Inconvenient Incontinence: Getting Control of the Leak
October 2019 Issue
One of the most dreaded conditions for women (and men) is urinary incontinence. Unwanted and untimely urine leakage is a problem that ranges from being inconvenient to completely embarrassing. Though it’s usually a topic discussed jokingly in women’s circles, urinary incontinence is truly no laughing matter. It can change a person’s lifestyle, making them not want to go out or socialize as much because of the chance of unwanted tinkling. The good news is urinary incontinence is not inevitable with age. In addition, there are many effective new treatments to consider. Read on to learn the various conditions of urine leakage—as they are not the same—and what you can do about it!
Is urinary incontinence inevitable as you age?
With some work you can help control an overactive bladder.
Aging incontinence, or overactive bladder, can be helped by learning behavioral therapy. Get in touch with a physical therapist to go over the steps, which they will lay out for your needs. Next, learn Kegel or pelvic floor muscle exercises to help strengthen the muscles of the urinary tract. How well this will work depends on your willingness to do the exercises on a regular basis.
You can also learn to train your bladder with scheduled bathroom trips. Create a time routine that will work for you, and then after a period of time, try to delay your trip a bit to see if you are doing better.
Monitor your fluid intake so you do not get dehydrated. You also will want to moderate or cut out alcohol and caffeine—they can be irritants for some people.
Supplements that may help are magnesium, vitamin D3 and Butterbur or Vinpocetine. These have been used in numerous studies with good results, but always talk to your doctor first.
Acupuncture is another therapy with much success that should be explored. Finally, a healthy lifestyle is very important. Being overweight or a smoker is unhealthy and can cause further health issues.
Thom Davis is a certified nutritionist with Feelin' Great Wellness Center, 718 Mall Blvd., Brunswick. He can be reached at 912.265.1552.
Harold L. Kent, MD
Georgia Coast Surgical
Can feminine rejuvenation help with incontinence?
Urinary incontinence will come with age to some of us due to the effect of gravity during our lifetime and weakening of pelvic floor muscles. In women, the condition of pregnancy and trauma of childbirth further contribute to the development of urinary incontinence. Pelvic muscle strengthening can help in these situations.
Feminine rejuvenation may help with urinary incontinence to some degree, however, strengthening the pelvic floor muscles is a key factor in treating incontinence. Kegel exercises, where the pelvic floor muscles are voluntarily contracted are often prescribed. Pelvic floor physical therapy can be done as well. In the last couple of years, treatment with the Emsella Device has been shown to relieve stress, urge and mixed incontinence in women and men. Emsella uses a 2.9 Tesla magnet to generate a magnetic field, which causes the pelvic floor muscles to contract supramaximally almost 12,000 times in 28 minutes. This procedure can be done non-invasively in patients who have no contraindications to this treatment. Generally speaking, the main alternatives to Emsella would be the use of a pessary, or a surgical procedure.
What is Overflow Incontinence?
Overflow incontinence happens when the detrusor muscle in the bladder is stretched to the point that it can no longer contract to empty the bladder. At some point the bladder will become so distended that only small amounts of urine can be evacuated at a time. This condition can be seen in a post-op patient, who has had a long operation where the bladder has become overfilled. The treatment in this scenario is to drain the bladder with a catheter for at least 24 hours to let the detrusor muscle regain its tone. Strengthening the pelvic floor muscles will help with voluntary control of incontinence. The Emsella Device can help with stress incontinence, which can happen during activities such as sneezing, laughing, jumping, or changing the position of the body abruptly.
Harold L. Kent, MD, Bariatric & General Surgery, is owner of Georgia Coast Surgical & Med Spa; 3226-F Hampton Avenue, Brunswick, Ga. You can reach him at 912-264-9724 or check out Georgiacoastsurgical.com, Facebook: Georgia Coast Surgical & Med Spa.
Lauren Knobel, NP
Centered on Wellness
Define Stress Incontinence.
What are the risk factors/causes?
Stress incontinence occurs from weakening of the pelvic floor muscles, which are the structures that support the bladder and regulate the release of urine. When these muscles weaken, individuals can experience urine leakage with forceful movements, such as sneezing, lifting, or laughing.
Risk factors for stress incontinence include:
> Prostate surgery
> Smoking, which can cause frequent coughing
> Previous pelvic surgery
> Illnesses that cause chronic coughing or sneezing
> High-impact activities, such as running and jumping, over many years
How Is Stress Incontinence Treated?
> Kegel exercises: Kegels help strengthen the muscles that support the bladder, uterus, and bowels.
> Weight loss
> Timed voiding: This is a method of recording leakage patterns so that one can schedule bathroom visits at those times.
> Bladder training: In bladder training, you “stretch out” the intervals at which you go to the bathroom by waiting a little longer before you go.
> Pessary Device: A pessary is a ring that is inserted into the vagina to put pressure on the urethra to prevent leakage.
> Injections: Bulking agents can be injected into the lining of the urethra to create resistance against the flow of urine.
> Surgery: When other methods for treating stress incontinence don’t work, surgery may be an option.
What is Urge Incontinence? What are the risk factors/causes? How do I minimize it?
Urge incontinence is the sudden need to urinate caused by abnormal bladder contractions that results in involuntary leakage. Abnormal bladder contractions may be caused by a an underlying condition in which the nerves are damaged, such as stroke, multiple sclerosis, or Parkinson’s disease. Individuals with spinal cord damage can experience urge incontinence. The bladder maybe irritated, due to infection. In many cases, the cause of urge incontinence cannot be identified.
People at greater risk for urge incontinence include:
> Older adults
> Women who have had a C-section or other pelvic surgery
> Those who are overweight or obese
> Men who have had prostate surgery or prostate conditions
> People who have nerve damage from conditions such as diabetes, stroke, or spinal cord injury
> People with certain cancers, including the bladder and prostate
> People who are suffering from urinary tract infections
What are the treatments for Urge Incontinence?
Urge incontinence can be treated with a variety of behavioral treatments, medications, electrical stimulation, or with surgery. These treatments include:
> Timed voiding and bladder training
> Kegel exercises
> Regular bathroom visits
> Avoiding caffeine
> Avoiding fluids before bedtime
> Avoiding heavy lifting
> Weight loss
> Medications that reduce bladder spasms
> Botox injections into the bladder muscle causing the bladder to relax
> Hormone therapy
> Electrical stimulation, in which a device is implanted that delivers an electric signal to control bladder spasms
> Surgical procedures
Lauren Knobel is Nurse Practitioner at Centered on Wellness, 1015 Arthur J Moore Dr., St. Simons Island. She can be reached at 912.638.0034 or check out www.centeredonwellness.net.