1 in every 3 women age 45 and older have issues with urinary incontinence. Loss of bladder control is a sensitive issue and can seem like a common problem in aging but in fact it isn’t. Many cases of incontinence are reversible with the proper diagnosis and treatment.
Urologist Damon Dyche, MD helps women with bladder control issues at McFarland Clinic.
“It is important to differentiate what type of incontinence you have to ensure the proper treatment,” says Dr. Dyche. “Urodynamic testing is used to determine the cause of your symptoms and to diagnose whether you have stress, urge or mixed incontinence.”
Incontinence types and symptoms:
· Stress incontinence is caused by weakened pelvic floor muscles which increases pressure on the bladder. It can be triggered by coughing, sneezing or laughing. Pregnancy often is a cause of the weakened muscles.
· Urge incontinence is characterized by a sudden, strong need to go and the need to go often. Sensitivity of the bladder tissue causes it to be hyperactive.
· Mixed incontinence has overlapping symptoms of both stress and urge.
“Medications are often the number one cause of bladder control issues. Caffeine, alcohol, urinary tract infections and constipation can contribute to incontinence,” says Dr. Dyche. “Normal bladder function is every 2-3 hours several times a day.”
Treatment options for stress incontinence:
- Strengthen muscles through pelvic floor exercises like Kegels
- Urethral bulking injections
- Surgery using mesh slings
Urethral bulking injections give immediate urine control with no activity restrictions. However, it does have limited durability and often needs to be repeated.
“Mesh slings are 90% effective in treating stress incontinence. The surgery is a minimally invasive outpatient procedure but does require 4-6 weeks of avoiding normal activities,” says Dr. Dyche. “Currently there are no FDA approved medications for treatment.”
Treatment options for urge incontinence:
- Strengthen pelvic floor muscles
- Botox bladder injections
- Posterior Tibial Nerve (PTN) Stimulation
- InterStim® surgery
“Treatments such as PTN stimulation and Botox injections can be quite effective for urge incontinence but require maintenance treatments because the effects can wear off,” says Dr. Dyche.
“InterStim® works like a pacemaker for the bladder. When the brain sends a chaotic signal resulting sudden need to go, an electrical signal pulses to the nerves that control the bladder alleviating reducing the urgency,” says Dr. Dyche. “Treatment using InterStim® is 80% effective.”
Treatment for mixed incontinence involves a combination of surgery and medication. Urge incontinence is treated first.
Learn more about treatment options for urinary incontinence available through the McFarland Clinic Urology Department or by calling 515-239-4490.
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