Amping Up Your Treatment: Medications And Surgery
When more conservative measures have failed, medications – then surgery – are the alternatives, says Galloway.
Medications: No drug helps with stress incontinence, but a class called anticholinergics does help with urge incontinence.
A transdermal patch called Oxytrol has also been effective, says Galloway, who adds that skin irritation at the patch site does occur in some patients.
Surgery: There are 300 surgical options to treat incontinence, says Brubaker.
“The hard part is picking the surgery that has the best chance of working well for that woman long-term,” he says. “Surgery can create problems. It can cause difficulty in urinating, worsen an urge incontinence problem, or it can do nothing to solve the problem.”
A large NIH study is examining the use of a sling — a medical device that is surgically inserted into the vagina and positioned underneath the urethra, says Brubaker.
“It helps the urethral sphincter remain closed when abdominal pressure tries to open it. At least, we think that’s how it works,” he says. “We have only five-year outcomes on one group of these devices. But they look promising.”
The Link Between Weak Bladder And Oab
When the smooth muscle within the bladder becomes overactive, it can lead to improper contraction and relaxation of the muscle. Problems in the nerves that stimulate the bladder, as well as some neurological conditions, may lead to OAB.
According to the Urology Care Foundation, as many as 30% of men and 40% of women in the United States have OAB symptoms.
The muscles in the lower abdomen that support the bladder and urethra are known as the pelvic muscles. For women, these muscles often stretch and weaken during pregnancy and childbirth, which can cause organs in the abdomen to shift.
A lack of muscle support around the bladder can cause sagging, which can lead to leakage. This can lead to stress incontinence, which often results from a mix of OAB and urge incontinence.
If a person is experiencing frequent urination or having urine leakage after a sudden urge to urinate, it may be time to talk with a doctor about treatment options to help with OAB.
However, there are also several lifestyle changes that a person can make to help to calm the bladder muscle, which may help improve OAB symptoms. Read on to learn more.
The sections below provide suggestions for ways to help manage a weak bladder, which may also improve OAB symptoms.
Treatment For Urge Incontinence
There are several different types of treatment for urge incontinence.
- Bladder training. This is usually the first treatment. Youll be asked to do it for six weeks to see if it works. The training includes lengthening the time between planned visits to the toilet. Distraction and relaxation techniques help you control the urge to pee.
- Medicines. Your doctor may offer medicines called anticholinergics . These help to stop the muscle in your bladder from tightening when it shouldnt. They can take about a month to work and can cause a dry mouth and constipation. But these can be signs that the medicine is working.
If these treatments dont work, there are other options.
- Botulinum toxin A. This is injected into the wall of your bladder. It helps to stop the muscle in your bladder being overactive.
- Nerve stimulation. This involves sending electrical signals to the nerves that control your bladder.
- Surgery. There are two main types of surgery for urge incontinence. One involves making your bladder bigger . The other redirects urine away from your bladder into a bag . Both are major operations and only used if other treatments havent worked.
Each treatment comes with risks and benefits. Talk to your doctor about your treatment options. Make sure you have all the information you need to decide whats best for you.
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Limit Caffeine And Alcohol
Caffeine and alcohol have a diuretic effect on your body. That means they increase the amount of urine you produce. If youre having trouble controlling your bladder, consuming caffeinated beverages may be contributing to the problem.
To help manage your symptoms, consider limiting caffeine and alcohol, or avoiding them altogether. Coffee, tea, soda, chocolate, and certain medications are common sources of caffeine.
Tips To Get Your Bladder Under Control
Take control of your bladder
Do you find yourself struggling to make it to the bathroom in time? Urinary incontinence is a common condition. Your doctor can help you understand whats causing it and recommend a treatment plan.
Lifestyle changes can also help get your bladder under control. Learn about six steps you can take to reduce your risk of accidents and help you get back to enjoying everyday activities, leak-free.
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Why Some Teenagers Also Suffer From Incontinence
We tend to associate uncontrolled urination either with very young children or the elderly. Although it tends to be more common in older people, incontinence can, however, strike at any age.
The involuntary leakage of urine can be embarrassing and confusing at first but most people quickly learn how to manage the situation.
According to Incontinence United Kingdom, urinary incontinence occurs in 3% of fifteen- to sixteen-year-old teenagers. A longitudinal study also showed that one-third of children who experience urinary incontinence in their younger years, will have the condition through puberty and beyond.
Another study by the University of Bristol and published in the British Journal of Health Psychology, showed that in young people urinary incontinence can have a far-reaching impact on their studies and social life. It found that teenagers are hesitant to speak up about their continence problems to their parents, friends and medical professionals due to embarrassment and fear of being teased.
