What Is Urinary Incontinence Treatment? Overview, Benefits, and Expected Results

Urinary ⁤incontinence (UI) ​is a condition where⁢ loss of bladder ⁤control leads to involuntary⁤ urine leakage. It affects millions of people all over the world, ‍but fortunately, there are⁣ treatments for it. Learning more about these treatments can give individuals suffering‍ from⁣ UI ​the‍ information they need to ‍manage their disorder.

What Is Urinary Incontinence?

Urinary incontinence​ is a lack of bladder control that causes an individual to involuntarily leak urine.⁢ It is not considered a disease, but‌ rather a symptom of an underlying condition or injury. Some common‌ causes of UI include childbirth, weakened pelvic‌ muscles, obesity, constipation, urinary tract infections, nerve damage, prostate⁣ gland issues, ​or hormonal imbalances.



There are several ‌types of UI, including stress incontinence, urge incontinence, functional incontinence, overflow incontinence, and mixed incontinence. Stress incontinence happens when an individual exerts pressure on the bladder, such as​ when they are ⁢coughing, ⁢laughing, or sneezing. Urge‌ incontinence occurs when there⁢ is an urgent sensation to⁢ urinate, even when the bladder isn’t full. ‍Functional incontinence occurs when someone isn’t physically able to‍ get to the bathroom in time. Overflow incontinence⁣ is when the⁣ bladder doesn’t empty completely, so it backs ‍up into the urethra‍ and leads to uncontrollable leakage. Mixed incontinence is a combination of stress and urge incontinence.

Symptoms of Urinary Incontinence

The primary symptom of UI is urine leakage. However, other ⁤symptoms can be present depending ⁣upon the underlying cause. Some other common symptoms include urgent urination, frequent urination, the‌ feeling of a full bladder, and a weak urine stream.

Urinary Incontinence Treatment

Fortunately, there ​are several⁢ treatments available for UI. Treatment options include ⁤lifestyle⁤ changes, medications, bladder drills, physical therapy, and surgery. Which treatment option is⁤ best depends on the underlying cause of the UI and each individual’s needs and preferences.

Lifestyle Changes

Even when other treatments are used, many people ‌find relief from‌ symptoms by making​ lifestyle changes. These can include​ losing weight ⁢or ⁢doing exercises ‍to strengthen the pelvic floor ⁤and the muscles ⁢that hold the bladder in place⁤ such ⁣as kegel ⁣exercises. Reducing caffeine, limiting alcohol, and not drinking ​too much fluid, especially close to bedtime, is also helpful.

Medications

Medications can also help manage UI symptoms. ⁣Medications vary depending on the type of ​UI and the underlying cause. Some commonly used ‍medications include anticholinergics,⁤ which work by reducing bladder muscle contractions. ⁢Alpha-blockers, which relax⁢ the bladder muscles,⁤ are also used for UI.

Bladder‌ Drills

Bladder drills are exercises ⁤that help patients ⁢control ​when they urinate and reduce the feeling of urgency. These exercises involve “bladder training”, which ‍involves learning how to relax the bladder ⁢and slowly⁣ increase the amount of time that passes⁣ between trips to the restroom.

Physical Therapy

Physical therapy for UI can involve ​exercises to strengthen the pelvic‍ floor muscles, electrical ⁣stimulation of the pelvic floor muscles, or‌ biofeedback to help individuals recognize when they​ need to relax the pelvic ⁣floor⁤ muscles.

Surgery

In some cases, surgery is necessary to‌ treat UI. The ⁤most ⁤common type of surgery for‌ UI is sling surgery, which involves making⁣ an incision through the vagina or abdomen to ‌lift up the ‌bladder and the ⁢urethra. This helps ⁤prevent the leaking of ‍urine. Other types of surgery ‍used to treat ‌UI include bulking agents, which are injected into the bladder or urethra to help close them and prevent leakage.

Benefits of Urinary Incontinence Treatment

Treating UI can bring a ⁤variety of benefits, such as:

• Reduced embarrassment and⁢ anxiety related to UI



• Improvement in quality of life



• Decrease⁤ in urinary tract ⁣infections



• Fewer falls or accidents ⁣related to UI



• Improved sleep

Expected Results

The results of UI treatment can vary from person to person. In⁤ general, it is⁣ best to have ⁢realistic⁢ expectations and understand that ​the results of treatment may not be a cure. For ⁣some individuals, the treatments⁢ may only be partially successful ‍and provide only a limited benefit.



However, it is also important​ to understand that the treatments can be very effective in some individuals, especially when ‍combined with lifestyle modifications. To⁣ achieve the best results, it is important to create a treatment plan with‌ your health care provider that works best for your individual circumstances.

Conclusion

Urinary incontinence ⁣is a ‌common condition that affects millions of people around the ‍world. Fortunately, there are many treatments for UI that‍ can be effective ⁤in reducing symptoms and improving quality​ of life.



The best treatment for UI will depend⁢ on each individual’s needs and preferences and may⁢ include lifestyle changes, medications, bladder drills, physical⁣ therapy, and⁤ surgery. While treatment ‌results may vary from⁢ person to ‌person, ​understanding the available treatments can help‌ individuals manage ⁢their UI and find relief.

