Urinary Incontinence

by Dr. Avelino Garcia

As seen in the Odessa American Medical Matters: http://www.oaoa.com/people/health/medical_matters/article_5e237dea-dd36-11e7-b864-efb69ed2f589.html

Though many are embarrassed to discuss it, urinary incontinence is very common among women. Urinary incontinence is leakage of urine. It can range from leaking just a few drops of urine to complete bladder emptying. Other accompanying symptoms include having the strong urge to urinate, urinating frequently, waking up several times during the night to urinate, burning with urination or leaking urine while sleeping.

There are three main types of urinary incontinence in women.

  • Stress Urinary Incontinence (SUI) is leakage of urine when laughing, coughing, sneezing or exercising.
  • Urgency Urinary Incontinence (UUI) is a sudden urge to urinate that cannot be stopped. Many women leak urine before they can make it to the restroom.
  • Mixed incontinence combines the symptoms of both SUI and UUI.

Several things can cause or worsen urinary incontinence. Urinary tract infections can cause leakage of urine. Certain types of medications, like diuretics, caffeine and alcohol, can contribute to urinary incontinence, as these are substances that cause your body to create more urine and/or are bladder irritants. Different disorders caused by weakening of the muscles of the pelvic floor can cause problems controlling urination. Long term constipation is often a trigger for urinary incontinence, especially in older women. Neuromuscular or anatomical problems can also cause problems controlling urinary leakage.

Urinary incontinence is diagnosed by medical history and a physical exam. A pelvic exam is necessary to determine if there is pelvic organ prolapse. Certain tests may be done during the physical examination to see if there is complete emptying of the bladder after urination. In some cases, imaging and bladder function tests can be ordered for further information.

The first line of treatment for urinary incontinence is nonsurgical. This may include lifestyle changes, like discontinuing caffeine and alcohol, and managing fluid intake during the day. Weight loss in overweight patients is beneficial for reducing leakage of urine. Bladder training may be discussed by your provider. According to the American College of Obstetricians and Gynecologists (ACOG), “the goal of bladder training is the learn how to control the urge to empty the bladder and increase the time span between urinating to normal intervals (every three to four hours during the day and every four to eight hours at night).”

Performing Kegel exercises helps strengthen pelvic muscles and can improve all types of urinary incontinence. There are many medications that help improve UUI by controlling bladder spasms, manage to relieve the urge to urinate and urinary frequency.

A pessary may be recommended for nonsurgical management of SUI and to improve pelvic support. A pessary is a small device that helps to support the walls of the vagina, thereby lifting the bladder and urethra. These devices come in many shapes and sizes and can be fitted by the provider during the pelvic exam. Pessaries can easily be removed for cleaning and re-inserted by the patient at home, making them a very convenient alternative to surgery for many women.

There are several surgeries that can be completed by the provider in a hospital setting to improve SUI. There are many different slings are available for the treatment of urinary leakage. A sling is a narrow strap made of synthetic materials that is placed under the urethra to lift and provide extra support. Other surgical procedures include lifting and securing the bladder neck to nearby supporting structures using stitches.

 

If you are suffering from urinary incontinence, call ProCare Women’s Clinic today and make an appointment at (432) 640-2491.