and comes in many forms, treatment depends on the results of diagnostic tests by your doctor, which may include X-rays, blood work, and urine analysis, and examination of your bladder capacity, the amount of urine left in your bladder after urination, and urethral pressure.
Your doctor may order urodynamic tests that evaluate how well your bladder is working. Urodynamic tests can be simple or complex and can provide a range of measurements, including:
Your urogynecologist will evaluate the results of your urodynamic tests to determine if your bladder is functioning normally and recommend appropriate treatment, if needed.
You may also be asked to keep a diary of your bathroom habits. This “voiding diary” keeps track of how much you drink and urinate. An accurate diary gives your urogynecologist a clear picture of how often you go, how often you leak, what you drink, how often your drink, and more. Together, these items provide valuable details about your bladder.
Incontinence is not a hopeless condition. UPMC Pinnacle’s Bladder and Pelvic Health program is a comprehensive program offering effective treatments for urinary incontinence.
Our providers have many years of experience treating women with these conditions. Treatments vary from behavioral modification and physical therapy to advanced surgical techniques that can maximize an individual’s quality of life with minimal-to-no down time.
It is important to understand that the two different types of urinary incontinence, urgency incontinence and stress incontinence, are treated differently. Urgency incontinence is usually treated with behavioral modification, physical therapy, timed toileting as well as medications to control bladder spasms, which allows for your bladder to hold for longer and higher volumes of urine. Stress incontinence is usually treated with physical therapy and a procedure known as a midurethral sling.
Medications for Urinary Incontinence*Mostly used to treat urgency incontinence.
Medications may be prescribed to help control incontinence. Medications relax your bladder and reduce spasms or instability. These drugs help prevent your bladder contracting spontaneously.
Drinking less water is not a good way to avoid problems with urinary incontinence because this may cause dehydration. Concentrated urine caused by dehydration can cause the lining of the bladder and urethra to become irritated and actually make your incontinence worse. Drinking two to three quarts of water a day may help. Some fluids, like alcohol and caffeinated drinks, may make your incontinence worse. Stop drinking any fluids two to three hours before bedtime.
After the cause of the incontinence has been determined, your provider may recommend timed voiding, fluid restrictions, and medications to address issues that cannot be changed with behavioral modification. If these provide some or no relief, then there are other treatments such as botox injections into the bladder wall and InterStim.
Not every treatment will work for every patient and sometimes patient will need a mixture of treatments to maximize outcomes.
For stress incontinence, treatment options can consist of physical therapy, pelvic floor exercises, or a patient may use an over the counter product called Imprezza™, which is similar to a tampon in that it stabilizes the urethra during increased abdominal pressure. The current mainstay treatment for stress incontinence is a mid-urethral sling. The mid-urethral sling is an outpatient procedure that is usually performed in the operating room and can provide cure rates up to 90 percent. It has been used in the U.S. for 20 years with significant clinical data that supports its treatment outcomes, safety profile with minimal risk.
You don’t have to deal with incontinence or “just live with it.” Bladder issues, like many other health concerns, are easier to treat the earlier you detect the problem. Medicare and most insurance cover treatment for incontinence, though the out-of-pocket cost will be different depending on any copays or deductibles
Bladder issues don’t have to stop you from enjoying life. Contact us today at 717-988-1451 to find out the facts about urinary incontinence and what you can do about it!
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