Patients should start a dialogue if experiencing symptoms of urinary incontinence sooner rather than later, so that your physician can help you better understand the causes. Additionally, your physician can offer guidance about the best treatment options.
There is no reason to suffer in silence from a sense of shame or embarrassment. Urinary incontinence is a common condition and it is highly treatable.
Here’s a brief list of FAQ’s to help you start a discussion with your physician.
What Are The Symptoms of Urinary Incontinence?
Patients can present with a wide variety of symptoms, but some of the most common are:
More frequent urination
Stronger urge to urinate
Pressure-induced leaking (while coughing, for example)
Waking from sleep to urinate, or leaking while sleeping
Are There Different Types of Urinary Incontinence?
Yes. Women experience three primary types of incontinence:
SUI—stress urinary incontinence, which can occur when pressure is exerted on the bladder. Many women experience leaking when coughing, laughing or exercising.
Urgency Urinary Incontinence— a sudden and intense need to urinate which is often hard to stop. This may result in leakage as a patient makes their way to a bathroom.
Mixed Incontinence— a combination of SUI and Urgent Urinary Incontinence
Is An “Overactive Bladder” The Same as Urinary Incontinence?
An “overactive bladder” (OAB) usually presents as an urgent, frequent need to urinate. It may or may not include urinary incontinence. Your doctor will likely take a detailed medical history and perform a pelvic exam to diagnose OAB, urinary incontinence, or a combination of both.
What Causes Urinary Incontinence?
There are many causes of urinary incontinence which can result in the types listed above, including:
UTI.The presence of a urinary tract infection (or UTI), which can be easily treated with antibiotics.
Diuretic medications.Taking diuretic medications which can cause your body to produce more urine. Your doctor will go over medications you are taking to identify if any might be the culprit of your symptoms.
Lifestyle factors. Your symptoms may be connected to regular consumption of caffeine, alcohol or sparkling water, or may be the result of ingesting high doses of Vitamin C, or even eating spicy or acidic foods.
Pelvic floor disorder. A pelvic floor disorder caused by weakened muscles and tissues of the pelvic floor.
Long term constipation, especially in older women. Because the rectum is located near the bladder and shares many of the same nerves, hard or compacted stool can cause these nerves to be overactive.
What Can I Expect When I See My Doctor?
Your physician will take a detailed medical history, and ask you to describe or demonstrate signs and symptoms you’ve noticed.
Sometimes doctors ask patients to fill out a bladder diary over the course of several days. This can provide good data about frequency, urgency, and volume of urine produced.
Your doctor may perform a pelvic exam to check for pelvic organ prolapse or other anatomical factors which can cause urinary incontinence.
Finally, your doctor may use diagnostic tools like imaging and bladder function tests to better understand the cause of urinary incontinence.
What Are Some of the Treatments Available?
In some cases lifestyle or behavioral modifications may help reduce the incidence of leakage.
For some patients, weight loss can help reduce urine leakage. Your doctor may recommend you manage your fluid intake by limiting the amount or type of fluid you ingest each day. In other cases, your doctor may advise you to avoid substances like caffeine or alcohol.
Your doctor may also recommend that you do Kegel exercises to help strengthen the pelvic floor. Another option is biofeedback techniques that measure the force of pelvic muscle contraction to help you locate the correct muscles to use when controlling urine flow. Both are effective physical therapies commonly used to treat urinary incontinence.
Can Medications Help?
Yes. There are a number of effective medications available to treat this condition.
Some help calm muscle spasms or unwanted bladder contractions that can cause urinary incontinence, and alleviate the frequent, urgent need to urinate. Others, injected directly into the muscle of the bladder, inhibit unwanted contractions, and can last anywhere from 3 to 9 months.
Another medication relaxes the bladder muscle, which allows the bladder to store a higher volume of urine, and is effective in treating urgency urinary incontinence.
Is Surgery An Option?
After doing a thorough evaluation to determine the type and cause of your urinary incontinence, your doctor may recommend a surgical procedure to best address the problem. There are a number of effective techniques, but common procedures include:
Sling surgery: A narrow strap made from either your own tissue or synthetic material is inserted to lift and support the urethra.
Urethral Bulking: A synthetic substance is injected into the tissue surrounding the urethra which act to narrow and thicken the opening of the urethra.
Colposuspension: The urethra is lifted and held in place using stitches attached on either side of the bladder neck connected to surrounding, supporting structures.
There are a number of other procedures which could be effective in treating your type of urinary incontinence, including ones that use nearby nerve tissue to control the bladder, or a procedure similar to acupuncture called percutaneous tibial nerve stimulation, or PTNS. Your doctor will walk you through the details if these procedures are recommended.
Don’t Put Off Talking With Your Doctor
What many of my patients don’t realize is that urinary incontinence is a very common condition, with lots of effective options available for treatment.
While very treatable, its symptoms can have a big impact, affecting daily life, and in some cases, limiting a patient’s ability and desire to interact and engage in activities that used to give them joy.
If you’re experiencing symptoms, call your doctor’s office today to set up an appointment.
For more information about urinary incontinence, we invite you to talk with your 4HER coordinator Johnson Memorial Women's Health Specialists.