March 14, 2018
Urinary incontinence is the involuntary and accidental leakage of urine. It is very common among elders, as the voluntary control over the bladder muscles decreases with age. More than half of nursing home residents are affected by urinary incontinence. The Department of Health and Human Services estimates that approximately 13 million Americans of different age groups suffer from this. Urinary incontinence is more common among women than men. Research concludes that about 30% of women are suffering from it, whereas it’s typically found in around 5-10% of men. Even though it’s not seen as a severe medical issue, it can have a severe impact on the quality of life for those affected. Different treatment options are available for this disease, but the choice depends on the severity and longevity.
The treatment options available for urinary incontinence are:
Behavioral training includes life style changes along with exercise. The life style changes can help to reduce the severity of any type of incontinence. A healthy diet, intake of fluids as prescribed, cutting down of alcohol and caffeine consumption can add to your overall health helping to recover soon.
The reason for many suffering from urinary incontinence is the weakening of the pelvic floor muscles. Physical therapists suggest exercises to strengthen these muscles known as Kegel exercises. The goal of Kegels is to relax and strengthen the pelvic floor muscles. The exercise includes squeezing and holding the pelvic muscles and then relaxing. These exercises should be performed with help from a health care professional or a physical therapist.
Incontinence for some may be due to the rigidity in pelvic muscles. Electrodes inserted through the rectum or the vagina stimulate and strengthen the pelvic muscles. The treatment along with pelvic floor exercise had proved to provide better results in a long run.
The therapy along with exercises is good to regain control over the pelvic muscles and cures urge incontinence effectively. There are steps in bladder training that can help. “Delaying the event” is concentrating on pushing back the urge to urinate, and increasing the time over each attempt. Double voiding involves holding while urinating for a couple of seconds and then releasing thus emptying the full bladder. Scheduling involves making a timetable for going to toilets rather than whenever you feel like.
The following medications can be prescribed as well:
- Anticholinergics: Used to calm an overactive bladder and relax the muscles.
- Topical estrogen: Applied on to the skin as ring or patches to reinforce and strengthen the muscles of urethra and vaginal areas.
- Imipramine: A tricyclic anti depressant used in combination with other therapies to treat urge and stress incontinence.
Medical devices that can help temporarily are:
- Urethral inserts: A disposable plug inserted into the woman’s urethra helps during physical activity. The woman can insert it before the activity and take it out for urination. The devices should be used after consultation and not on a daily basis.
- Pessary: Those suffering from prolapsed bladder or uterus can make use of pessary, a rigid ring inserted into a woman’s vagina to hold the bladder firmly and thus avoiding leakage.
For incontinence patients that don’t have a favorable reaction to therapies or medications, surgery might be necessary. The following surgeries are available depending on the situation:
Sling procedures: A polypropylene strip called a sling, inserted into the urethra to support it and to stop the leakage of urine.
Colposuspension: A process, which makes incision in the lower abdomen and lifts the bladder neck by stitching it on to the bladder walls cures stress or urge incontinence.
Artificial sphincter: An artificial valve inserted into the urethra to control the flow of urine is recommended only if the other procedures are not effective for the patient.