Treatment options for urinary incontinence

Urinary incontinence is a condition that affects more women than it does men. The number of individuals who suffer from urinary incontinence has prompted manufacturers to develop products which help these individuals to remain socially active without fear of an odor. A urologist or primary care physician will differentiate between the four or five different types of urinary incontinence before they are able to make an effective recommendation for treatment protocols. Because this condition has a high treatment success rate most individuals will find that with treatment they are either cured or their symptoms are improved significantly.

In some cases simple lifestyle or behavioral modifications will be enough to make significant changes. Some women find that certain foods or fluids will irritate their bladder and cause further difficulty with stress incontinence. At other times it may be necessary to only reduce fluids before bedtime.

Another modification can be made in the type of exercises done to increase the strength of the muscles that control the bladder. For instance, pelvic floor muscle exercises will help strengthen the muscles around the urethra so that there is much less likelihood of leakage even under pressure. In some cases the woman may have difficulty identifying her pelvic floor muscles for strengthening exercises. In this case specialists will often use biofeedback and electro-simulation as training aids. They have no side effects and are very effective.

At this time there are also several medications used to treat incontinence which help to prevent unwanted bladder contractions that place undue pressure on the urethra, they tightened the bladder or urethral muscles or relax the bladder muscles depending upon the issue or problem the woman may have.

When the issue is from an abnormal amount of space, collagen, or other space filling substances, can be injected into the area around the urethra to add bulk. This is an outpatient procedure done with local anesthesia or sedatives.

Botox is another option that could be injected into the muscle of the bladder. Botox blocks the release of chemicals that cause spasms. At this time it is not an FDA approved treatment and so is not covered by insurance companies. The injection is often given under anesthesia and effective for nine months to a year.

Some men or women respond well to timed urination or bladder training. This involves using a routine planned toileting in order to help train the bladder to hold the urine better. It involves voiding prior to feeling the urge to urinate.

In men who are having prostate issues, drugs may be used that include alpha blockers which relax the muscles of the prostate or 5-alpha reductase inhibitors used to reduce the size of an enlarged prostate.

Hormone replacement therapy has been recommended in the past in order to relieve menopausal type symptoms. The decreased amount of estrogen in the body changes the lining of the urethra and vagina which can contribute to the development of incontinence. Most experts no longer recommends using hormone replacement therapy strictly for the treatment of urinary incontinence but may consider it when a woman presents with multiple symptoms, all of which would be appropriately treated with hormone replacement therapy.

If medical and behavioral treatments are not successful some women will find it necessary to undergo surgical treatment. One option is a sacral nerve stimulator which is implanted under the skin in the abdomen. A wire is connected to this where the device sends an electrical impulse that controls the bladder and pelvic floor contractions.

A sling procedure is a strip of tissue or synthetic material that is surgically attached below the urethra and acts as a hammock. Following this procedure most people are able to control when urine is released and it is the most popular surgery for women and also available for men.

The last surgical procedure is an artificial sphincter. This is an implanted device used to control the opening in men who have urinary incontinence. Demand will trigger the release of urine using a pump that\’s implanted into the scrotum.

There are a number of interventional, medication and surgical procedures which are available to help treat urinary incontinence in both men and women. When the urologist or primary care physician has discovered the underlying cause of the problem they are best able to make recommendations for treatment protocols that have a higher rate of success. If you or someone you love has trouble with urinary incontinence do not allow embarrassment to keep you captive in your own home. Make an appointment with your physician today!

RESOURCES

MayoClinic: Urinary Incontinence: Treatments and Drugs

Mayoclinic: Bladder Control Problems: Medications for Treating Urinary Incontinence

American Family Physician: Selecting Medications for the Treatment of Urinary Incontinence

National Kidney and Urologic Diseases Information Clearinghouse: Urinary Incontinence in Women

NHS Choices: Incontinence, Urinary – Non-Surgical Treatm