At Memorial Hermann, affiliated specialists use technologically advanced equipment to create comprehensive, personalized diagnostic evaluation and treatment plans for men's and women's incontinence and pelvic floor disorders.
Urinary incontinence, the most common pelvic floor disorder, is a urinary condition relating to the involuntary release of urine due to a loss of bladder control. Its severity varies from person to person. Some may "leak" a few drops of urine when they cough, laugh, sneeze or exercise. Others may feel strong, sudden urges to urinate that can’t be controlled. Others may lose some urine during sexual activity.
In normal urinary function, the neck (end) of the bladder is closed. The sphincter muscles are closed around the urethra (the tube that carries urine out of the body) which prevents urine from leaking. Upon urination, the brain sends a signal to the bladder to contract the bladder muscles, to expel urine out through the urethra. Incontinence can occur when there is a disruption between the brain signal and the bladder muscles.
As many as 25 million Americans suffer from incontinence, but research estimate that less than half of this population have been evaluated and treated due to embarrassment of lack of information about available treatments. Urinary incontinence is not limited to older adults—young people, including athletic women, new mothers, and people coping with illness, birth defects or physical trauma, such as surgery or spinal cord injuries are also affected.
There are three main types of urinary incontinence:
This occurs when urine accidentally leaks out when a person laughs, coughs, sneezes, exercises or lifts heavy items. This leakage is due to weakened and/or stretched pelvic muscles. Stress urinary incontinence is more common in older women but not as common in men. The most common symptom is the accidental leaking of urine with activity.
Stress incontinence can result from multiple vaginal births, pelvic surgery, chronic coughing, obesity, heavy lifting, frequent straining during bowel movements or pelvic organ prolapse.
When a person has a sudden urge to urinate, this is caused by urge incontinence or overactive bladder. Because urinary control is controlled by both the brain and the bladder, urge incontinence can scramble these signals and cause the brain to send a signal to urinate to the bladder even though it isn’t full. Or, the bladder will begin contracting in anticipation of urination when the bladder isn’t full – this causes the sudden “urge” to go. The most common symptoms associated with urge incontinence are:
Mixed incontinence is having more than one form of incontinence at the same time. The most common form of mixed incontinence is stress urinary incontinence with overactive bladder. Symptoms include: urinary leaking and a strong, sudden urge to urinate.
Overflow incontinence results in unwanted loss of urine associated with incomplete emptying of the bladder. Causes include obstruction of the bladder outlet in men due to prostate enlargement, pelvic floor disorders in women or neurogenic bladder caused by peripheral neuropathy, diabetes or spinal cord injury.
Transient incontinence is less common and can result from urinary tract infections, medications, urtheritis or chronic incomplete emptying of the bladder. Normally, this condition can be resolved by diagnosis and treatment of the underlying cause.
Urinary conditions affects both men and women. In the U.S., approximately 25% to 30% of men and women suffer from urinary incontinence.
It’s difficult to determine exactly how many people are affected by urinary conditions due to the embarrassing side effects that people avoid reporting to their doctors. Additionally, some may simply think the condition is a normal part of aging and simply not seek treatment.
Generally, there are several risk factors linked to urinary incontinence: diabetes, smoking, obesity and high blood pressure. Women are more likely to develop urinary incontinence due to childbirth and the additional pressure this puts on the pelvic area. Also, women in menopause are more likely to develop urinary incontinence due to lower estrogen rates in the body.
For men, those who experience problems with their prostate are more likely to have urinary incontinence.
There are specific medications one can take to help manage their symptoms and successfully treat urinary incontinence or overactive bladder.
The most commonly prescribed are those that prevent bladder spasms such as: Detrol, Ditropan XL, Enablex, Oxytrol, Urispas, and Vesicare. Some of these medications, or hormone therapy (Premarin® cream), will also be prescribed for overactive bladder.
Certain lifestyle changes can help address symptoms of urinary conditions and can be relatively easy to adopt. For stress related conditions, limiting one’s daily fluid intake can help prevent any accidental leakage of urine.
For urge incontinence, it may be helpful to avoid foods that can irritate the bladder such as spicy foods, caffeine, and carbonated drinks.
Kegel exercises are also helpful with strengthening the pelvic floor muscles and may aid with alleviating urinary incontinence symptoms.
Bladder training and timed voiding may be as effective or more effective for some types of urinary incontinence than treatment with medication.
There are medical devices specifically for women with urinary incontinence that may help treat the condition. The first is a urethral insert, which is similar to a tampon, and is inserted into the urethra prior to any physical activity to prevent accidental leakage. Another device is called a pessary which is similar to a diaphragm as it is inserted into the vagina to help support the bladder.
Radiofrequency therapy is a non-surgical approach to treat stress urinary incontinence. A small catheter-like device is inserted into the urethra where low level heat is applied to the bladder. The heat stimulates the collagen in the bladder tissue so that it becomes more firm to stop urine leaks during physical activity.
Primarily used for overactive bladder, Botox injections are administered into the bladder muscle to help strengthen bladder function.
Bulking agents are injected into the tissue of the urethra to keep it closed, preventing leakage.
Nerve stimulation using InterStim® therapy occurs when a device similar to a pacemaker is inserted under the skin. The device delivers electrical pulses to the sacral nerves that control bladder function.
There are several surgical treatment options for urinary incontinence:
Bladder Augementation offers patients who have not responded to other treatments for urge incontinence a surgical option. Memorial Hermann-The Medical Center offers minimally invasive robotic-assisted bladder augmentation for patients who qualify for the procedure.
Memorial Hermann is affiliated with highly qualified, experienced specialists and provides technologically advanced equipment for personalized diagnosis and treatment of men's and women's incontinence. Fill out our contact form to get started, or call us at (713) 242-4733.
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