Female Health Associates of N. Texas on Urinary Incontinence

Urinary Incontinence – Are You Ready to Reclaim Control

If bladder control problems are keeping you from enjoying your life, you are not alone. This problem afflicts approximately 13 million adults in the United States with 85% of them being women. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference.

“If you are having problems with incontinence, talk with your physician,” says Dr. Jeff Hantes, Director of Urogynecology at Texas Health Harris Methodist Hospital in Fort Worth. “You do not have to live with the pain or embarrassment keeping you from enjoying activities with your family and friends. There is a whole realm of available treatments to help you reclaim control of your life.”

Types of Urinary Incontinence

Stress Coughing, laughing, sneezing, or other movements that put pressure on the bladder which cause urine to leak. Physical changes resulting from pregnancy, childbirth, and menopause often cause stress incontinence.
Urge Loss of urine for no apparent reason after suddenly feeling the need or urge to urinate.
Overactive Bladder Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. Voiding more than seven times a day may be an indication of overactive bladder.
Functional Untimely urination because of physical disability, external obstacles, or problems in communicating that prevents a person from reaching a toilet.
Overflow Unexpected leakage of small amounts of urine because of a full bladder.
Mixed Stress and urge incontinence often occur together in women. Mixed incontinence may be the most common type of urine loss in women.

How is Incontinence Evaluated?

The first step toward relief is to see a doctor who has experience treating incontinence. A urologist specializes in the urinary tract. A urogynecologist focuses on the female urinary tract and associated pelvic problems. Either of these doctors may be able to help you.

To diagnose the problem, your doctor will discuss your symptoms and medical history. You will then receive a physical examination for signs of medical conditions causing incontinence, including a condition called prolapse, which is a weakness of the pelvic floor where the vagina or bladder begins to protrude out of your body.

Other tests your doctor may recommend include:

  • Bladder stress test—You cough vigorously as the doctor watches for loss of urine from the urinary opening.
  • Urinalysis and urine culture—Laboratory technicians test your urine for evidence of infection, urinary stones, or other contributing causes.
  • Ultrasound—This test uses sound waves to create an image of the kidneys, ureters, bladder, and urethra.
  • Cystoscopy—The doctor inserts a thin tube with a tiny camera in the urethra to see inside the urethra and bladder.
  • Urodynamics—Various techniques measure pressure in the bladder and the flow of urine.

How is Incontinence Treated?

Behavioral Remedies

Your doctor may suggest using the bathroom at regular timed intervals, a habit called timed voiding. As you gain control, you extend the time between scheduled trips to the bathroom.

Medicines for Overactive Bladder

For an overactive bladder, medication may be prescribe to block the nerve signals that cause frequent urination and urgency.

Pelvic Muscle Therapy

Pelvic Muscle Therapy can provide long-term gains as pelvic floor muscles are retrained, strength is improved and pain is eliminated. To relieve incontinence, exercises are introduced to target key muscles. During each exercise, biofeedback equipment monitors electrical impulses of the working muscles in order to educate patients and improve exercise effectiveness.

Neuromodulation

For urge incontinence not responding to behavioral treatments or drugs, stimulation of nerves to the bladder leaving the spine can be effective in some patients. Neuromodulation is the name of this FDA approved therapy.

Surgery for Stress Incontinence

In some women, the bladder can move out of its normal position, especially following childbirth. Surgeons have developed different techniques for supporting the bladder back to its normal position, primarily retropubic suspension and sling procedures.

If you are one of the millions of Americans who suffer from urinary incontinence, speak to a physician who has experience in the treatment of the disorder. You can regain the freedom to live spontaneously, without constantly looking for the nearest restroom.