However, hiding the issue will not only have a psychological effect, but may be dangerous if there’s an underlying medical problem that’s causing the incontinence.
Reasons why teenagers experience incontinence
To start proper incontinence management, its important to establish the cause of the condition. There are different types of incontinence:
These types of incontinence can be caused by many factors such as:
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Does Sex Cause Oab
A healthy sex life doesnt cause OAB. In fact, for women, a healthy sex life could actually help OAB. Vaginal contractions during intercourse and orgasm are a workout for the muscles of the pelvic floor, also known as Kegel muscles. Strong Kegel muscles can help women with OAB control urination by strengthening their pelvic floor.
Is Incontinence More Common In Women
Incontinence is much more commonly seen in women than in men. A large part of this is because of pregnancy, childbirth and menopause. Each of these events in a womans life can lead to bladder control issues. Pregnancy can be a short-term cause of incontinence and the bladder control issues typically get better after the baby is born. Some women experience incontinence after delivery because of the strain childbirth takes on the pelvic floor muscles. When these muscles are weakened, youre more likely to experience leakage issues. Menopause causes your body to go through a lot of change. Your hormones change during menopause and this can alter your bladder control.
Men can also experience incontinence, but it isnt as common as it is in women.
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Urinary Incontinence In Children
The prevalence of urinary incontinence is 6.39 % in 7-year-olds and 1.14.2 % in children aged 1113 years . General paediatric guidelines distinguish between urinary incontinence related to an overactive bladder, delayed micturitions, bladder sphincter dyssynergia/discoordination, combined forms, giggle incontinence, bladder dysfunction and constipation-related incontinence . Urinary incontinence significantly impairs the quality of life and self-esteem of affected children . In 2015, Maternik et al. published a good review of incontinence as well as the testing and treatment of children.
In general practice, assessment is limited to the medical history, clinical examination and evaluation of drinking/diuresis diaries. In addition, the urine can be tested with urine dipsticks and bacterial cultures if appropriate. General practitioners can also request ultrasound of the kidneys/urinary tract, but if a non-functional cause of incontinence is suspected, the child should be referred to a paediatrician. The Norwegian Enuresis Forum has useful information and micturition diaries available for download from its website .
What Is Urinary Incontinence
Urinary incontinence is the accidental loss of urine. According to the National Association for Continence, over 25 million adult Americans experience temporary or chronic urinary incontinence. UI can occur at any age, but it is more common among women over 50. Urinary incontinence may be a temporary condition that results from an underlying medical condition. It can range from the discomfort of slight losses of urine to severe, frequent wetting.
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How Is Urinary Incontinence Diagnosed
For people with urinary incontinence, it is important to consult a health care provider. In many cases, patients will then be referred to an urogynecologist or urologist, a doctor who specializes in diseases of the urinary tract. Urinary incontinence is diagnosed with a complete physical examination that focuses on the urinary and nervous systems, reproductive organs, and urine samples.
Bladder Leakage 3 Things Women Should Know About Urinary Incontinence
To dispel misconceptions, a urogynecologist discusses the surprisingly common, lingering issue many women experience.
Bladder leakage. For some women, the condition runs their life from the inside, preventing them from playing outside with their kids, going to a workout class or staying the night with family or friends.
And theyre not alone. Living with some degree of urinary incontinence, defined as an uncontrolled leakage of urine, is actually common, according to Pamela Fairchild, M.D., a urogynecologist at Von Voigtlander Womans Hospital at Michigan Medicine.
She says that approximately half of all women over the age of 20 experience some degree of incontinence. This means urinary incontinence isnt just an issue that affects elderly or postpartum women, although aging and childbirth are risk factors.
But if so many women experience it, then why does the topic still seem embarrassing?
Women get the sense that this is inevitable, that its a natural part of aging and they have to live with it, says Fairchild. This false perception leaves women feeling powerless, even though there are ways to greatly improve their quality of life.
To help overcome the stigma, Fairchild shared three facts about urinary incontinence that all women should know.
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When To Seek Medical Advice
See a GP if you have any type of urinary incontinence. Urinary incontinence is a common problem and you should not feel embarrassed talking to them about your symptoms.
This can also be the first step towards finding a way to effectively manage the problem.
Urinary incontinence can usually be diagnosed after a consultation with a GP, who will ask about your symptoms and may do a pelvic or rectal examination, depending on whether you have a vagina or a penis.
The GP may also suggest you keep a diary in which you note how much fluid you drink and how often you have to urinate.
Find out about diagnosing urinary incontinence.
