Urinary Incontinence in Women: A Flood of Treatment Options

By Dmitry Volkin, MDUrologic SurgeonDirector of Pelvic Health, Hartford HealthCare East Region
Urinary incontinence is the loss of bladder management. It is a typical and infrequently embarrassing drawback, however normally a benign situation. It can vary from leaking urine once you sneeze to having an urge to urinate that’s so sudden and powerful you don’t get to a rest room in time. For most individuals, easy life-style and dietary modifications or medical care can deal with signs of urinary incontinence.
Types of Urinary Incontinence

Stress: Urine leaks once you exert strain in your bladder by coughing, sneezing, laughing, exercising or lifting one thing heavy.
Urge: A sudden, intense urge to urinate adopted by an involuntary launch of urine. This is perhaps brought on by an an infection, or one thing extra critical like a neurological dysfunction or diabetes.
Mixed: This is a mix of stress incontinence and urge incontinence.

Temporary urinary incontinence could also be brought on by an simply treatable medical situation, similar to:

Urinary tract an infection: This irritates your bladder, inflicting you to have sturdy urges to urinate and, typically, incontinence.
Constipation: Hard, compacted stool in your rectum can lower the quantity of house in your pelvis and result in elevated frequency or urgency, and even incontinence.

Persistent urinary incontinence could be brought on by:

Neurologic circumstances.

Treatments for incontinence vary from life-style modifications to modifications in your food regimen to medicines to procedures. Bladder coaching, pelvic flooring muscle workout routines, fluid and food regimen administration is perhaps one of the best place to begin.
If conservative remedies or medicines don’t appear to assist, there are different choices. The possibility that’s proper for every affected person is dependent upon the kind of incontinence and the affected person’s targets and priorities.
Some procedural choices embrace:
For Stress Incontinence

Bulking brokers: Bulking brokers are injected into the partitions of the urethra to assist shut the sphincter. The process is a collection of 3-4 small injections that takes round 10-Quarter-hour beneath native anesthetic. Up to 92 p.c of girls reported being cured or improved after one yr following therapy.
Urethral slings: Slings are made of both an artificial materials or your physique’s personal tissue and are supposed to present help for the urethra to forestall it from releasing urine. This is a fast outpatient process carried out in the working room and is the “gold normal” therapy for stress incontinence.

For Urgency Incontinence

Botulinum toxin injections: Botulinum toxin is a drugs that’s used to “calm” the bladder muscle and cut back frequency, urgency and urgency incontinence. It is a fast in-office process, however requires repeat injections roughly each six months.
Sacral Neuromodulation: Commonly known as a “bladder pacemaker,” sacral neuromodulation is a way the place a medical system is implanted to dampen the alerts to the bladder that outcomes in frequency, urgency and urgency incontinence. A everlasting system is implanted that delivers delicate electrical pulses to the focused sacral nerve in order to revive regular communication to and from the mind. SNM remedy is a protected and established remedy demonstrated in peer reviewed publications. To date, over 300,000 sufferers have been implanted with an SNM system worldwide.
Percutaneous Tibial Nerve Stimulation: This is a type of electro-acupuncture the place a really tiny needle is positioned close to the ankle. This is stimulated for half-hour with an electrical pulse and may help restore regular communication between the bladder, spinal wire and mind. The therapy in carried out as soon as per week for 12 weeks adopted by periodic upkeep remedies after that. It could be very protected and has nearly no unintended effects.


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