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Women need not be embarrassed by incontinence
because much of the time it can be cured, or at least treated.
Behavioral techniques, exercise, lifestyle changes and medical
devices are often tried first. However, their success depends
on your ability to stick with them and on the severity of your
incontinence. Surgical techniques are minimally invasive and
can have quick recovery times.
Stress Incontinence
This is the involuntary loss of urine during physical activity
such as coughing, laughing or lifting. The muscles that support
the urethra (the small tube that carries urine out of the body)
and bladder neck have weakened, causing the urethra to drop
during physical activity, resulting in urine leaking out of
the body.
Urge Incontinence
This is the accidental leaking of urine that usually occurs
when there is a sudden strong urge to urinate and an inability
to get to the toilet in time. However, some people may leak
urine without warning.
Urodynamic Testing
This test evaluates the bladders function and efficiency by
measuring the volume and rate at which the bladder empties.
A thin, flexible tube (catheter) is inserted into the bladder
and the volume of any urine remaining after emptying is measured.
The bladder may also be filled with water to measure the point
at which you have the first urge to urinate.
Behavioral Techniques
Three types of behavioral techniques are used to treat urinary
incontinence: Bladder training, timed urination and prompt
voiding. With bladder training, you increase how long you can
wait before having to urinate by trying to delay urination
after you get the urge to go. With timed urination, you will
urinate every 2-4 hours during waking hours, even if you feel
as though you don't have to go. Prompt voiding requires a caregiver
to prompt the incontinent person to go.
Medication
If exercise and behavioral therapies are not successful, your
doctor might combine these treatments with medication that
relaxes the bladder and increases bladder capacity or may cause
the muscles at the bladder neck to contract.
Medical Devices
A pessary is a rubber device that is inserted into the vagina
and supports the urethra, thus helping to retain urine in the
bladder.
Surgery
Stress incontinence that does not respond to other therapies
is often treated with surgery. Surgery is typically not done
for urge incontinence. A tension free vaginal tape (TVT) is
a mesh like tape positioned under the urethra like a sling
or hammock to support it and return it to its normal position.
The tape is inserted through a small incision in your vagina
and pubic hairline. Other surgeries may include a retpubic
suspension and/or transobturator (TOT) tape, which is a mid
urethral sling, using polypropylene mesh.
Additional steps may reduce or eliminate your urinary incontinence.
Strengthening our pelvic muscles by performing pelvic floor
(Kegal) exercises every day, losing weight, quitting smoking,
trying to identify foods that may irritate your bladder, avoiding
alcohol and caffeine may help. |
