Urinary incontinence has a reputation of being something only little old ladies have. But many young people get urinary incontinence. And while more women than men are affected, men can have urinary problems, too. Fortunately, there are many treatments for urinary incontinence.
Lou Dunn is one of those women who's always on the go. The Pittsburgh mother and wife runs her own calligraphy business and usually has energy to burn.
But for years, her active schedule was hampered by a serious downside. Nature called way too often.
Like millions of others, Dunn suffers from overactive bladder, or OAB, in which the bladder wall muscle inappropriately contracts, causing the urge to urinate. The urge can be so strong and sudden that there is not enough time to get to a bathroom...
Behavioral treatment. Some people with urinary incontinence may get relief by making simple changes to their lives. If you have stress incontinence, for instance, in which you leak urine when you cough, sneeze, or laugh, your doctor may tell you to limit how much you drink. If you have urge incontinence, in which you get the sudden urge to urinate and can't always make it to the bathroom in time, your doctor may tell you to avoid spicy foods, caffeine, and carbonated drinks, because they can irritate the bladder and make the problem worse. Exercises to strengthen the pelvic floor muscles, known as Kegels, can help people with stress incontinence. Kegels can also help people with urge incontinence. Sometimes, Kegels are combined with biofeedback techniques to help you know if you are doing the exercises properly. For urge incontinence, bladder training, sometimes called bladder retraining, can also help. This involves gradually increasing the interval time between trips to the bathroom, working up to longer and longer intervals between bathroom stops.
Devices and absorbent products. Protective pads and panty liners can help avoid embarrassing situations. A pessary, a plastic device inserted into the vagina, can help prevent urine leakage by supporting the neck of the bladder; it is most useful for stress incontinence.
Drugs. For urge incontinence, medications known as anticholinergics/antimuscarinics (Detrol,DitropanXL, Enablex, Oxytrol, Urispas, and Vesicare) can prevent bladder spasms. Oxytrol, Detrol, Ditropan XL, and Vesicare are approved for women with overactive bladder (OAB) as well. OAB is a condition in which the bladder squeezes too often or without warning, resulting in incontinence. Also, Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity and reducing episodes of urinary incontinence. It can be used for adults who do not respond to or can't use the medications listed above.
Surgery. If the above treatments for urinary incontinence don't provide enough relief, surgery may help. One procedure works by supporting the bladder so that it returns to its normal position. Another surgery for urinary incontinence, called a sling procedure, uses a strap of synthetic mesh or natural tissue to support the urethra, the tube that carries urine.
When Should You Seek Treatment for Urinary Incontinence?
It's difficult to say when you should get help, but if you notice more urine leaking than previously, are avoiding social events, withdrawing from life, or feeling depressed, it's time to see a doctor.
Where to Go for Urinary Incontinence Treatment
For urinary incontinence treatment, start with your primary care doctor. Tell him or her you are having problems with bladder control. If your primary care doctor is unable to help, ask for a referral to a specialist. Doctors who specialize in treating urinary incontinence include urogynecologists, gynecologists with extra training in urinary incontinence, or urologists, doctors who specialize in problems of the urinary tract system in men and women.
How Successful Is Treatment for Urinary Incontinence?
The outlook is promising for urinary incontinence treatment. About 80% of people with urinary incontinence can improve or even be cured. The best outcome depends, of course, on getting the correct diagnosis and following your doctor's advice to help improve your condition.
American Academy of Family Physicians: "Urinary Incontinence: Embarrassing but Treatable."
Jennifer Anger, MD, MPH, urologist, Cedars-Sinai Medical Center, Los Angeles.
Amy Rosenman, MD, co-author, The Incontinence Solution, urogynecologist, Santa Monica, CA, associate clinical professor, UCLA.
National Library of Medicine MedlinePlus Medical Encyclopedia: "Urge Incontinence."
Halina Zynczynski, MD, director, division of Urogynecology and Reconstructive Pelvic Surgery, Magee-Women's Hospital, associate professor of obstetrics and gynecology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
American Family Physician: "Selecting Medications for the Treatment of Urinary Incontinence."
National Association for Continence: "Treatment Options for Incontinence."