Treatment Options For Urge Incontinence
Treatments for this type of condition also should address the underlying cause, such as better diabetic control weight loss or limiting of bladder irritants, like smoking, alcohol, caffeine and carbonated beverages. Bladder retraining with timed voiding intervals may provide significant relief for some patients and can be quite effective.
Medications that relax bladder muscles can improve urge incontinence symptoms as a second-line treatment. The most reported side effects include dry mouth, constipation, heartburn and dry eyes. A newer class of medications avoid some of these side effects however, they may cause slight elevations in blood pressure.
Peripheral tibial nerve simulation is a third-line treatment option offered in the clinic setting that uses an acupuncture-like needle and mild electric simulation. The treatment consists of 12 sessions lasting 30 minutes each with optional once-a-month maintenance therapy options.
Bladder muscle Botox injections are being used in patients who have severe symptoms. Injections offer reasonable improvements in symptoms for six months or longer, with common side effects being related to urine retention or urinary tract infections. These injections must be repeated every six to nine months.
Watch this video to learn more about urinary incontinence treatments, including sacral neuromodulation therapy:
Tarek Khalife, M.D., and Gokhan Anil, M.D., are OB-GYNs in Mankato and New Prague, Minnesota.
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Why Does Pregnancy Cause Incontinence
During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.
Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.
Types Of Urinary Incontinence
There are different types of incontinence:
- Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. Its the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.
- Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimers disease, Parkinsons disease, multiple sclerosis, or stroke.
- Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.
- Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
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Urinary Incontinence Is Not Normal But It Is Treatable
Have you ever leaked a bit of urine, maybe after sneezing or laughing? Urinary incontinence, or accidental bladder leakage, can be embarrassing, and it happens more often to women after childbirth or with aging. But its not normal! Treatment is available, and theres no reason why women shouldnt seek it.
Getting treatment for urinary incontinence can improve your quality of life. Imagine no more rushing to the bathroom or avoiding exercise due to urine leakage! The first step toward effective treatment is determining which type of incontinence you have.
Bladder Leakage Causes Symptoms & Treatments
Experience bladder leaks? Use this guide to understand the causes of bladder leaks, signs and symptoms, as well as tips to prevent or stop leaks.
Female bladder leakage occurs when the muscles around your bladder are weakened and canât successfully close off the bladder as they should. If youâre experiencing a leaking bladder, know that youâre not alone. You likely have many questions, which is why we put together this guide to help you understand the causes of bladder leaks, the signs and symptoms, as well as tips to prevent or stop leaks.
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Supplements To Help Alleviate Male Incontinence
There is a dearth of clinical science on the use of natural supplements to treat incontinence, but the following supplements have been long used and shown some success in remedying urinary function:
Buchu is a shrub native to South America, and has been used to promote health urinary tract function and urine flow, per myconfidentlife.com. The extract of this plant has also been used to treat urinary tract infections. Buchu has been favorably mentioned in a study published in Reviews in Urology. Here at Wonder Labs, buchu is found in K-U supplements designed for overall urinary health
Gosha-jinki-kan is a traditional Japanese herb, or, actually, a combination of herbs, that has been mentioned favorably in the same study in Reviews in Urology. Myconfidentlife.com mentions another study that discusses Gosha as useful in balancing ones sympathetic and parasympathetic nervous systems, which govern muscular impulses. It has been one of the most studied herb combinations in overcoming an overactive bladder.
Cornsilk has been thought to encourage urinary health for multiple reasons. It has been used to treat both bladder infections and urinary tract infection. Its also cited in Reviews in Urology as a hopeful agent in treating incontinence.
Saw palmetto has been cited as a supplement helpful in overcoming enlarged prostate in men, per myconfidentlife.com, which is one of the potential causes of incontinence.
Keeping A Bathroom Journal
You may be asked to keep a bathroom journal before or after your appointment. In your journal, youll log all your bathroom trips and bladder leakage or issues. It can also be helpful to record what you eat and drink in your bladder journal. This record will help your doctor get a more accurate idea of your symptoms and how often they occur. Keeping a journal can also determine what triggers your need to pee or any accidents.
