Incontinence

Evaluation, Diagnosis and Treatment

There are three types of incontinence: stress, overflow and urge. You also may have a combination of these.

Stress

This occurs when pelvic organs slip down. As a result, the bladder neck is not in the correct position and activity such as coughing or sneezing increases pressure of the abdominal cavity and bladder. Some symptoms of stress incontinence include:

• Leaking urine during a cough, sneeze or laugh.
• Going to the bathroom more frequently to avoid accidents.
• Avoiding exercise because it may cause leaks.

Overflow

Overflow incontinence can result when scar tissue or dropped organs make the urethra (urine channel) very narrow, or may arise temporarily after pelvic surgery or childbirth. Overflow can also occur when the bladder stops contracting due to medications, injured nerves, prostate enlargement, or a habitually overstretched bladder. Some symptoms of overflow incontinence are:

• Getting up frequently during the night to urinate.
• Taking a long time to urinate, then urinating small amounts but not feeling empty.
• Dribbling urine throughout the day.

Urge

Urge incontinence is caused by an overly sensitive bladder, which feels full even when it contains a small amount of urine. The bladder contracts unexpectedly, the bladder neck opens, and if the external sphincter is weak, urine in the bladder is expelled. Some symptoms include:

• Wetting, if there's a delay in getting to the bathroom.
• Going to the bathroom at least every two hours.
• Getting up frequently during the night; wetting the bed.

Treatment

Behavioral treatment, medication, and surgery are three treatment options for the management of bladder control problems.

Behavior Treatment

Successful pelvic muscle exercises and bladder training can often eliminate the need for surgery for some patients.

Medication

Following through evaluation, medication can often be used to correct a patient's bladder control problem.

Surgery

Surgical procedures are performed to reposition the muscles and the connective tissues that support the bladder and the bladder neck. For most patients, no leakage occurs because the bladder neck stays closed even after a cough or sneeze.

Collagen

Collagen treatment is performed on an out-patient basis. Once it has been determined that you are a good candidate for this treatment, your physician will test you to avoid allergic reaction to collagen. (Collagen is a naturally occurring protein in skin and connective tissue of mammals.)

Collagen is injected into the connective tissue of the urethra to narrow the area near the urinary sphincter muscle, which controls the release of urine for the bladder.

10 Warning Signs of Bladder Problems

1. Leakage of urine which prevents desired activities.
2. Leakage of urine which causes embarrassment.
3. Leakage of urine which began or continued after an operation (hysterectomy, cesarean section, prostate surgery, lower intestinal or rectal surgery).
4. Inability to urinate (retention of urine) following an operation.
5. Urinating more frequently than usual without a proven bladder infection.
6. Needing to rush to the bathroom and/or losing urine if you do not "arrive in time".
7. Pain related to filling the bladder and/or pain related to urination (In the absence of a bladder infection).
8. Frequent bladder infections.
9. Progressive weakness of the urinary stream with or without a feeling of incomplete bladder emptying.
10. Abnormal urination or changes in urination related to a nervous system abnormality (stroke, spinal cord injury, multiple sclerosis, etc).

If you would like more information on this topic, please contact us.

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