Definition & Overview

Urinary incontinence refers to the involuntary leakage of urine due to loss or weakened control over the urinary sphincter. As a result, the body is unable to effectively hold the urine in the bladder. This condition can be treated using a combination of medications, surgery, and long-term management with the goal to improve the patient’s quality of life despite the problem. The techniques used are chosen based on the type of incontinence, its cause, and the severity of the problem.

Who Should Undergo and Expected Results

Urinary incontinence treatment is offered to patients with:

• Stress incontinence, wherein the patient leaks urine when coughing, laughing, or sneezing due to the sudden extra pressure on the bladder. This is commonly caused by bladder damage due to vaginal childbirth or neurological and connective tissue disorders.
• Urge incontinence, which is commonly caused by excessive consumption of alcohol and caffeine, urinary tract infections, and inadequate fluid intake that leads to bladder irritation and overactive bladder.
• Overflow incontinence, which is caused by bladder stones, nerve damage, or an enlarged prostate gland
• Mixed incontinence, which occurs due to a combination of different causes
• Functional incontinence, which is caused by an underlying medical condition
• Total incontinence, which is caused by congenital bladder abnormalities or any long-term injury to the spinal cord

Incontinence can be either temporary or persistent:

• Temporary urine incontinence is caused by infection (such as urinary tract infection) or diuretic foods, drinks, or medications that stimulate the bladder and increase urine volume

• Persistent incontinence occurs as a result of pregnancy, childbirth, menopause, ageing, disease (such as prostate cancer, neurological disorders or a spinal cord injury), and surgery (such as a hysterectomy).

The long-term goal of urinary incontinence treatment is to help patients hold in their urine to prevent unintentional leakages.

How is the Procedure Performed?

Urinary incontinence treatment may involve:

• Behavioural techniques

1. Bladder training, wherein the patient is trained to delay urination, starting with a 10-minute interval between each toilet trip, with the goal of lengthening this interval from two to four hours
2. Double voiding, wherein the patient is trained to empty the full contents of the bladder with each toilet trip
3. Fluid and diet management, which is done by limiting the intake of alcohol, caffeine, and acidic foods, as well as increasing physical activity
4. Scheduled toilet habits, wherein patients are trained to urinate every two to four hours regardless of whether they feel the urge to urinate or not

• Exercises

1. Kegel exercises, which help restore the strength of the pelvic floor muscles that are responsible for stopping urine flow.

• Medications

1. Anticholinergics, which are effective in calming overactive bladders
2. Alpha blockers, which are used by male patients suffering from urge or overflow incontinence. This type of medication relaxes muscle fibres in the prostate area as well as the bladder neck muscles so the bladder is easily emptied.
3. Oestrogen creams, also known as vaginal creams, which are used by women to help tone and restore strength to the vaginal and urethral tissues
4. Mirabegron, which relaxes the bladder muscles, thus increasing the amount of urine the patient can hold at any given time

• Medical devices

1. Urethral inserts
2. Pessary, a stiff ring inserted into the vagina to hold up the bladder. These medical devices are highly effective among female patients who experience urine leakage due to a bladder prolapse.

• Long-term therapies

1. Botox injections, which work by temporarily paralysing the bladder muscle so it can hold urine in better
2. Nerve stimulators, which work by stimulating the sacral nerves to help with bladder control. This is done by implanting a nerve stimulating device under the skin in the buttock area to deliver timely electrical pulses to the sacral nerves

• Surgery and medical procedures

1. Sling procedure, wherein a pelvic sling is created around the urethra to keep it closed until the patient is ready to urinate
2. Artificial urinary sphincter, wherein a small ring is implanted around the neck of the bladder to keep the sphincter sealed.
3. Bladder neck suspension, wherein additional support is provided to the urethra and bladder neck
4. Prolapse surgery, which is performed on female patients who suffer from pelvic organ prolapse that causes urine leakage
5. Catheterisation, wherein a soft catheter tube is inserted into the urethra to empty the bladder
6. Electrical stimulation, which is performed by inserting electrodes into the rectum or vagina to stimulate and strengthen the pelvic floor muscles

Possible Risks and Complications

Patients who undergo surgical intervention are at risk of bleeding, blood loss, and infection, as well as adverse reactions to anaesthesia. Meanwhile, patients who use a variety of techniques are at risk of recurrence, especially in cases related to disease or other causes of persistent incontinence. Thus, it is important that urinary incontinence treatment is accompanied by necessary lifestyle changes.

References:

• Subak L., Wing R., West DS., et al. “Weight loss to treat urinary incontinence in overweight and obese women.” N Engl J Med 2009; 360:481-490. http://www.nejm.org/doi/full/10.1056/NEJMoa0806375#t=article

• Hersh L., Salzman B. “Clinical management of urinary incontinence in women.” Am Fam Physician. 2013 May 1; 87(9) 634-640. http://www.aafp.org/afp/2013/0501/p634.html

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