Urinary Incontenence

What Is Urinary Incontinence?

Urinary incontinence is the involuntary and unwanted loss of urine. It may range from leaking a few drops when you cough or laugh - to constant dribbling - to having the entire bladder empty suddenly without warning.

Urinary incontinence is not an inevitable result of aging. It is a very common condition, with more than 15 million American adults affected. Urinary Incontinence occurs twice as often in women, but is not unusual in men.

Many people suffering from urinary incontinence are too embarrassed to seek help, but if left untreated incontinence can increase the chance of skin irritation, urinary infection and the risk of developing bedsores.

With the help of medical treatment, many men and women have been able to overcome or improve their urinary incontinence problems and lead normal, healthy lives. In most cases, urinary incontinence can be treated successfully or at least controlled.

What Causes Incontinence?

Urinary incontinence can be caused by many physical conditions. Many causes of incontinence are temporary and can be managed with simple treatment. Our practitioners can find the exact cause of your incontinence and design a treatment program that best suits you and helps you regain control of your bladder.

Types Of Incontinence

There are many different types of incontinence, and some people suffer from more than one type of incontinence. Identifying the type you are experiencing is the first step toward finding the appropriate treatment. The three most common types of incontinence are urge incontinence, stress incontinence and overflow incontinence.

Urge Incontinence

Urge Incontinence is a sudden, urgent need to urinate, with leakage before you reach the toilet. People with urge incontinence lose urine as soon as they feel a strong urge to go to the bathroom. The most common cause of urge incontinence is involuntary bladder contractions.

Stress Incontinence

Stress incontinence is characterized by the loss of urine when exercising or moving in a certain way. It is usually due to weakened pelvic floor muscles, and the increased physical pressure on the bladder. Stress incontinence is most common among women who have had multiple children.

Overflow Incontinence

Overflow incontinence is the unwanted loss of urine associated with the feeling of never completely emptying the bladder. Most people with overflow incontinence experience a frequent or constant dribbling of urine. It is usually caused by either a blockage of the outflow of the urinary tract such as an enlarged prostate, or an underactive or poorly contracting bladder which does not sense the filling of urine.

Finding the Cause

It is important that you speak openly and honestly about your medical history and urinary habits with your practitioner. A good history should include the exact periods of incontinence and the voiding patterns of the patient. Because the bladder has the same nerve roots as the bowel and sexual function, these should also be included in the history. We may ask you to keep a chart of your voiding patterns to help us make a firm diagnosis.

After establishing your medical history, your practitioner will perform a physical examination and a urinalysis. A physical examination for a woman should include a complete abdominal, pelvic and rectal exam. A man's physical exam consists of an abdominal, genital and rectal exam. Each examination is necessary for identifying possible masses, and testing the nerve function of the muscles of the perirectal area. A urinalysis detects any sign of infection. In some patients, more specialized tests are required. A urodynamic evaluation may be ordered to aid in diagnosis. This comprehensive test measures total bladder function.

Additionally, measurement of the amount of urine left in the bladder after voiding, and in some patients the urinary flow, assists the practitioner in making a diagnosis. A urodynamic evaluation maybe ordered to aid in diagnosis. This comprehensive test measures total bladder function.

What Treatment Is Available?

Once the type and cause of your urinary incontinence is known, treatment can begin. It is most often treated by one or more of the following methods:

  • Behavioral Techniques

  • Pelvic Floor Rehabilitation

  • Medication

  • Surgery

  • Products can be used to help manage incontinence, such as pads and catheters.

Each treatment is personalized to your needs and diagnosis. Oftentimes, several treatment options will be available to the patient. Your practitioner will discuss each option with you and recommend the treatment best suited for you and your needs.

Pelvic Floor Rehabilitation

Pelvic Floor Rehabilitation is a relatively new therapy in the treatment of incontinence, overactive bladder and pelvic pain disorders. It offers an alternative to more conventional treatments, and has proven successful in 80-90% of patients receiving therapy. It can be used as a stand-alone therapy or in conjunction with other treatments.

Treatment includes diet, exercise and behavior modification. Patient participation and compliance are required to successfully treat the condition and provide a positive outcome. Approximately 6-10 visits are necessary for initial treatment followed by maintenance treatments every 6 months.

The initial consultation lasts about one hour. It includes an in depth evaluation of symptoms and behaviors, a physical examination and formulation of a treatment plan followed by therapy consisting of mild electrical stimulation to the pelvic floor muscles via a vaginal or rectal sensor. This treatment is not painful. It simply causes the contraction of the muscle and feels like Kegel's exercises.

Follow up visits are scheduled in 45 minute increments and include re-evaluation of symptoms and a treatment.

Specific exercises are given to the patient to be done at home as well as tips on diet and behavior modification.

Most insurance companies will cover the cost of treatments. Unfortunately, patients with pacemakers are ineligible for this therapy.

If you would like more information about urinary incontinence, or would like to schedule an evaluation at Southeastern Urological Center, P.A., please call (850) 309-0400 or toll free, (800) 689-6678.