What Causes Poor Bladder Control
Pelvic floor muscles help to hold urine in the bladder. Urine may leak out when you laugh, cough or sneeze if your pelvic floor muscles are weak. Pelvic floor muscles can be weakened by pregnancy and childbirth. You can also leak when you are active. Urine might leak when you exercise, get out of bed or stand up. If these muscles are weak already, getting older or being overweight can make them even weaker. Constipation can mean you need to strain to empty your bowels. This straining can also weaken your pelvic floor muscles.
Some people have a bladder muscle that does not contract well. The bladder may not empty out fully. These people have trouble passing urine normally.
Any pressure on the urethra can cause it to narrow. This makes it difficult to get urine out of the bladder. This can happen in men due to an enlarged prostate. A prolapse of the uterus can affect how the bladder empties in women.
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Urinary Incontinence In Women Facts
*Urinary incontinence in women facts medical author: Melissa Conrad Stöppler, MD
- The definition of urinary incontinence in women is the unintentional loss of urine.
- Urinary incontinence occurs more often in women than in men. Pregnancy, childbirth, and menopause may contribute to urinary incontinence in women.
- Weak bladder muscles, overactive bladder muscles, and nerve damage may also cause urinary incontinence in women.
- Urinary incontinence in women is common and treatable.
- There are different types of urinary incontinence in women, including stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, mixed incontinence, and transient incontinence.
- Diagnosis of urinary incontinence in women may involve a physical exam, an ultrasound, urodynamic testing, and tests including cystoscopy, urinalysis, and a bladder stress test. The doctor will also take a medical history and may recommend keeping a bladder diary.
- Treatment of urinary incontinence in women may include behavioral or nonpharmacologic treatments, like bladder training and Kegel exercises, medication, biofeedback, neuromodulation, surgery, catheterization, or a combination of these therapies.
- Research is ongoing to discover new and better treatments for urinary incontinence in women.
Treatments For Urgency Incontinence
Urgency incontinence is when you get the urge to go, and if you dont make it to a bathroom, your bladder will empty. It can have serious effects on your life and your work.
Experts dont know what causes urgency incontinence, but there are different ways to approach it. First we start with behavioral changes, which vary based on your situation. Steps could include:
Weight loss again, losing even a small amount of weight can help.
Avoiding excess fluids. If youre having trouble sleeping, we talk about limiting fluids before bedtime so sleep is less interrupted.
Time voiding, which is retraining the bladder. If the patient is in the bathroom every hour, well slowly lengthen that interval so theyre in the bathroom less often.
Pelvic floor exercises, with help from a physical therapist.
Changing your diet. I review a list of bladder irritants: coffee, chocolate, alcohol, spicy foods, and other things. We have patients skip those foods and drinks for a week or two and see what their urgency or frequency is like.
If behavioral changes dont help, there are other options to explore. We can try certain medications that relax your bladder muscles and prevent leakage. Botox, injected into the muscles of the bladder, can help some patients temporarily. And there are several medications we can try, including anticholinergics, which block the impulse to urinate. This can help you get more sleep at night.
What Are Kegel Exercises
Kegel exercises, also called Kegels or pelvic floor muscle training, are exercises for your pelvic floor muscles to help prevent or reduce stress urinary incontinence. Your pelvic floor muscles support your uterus, bladder, small intestine, and rectum.
Four in 10 women improved their symptoms after trying Kegels.9 Kegels can be done daily and may be especially helpful during pregnancy. They can help prevent the weakening of pelvic floor muscles, which often happens during pregnancy and childbirth. Your pelvic floor muscles may also weaken with age and less physical activity.
Some women have urinary symptoms because the pelvic floor muscles are always tightened. In this situation, Kegel exercises will not help your urinary symptoms and may cause more problems. Talk to your doctor or nurse about your urinary symptoms before doing Kegel exercises.
How Is Incontinence Treated
There are many different factors that your healthcare provider will consider when creating a treatment plan for your incontinence. The type of incontinence and the ways it affects your life are both big considerations. Your provider will also talk to you about the type of treatment you are most comfortable with. There are three main types of treatment you can explore for incontinence medications, lifestyle changes and surgery. Each option has pros and cons that your provider will discuss with you.
Medications to treat incontinence
There are quite a few medications that can reduce leakage. Some of these drugs stabilize the muscle contractions that cause problems with an overactive bladder. Other medications actually do the opposite thing relaxing muscles to allow your bladder to empty completely. Hormone replacement therapies can often involving replacing estrogen thats decreased during menopause may also help restore normal bladder function.
In many cases, medications can work very well to return normal function to the bladder. Your provider will carefully select a medication that matches your specific needs. Often, your provider will start you on a low dose of the medication and then increase it slowly. This is done to try and reduce your risks of side effects and to keep track of how well the medication is working to treat your incontinence.
Common medications that can be used to treat incontinence include:
Lifestyle changes to manage incontinence
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