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What Causes Urinary Incontinence
It helps to know that male urinary incontinence is not a disease but rather a symptom of an underlying problem, per Michigan Medicine. To understand this, its important to know some basic physiology:
After urine is produced in the kidneys, it goes to reside in the bladder, and then it travels through the urethra to exit your body. When urine is residing in the bladder, the urethra muscles are contracted while the bladder is relaxed. When its time to pee, the urethra muscles relax while the bladder works to move the urine out. If either of these muscles doesnt do its job properly, incontinence can occur. Naturally, there are various potential causes for this.
Hopkins Medicine explains that there are usually two types of incontinence. The first is stress incontinence, in which the muscles in your urinary system malfunction due to stress put on the abdomen from sneezing, coughing, or other activities. The other typical occurrence is urge incontinence, in which, your brain, spinal cord and bladder dont work together properly to allow you to hold and release urine at the right time. Its important to know that both types can happen at the same time. There are other possible causes, as well. Its also important to know that male incontinence doesnt occur entirely out of your control. Following are some ways to prevent it.
Botulinum Toxin A Injections
Botulinum toxin A can be injected into the sides of your bladder to treat urge incontinence and overactive bladder syndrome .
This medication can sometimes help relieve these problems by relaxing your bladder. This effect can last for several months and the injections can be repeated if they help.
Although the symptoms of incontinence may improve after the injections, you may find it difficult to fully empty your bladder. If this happens, you will need to be taught how to insert a catheter into your urethra to drain the urine from your bladder.
Botulinum toxin A is not currently licensed to treat urge incontinence or OAB, so you should be made aware of any risks before deciding to have the treatment. The long-term effects of this treatment are not yet known.
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Try Pelvic Floor Therapy
Pelvic floor therapy is a type of specialized physical therapy that strengthens the muscles that support your bladder and bowels. This can be very effective in treating urinary incontinence caused by an overactive bladder.
During pelvic floor therapy, a physical therapist may lead you through exercises that target your pelvic floor, use mild electrical stimulation to help you have more awareness of your pelvic floor muscles, and use other specialized techniques. If youre interested in pelvic floor therapy, talk with a doctor about getting a referral.
What Are The Treatments For Urinary Incontinence
Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:
- Lifestyle changes to reduce leaks:
- Drinking the right amount of liquid at the right time
- Being physically active
- Staying at a healthy weigh
- Avoiding constipation
If these treatments do not work, your provider may suggest other options such as:
- Medicines, which can be used to
- Relax the bladder muscles, to help prevent bladder spasms
- Block nerve signals that cause urinary frequency and urgency
- In men, shrink the prostate and improve urine flow
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Drink Plenty Of Water
Drink 6 to 8 glasses of fluid a day unless your doctor advises you otherwise.
Many people with urinary incontinence avoid drinking fluids, as they feel it causes more problems. However, limiting your fluid intake makes incontinence worse, because it reduces your bladder’s capacity.
Not drinking enough fluid can also cause constipation or make it worse.
Find out which are the healthiest drinks.
Nay On Horsetail Cranberries
Horsetail , an ancient plant that resembles a bristly tail when dried, may produce a mild diuretic effect. The goal of OAB treatment is control over random bladder spasms, not increased urine flow. The diuretic effect and lack of studies mean you should cross horsetail off your list if youre looking for help for OAB.
The same is true for cranberries. The fruit is very acidic, which may aggravate the symptoms of OAB. Cranberries may change the way bacteria adheres to the bladder in a urinary tract infection, but bacteria isnt involved in involuntary contractions that cause OAB.
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Who Is Most At Risk
In addition to the causes mentioned above, there are some things that can increase your risk of developing urinary incontinence without directly being the cause of the problem. These are known as risk factors.
Some of the main risk factors for urinary incontinence include:
- family history there may be a genetic link to urinary incontinence, so you may be more at risk if other people in your family have experienced the problem
- increasing age urinary incontinence becomes more common as you reach middle age and is particularly common in people over 80
- having lower urinary tract symptoms a range of symptoms that affect the bladder and urethra
How Is Urinary Incontinence Treated
You and your doctor or nurse will work together to create a treatment plan. You may start with steps you can take at home. If these steps do not improve your symptoms, your doctor or nurse may recommend other treatments depending on whether you have stress incontinence or urge incontinence or both.
Be patient as you work with your doctor or nurse on a treatment plan. It may take a month or longer for different treatments to begin working.
