Don’t Suffer in Silence - Seek Treatment for Urinary Incontinence
by Margaret Minuth
November 2009
Approximately 25 million American adults experience loss of bladder or bowel control, but they often don’t have to. According to the National Association for Continence, 80 percent of those affected by urinary incontinence can be cured or significantly helped. For some people, this involuntary release of urine can affect their quality of life. Women are twice as likely as men to experience incontinence; approximately 10 percent of people over the age of 65 have this potentially embarrassing problem.
Incontinence is a symptom, not a disease. On a temporary basis, it can be caused by vaginal infections, constipation, or certain medications. Persistent urinary incontinence may be caused by weakness of the bladder or the muscles supporting it, overactive bladder muscles, or urinary tract blockage.
There are four types of urinary incontinence:
- Stress incontinence happens when certain activities such as coughing, sneezing or laughing increase abdominal pressure on the bladder.
- Urge incontinence occurs when the need to urinate happens too quickly for the person to get to the bathroom in time.
- Overflow incontinence involves small amounts of urine leaking from a bladder that never empties completely.
- Functional incontinence affects people with normal bladder control, but who cannot get to the bathroom quickly due to physical limitations that make moving difficult such as arthritis.
Once the cause of urinary incontinence has been identified, treatment options usually fall into three main categories.
Behavioral techniques require making certain lifestyle changes. For example, setting up a schedule to go to the bathroom every two to four hours or retraining the bladder to gradually extend the time between bathroom trips. Pelvic floor muscle exercises, also called Kegel exercises, are recommended to strengthen the muscles below the bladder that control urination.
Medications can be prescribed to treat an overactive bladder, or urge incontinence. These drugs block nerve impulses to the bladder, decreasing the urgency and frequency of urination. Men with an enlarged prostate resulting in urinary incontinence may benefit from other drugs called alpha-blockers that relax the prostate and bladder neck, improving urine flow. There are no drugs approved for stress incontinence.
Medical devices or surgery are also available to treat incontinence. Women can use a urethral insert (a small tampon-like disposable device) or pessary (a vaginal insert) to help manage stress incontinence. More than 200 variations of surgical procedures can be performed to treat causes of urinary incontinence. These include placement of an artificial urinary sphincter to control urine flow, injection of a bulking agent (such as collagen) into the urethra to create resistance against urine flow, or implantation of a sacral nerve stimulator to help control the bladder. A bladder neck suspension, or sling procedure, can be done to help hold up the bladder and narrow the urethra to prevent leakage.
Urinary incontinence should not be suffered in silence. Hiding incontinence can lead to rashes, sores, and skin or urinary tract infections. Talk to your doctor about your signs and symptoms as well as your options. For more information visit the National Association for Continence Web site at nafc.org.
Margaret Minuth is Director of Marketing for Central Carolina Hospital in Sanford.