Urinary Incontinence: Types and Treatments
Urinary incontinence may be common, but it’s not normal. Although it occurs more as people get older, it is not a normal part of aging.
More than 13 million Americans of all ages have some type of urinary incontinence, and about 85% of them are women. It can interfere with a person’s lifestyle, relationships and job. Fortunately, there are many treatment options available.
Urinary incontinence is a pelvic floor dysfunction that results in the loss of voluntary control of urinary function. It may consist of the loss of a few drops of urine while coughing or laughing, or urine loss with a sudden urge to urinate.
Types of urinary incontinence are:
Stress incontinence – This is a loss of urine when the abdomen is under physical stress, such as when a person is laughing, coughing or lifting something heavy.
Urge incontinence – This is a sudden, strong urge to urinate combined with an uncontrollable leakage of urine.
Mixed – A person can experience a combination of stress and urge incontinence.
Neurogenic – Nervous system injury or damage, such as with Parkinson’s disease or stroke, can sometimes cause loss of bladder control.
Overflow – This describes a rare condition in which there is a frequent or constant dribble of urine.
Stress and urge incontinence are the most common types. Physical fitness activities that involve high-impact aerobics, running and lifting have contributed to a rise in stress incontinence among people as young as their 20s.
Treatment options for stress incontinence include:
- Behavior techniques, such as restricting liquids, practicing Kegel exercises and consulting with a pelvic therapy specialist. For many patients, pelvic therapy can dramatically improve in stress incontinence.
- Minimally invasive surgery to place a mid-urethral sling. This procedure corrects stress incontinence by supporting the bladder neck and urethra in their natural position. After a sling procedure, most women can once again regain control of their bladder.
Treatment options for urge incontinence include:
- Behavior techniques, such as restricting liquids, practicing Kegel exercises and consulting with a pelvic therapy specialist.
- Drug therapy. There are many medications designed to help control urge incontinence.
- Medications such as Botox injected into the urethra or bladder. These are effective, but they are temporary. Injectable agents need to be repeated at regular intervals.
- Sacral nerve stimulation. This is a minimally invasive, reversible treatment in which a device called a neurostimulator is surgically placed beneath the skin of the buttocks, near the sacral nerves. The device delivers electrical impulses to the sacral nerves, which regulate bladder activity.
If these treatments are not effective, urinary incontinence can be managed with self-catheterization, pessaries inserted in the vagina for pelvic floor support, or by wearing absorbent products such as pads. Fewer than 5% of patients fall into this category. Most cases of urinary incontinence can be helped with treatment. If a person’s lifestyle is affected by urinary incontinence, they should talk with their primary care provider or a urologist.
Request an appointment at Washington Regional Ozark Urology Clinic.