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Posterior Tibial Nerve Stimulation
Your posterior tibial nerve runs down your leg to your ankle. It contains nerve fibres that start from the same place as nerves that run to your bladder and pelvic floor. It is thought that stimulating the tibial nerve will affect these other nerves and help control bladder symptoms, such as the urge to pass urine.
During the procedure, a very thin needle is inserted through the skin of your ankle and a mild electric current is sent through it, causing a tingling feeling and causing your foot to move. You may need 12 sessions of stimulation, each lasting around half an hour, one week apart.
Some studies have shown that this treatment can offer relief from OAB and urge incontinence for some people, although there is not yet enough evidence to recommend tibial nerve stimulation as a routine treatment.
Tibial nerve stimulation is only recommended in a few cases where urge incontinence has not improved with medication and you don’t want to have botulinum toxin A injections or sacral nerve stimulation.
Do The Right Exercises
High-impact exercise and sit-ups put pressure on your pelvic floor muscles and can increase leaks.
To strengthen your pelvic floor to relieve symptoms, replace high-impact exercise, such as jogging and aerobics, with strengthening exercise, such as pilates.
Pilates strengthens your core muscles, which is beneficial for stress incontinence.
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Begin By Talking To Your Doctor
What should you do if youre experiencing bladder problems? First, speak up. People often dont bring up issues of incontinence with their clinical providers, either due to embarrassment or because they feel there are no available options that can helpor that surgery may be the only option, says Tomas Griebling, M.D., professor of urology and senior associate dean for medical education at the University of Kansas School of Medicine. But the symptoms can almost always be eased, Hochman says.
So start by working with a general practitioner, who can determine whether there may be an underlying cause for your symptoms. Urgency, incontinence, and urinary frequency can be caused by urinary tract infections or kidney stonesor, in men, a prostate infection or prostate enlargement. Medication you take to treat other conditions, such as anxiety, depression, high blood pressure, insomnia, and pain, can also lead to bladder leaks.
Your doctor might ask you to keep a diary of how often you urinate, when you have leaks, and how much liquid you consume. That will help define the problem and pinpoint the triggers.
What Is The Treatment For Urinary Incontinence
The most appropriate treatment for urinary incontinence will depend on what is causing it.
If the problem is with your pelvic floor muscles, physiotherapy can make a big difference. Medicine can help to relax the bladder muscles, which can help with urge incontinence. Talk to your doctor about whether medicine is right for you.
Some lifestyle changes may also help to treat urinary incontinence. These include:
If medicine, physiotherapy or lifestyle changes dont work, surgery to support your bladder and urethra is an option for some types of urinary incontinence.
You can also try to train your bladder to improve control and increase the amount of urine you can hold. Talk to your doctor or incontinence health professional about a bladder training program.
If you are caring for someone with incontinence, make sure they can access the toilet easily and that its clearly signposted. Make sure their clothing is easy to remove and monitor their routine so you can remind them to go to the toilet regularly. You can read more about caring for someone with incontinence on the Continence Foundation of Australia website.
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What Steps Can I Take At Home To Treat Urinary Incontinence
Your doctor or nurse may suggest some things you can do at home to help treat urinary incontinence. Some people do not think that such simple actions can treat urinary incontinence. But for many women, these steps make urinary incontinence go away entirely, or help leak less urine. These steps may include:
You can also buy pads or protective underwear while you take other steps to treat urinary incontinence. These are sold in many stores that also sell feminine hygiene products like tampons and pads.
Ways To Treat Bladder Leakage
With so many bladder leakage products and treatment options, how do you know what is the best one for you?
First, be sure to check in with your urologist or urogynecologist to see what may be causing your bladder leakage. Knowing the cause will help you and your doctor decide what treatment option will work best for you. While certain drinks, foods and medications may stimulate your bladder, there are other medical reasons that can cause your symptoms, including:
- Urinary tract infections
- Weakened pelvic floor, sometimes caused by pregnancy, childbirth, menopause or having had a hysterectomy
- Neurological disorders
Depending on what is causing your urinary incontinence, a unique treatment plan should be developed based on your personal situation, says Nina Bhatia, M.D., urogynecologist at Hackensack Meridian Health. There are several lifestyle changes, including bladder retraining techniques, dietary changes, avoiding bladder irritants, pelvic floor exercises and pelvic floor physical therapy that can help tremendously. If those fail to provide you relief, there are non-surgical and surgical options that we can offer.
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