Types of Urinary Incontinence
Stress Incontinence: the most common
SYMPTOMS: Loss of urine with coughing, sneezing, laughing, lifting, exercise or maybe just walking. The increased pressure created on the bladder by these activities overcomes the muscular support of the urethra allowing urine to escape.
CAUSES: Pregnancy, impact exercise activity, abdominal or pelvic surgery, pelvic organ prolapse,
change in hormone status.
Urge Incontinence: the second most common (overactive bladder)
SYMPTOMS: Sudden uncontrollable loss of urine usually associated with a strong urge to void. May be precipitated by hearing water running, arising from a sitting position, getting out of bed, seeing a bathroom, or starting to enter your house.
CAUSES: Urinary tract infections, Diabetes, neurologic conditions, hormone changes, prior bladder or pelvic surgery, radiation, Pelvic Organ Prolapse, or it can develop without any apparent cause.
SYMPTOMS: combination of both Stress Incontinence and Urge Incontinence
SYMPTOMS: Usually a constant seepage of small amounts of urine associated with the occasional loss of large volumes of urine when the individual coughs, laughs or moves. May also have significant urinary frequency, getting up frequently at night and wetting the bed while asleep.
CAUSES: Certain medications such as pain medication, muscle relaxants, antidepressants, and medications for overactive bladder are just a few. Other causes are diabetes, spinal cord injuries, neurologic conditions and Pelvic Organ Prolapse.
SYMPTOMS: A person is aware of the need to urinate but is unable to get to the bathroom in time.
CAUSES: Debilitating injuries or illnesses.
Diagnosing Urinary Incontinence
While the most important factor in diagnosing Urinary Incontinence is your medical history, there are some tests that be conducted to determine the type of Urinary Incontinence you are experiencing. These test include:
- URINALYSIS: microscopic evaluation of your urine
- RESIDUAL URINE: Measurement of how much urine is left in the bladder after a person voids
- CYSTOSCOPY: Looking in the bladder with a small flexible telescope.
- STRESS TEST: Placing saline into the patients bladder and asking her to cough or strain to see if incontinence occurs.
- URODYNAMIC TESTING: Series of advanced test that gives the physician a detailed report on the function of the bladder, urethra and pelvic floor support structures.
Treatment for Urinary Incontinence
There are surgical and non-surgical options for the treatment of Urinary Incontinence.
Non‐Surgical Treatment Options
Non‐surgical treatments apply to all types of urinary incontinence. These options are more effective for
lesser degrees of incontinence. These include:
- Pelvic Floor Exercises: Either with a physical therapists who specializes in pelvic floor disorders and urinary incontinence or performing Kegel exercise at home
- Lift Style Changes: Weight loss, Dietary changes,Yoga, Smoking cessation
Surgical Treatment Options
Surgical treatments for Urinary Incontinence are minimally invasive, performed on an outpatient basis and are very effective. Procedures include:
Sling: The most successful treatment for Stress Urinary Incontinence. It is composed of a "polypropelene" mesh that is inserted underneath the urethra to provide the needed support. The success rate is greater than 90%.
Bulking Agents: This is used for a specific type of Stress Urinary Incontinence. A thick liquid compound is injected into the urethral wall to close the urethral channel tighter. This is a temporary "fix" and may last 2 to 12 months.
Sacral Nerve Stimulation: Indicated for Urge Incontinence in patients who have failed with medications. A small wire or electrode is placed on the nerves that help coordinate the bladder function. This wire is connected to a small implantable pacemaker that sends a low level stimulation to the bladder and pelvic floor.