If you are a woman who has endured the inconvenience and embarrassment of urine leakage, you may be needlessly suffering from female incontinence. This condition may be temporary or long-term, and it can affect women at any time of life. At South Lake OB/GYN in Clermont, FL, we have multiple treatments available designed to improve your confidence, comfort, and lifestyle.
Why Female Incontinence?
Although men may develop incontinence as well, women are twice as likely to experience incontinence. Part of this is a result of the structural differences between men and women. However, the greater number of women enduring incontinence can also be attributed to events that men do not experience, such as pregnancy, childbirth, and menopause, all of which place additional stresses on the body.
What Is Female Incontinence?
There are two types of incontinence experienced by women, although some women may exhibit symptoms of both types and may be referred to as having mixed incontinence.
How We Discover Your Type
After a physical exam, we will ask questions regarding your bladder control issues. Information about your diet, lifestyle, and general health history, which will include information regarding pregnancies, surgeries, and so on, will also be required. With all of this data, we will be better able to determine exactly what type of incontinence you have. From there, we will prescribe a course of treatment designed specifically for you.
Types of Incontinence
The most common type of incontinence, stress incontinence, often occurs due to conditions stemming from pregnancy, childbirth, menopause, obesity, and aging. All of these conditions can put pressure on the vagina, pelvic floor muscles, and ligaments, causing them to weaken over time. This weakening then causes the bladder to move down and press on the vagina. As a result, this impairs the sphincter muscles, which are those that control the passing of urine, and urine is leaked.
Actions such as sneezing, coughing, exercising or laughing, can all place stress on our system. In addition, symptoms may worsen at different times of the month or our lives. Since estrogen levels decrease the week before menstruation and during menopause, women may find these times particularly bothersome.
Unlike stress incontinence, which occurs under very specific, stressful conditions, urge incontinence refers to an inability to hold one’s urine until reaching the bathroom. Although issues related to the nervous system, including Parkinson’s, Alzheimer’s, strokes, multiple sclerosis, or spinal cord injuries, may cause urge incontinence, the causes of urge incontinence are frequently undetermined.
Furthermore, other health issues and regimens may exacerbate this type of incontinence. Stress, uncontrolled diabetes, and hyperthyroidism have been known to worsen symptoms, and so, too, may the use of diuretics. Sometimes, even touching water, drinking water, or hearing running water may produce the urge to urinate.
As with most medical conditions, there are a number of treatment options available that have been found to be quite successful. Typically, treatments begin with those that have the least impact on your body but still effectively control or treat your symptoms.
Because treatments may involve a multiple-pronged approach, it may be recommended that the patient develop sound strategies for everyday help with female incontinence. This may include effective urine elimination, which calls for fully emptying the bladder, reducing excessive straining when eliminating waste, and avoiding pre-emptive urination, which is going to the bathroom when not actually needing to go. Moreover, you may also be counseled to limit drinking during the day, avoid caffeine and alcohol, and even lose weight.
Bladder training remedies for female incontinence focus on controlling when and how often you go to the bathroom. Usually, this begins with the patient keeping a diary over the course of several days and nights in order to get a better indication as to what may be causing the incontinence. Details regarding such things as what you drink, when you drink, and how you feel right before a leak are all important to note.
From this information, we can help create a schedule for you. The longer you can go without urinating, the more the bladder can stretch and the more it can hold. There are also several other behavioral remedies for female incontinence. Pelvic floor exercises, or Kegels, strengthen the pelvic floor by having the patient tighten the pelvic muscles, hold, relax, and repeat the procedure.
This behavior helps control the urine flow and may be used in conjunction with deep breathing exercises and distracting the mind, both of which form a treatment called urgency suppression. Finally, quitting smoking may be recommended. With coughing a frequent by-product of smoking, consistent coughing can irritate the muscles in your bladder, causing difficulty with holding your urine.
There are several types of medications available to assist with symptoms from female incontinence. One drug called pseudoephedrine is used to strengthen the urethra and works for patients exhibiting symptoms of stress incontinence. Urge incontinence can be treated with numerous medications, all of which work by relaxing the bladder and lessening the spasms that can cause an urge to urinate.
Because it treats women with both types of incontinence, one of the most common types of medication is estrogen replacement therapy. This treatment is available in a cream or with a vaginal ring. The estrogen causes the area around the urethra to swell, which helps to protect against leakage.
At times, Botox may even be prescribed in the event that neurological conditions or multiple sclerosis are causing incontinence. Botox works by relaxing the bladder, providing relief from symptoms.
Providing relief for those women suffering from stress incontinence, injections are basically fillers that plump up the tissues around the area where urine is released. Injections come in two forms: collagen and carbon beads. Although this treatment can be quite successful, the positive effects of the injection will dissipate over time, which may result in a need to periodically repeat the treatment.
For those with stress incontinence, an insert for your urethra (the tube where the urine travels from your bladder) may be the best course of action. Urethral inserts, which function much like tampons, serve as leak barriers. They will often be prescribed for you if you have a special event coming up and wish to avoid distraction and inconvenience. Just like tampons, urethral inserts are disposable, allowing you to feel fresh, clean, and prepared for anything that may come your way that big day.
A vaginal pessary is another option for female stress incontinence. Usually ring-shaped, this device is made from silicone, a soft, harmless, nonabsorbent material that is also removable. If your bladder has dropped (often referred to as being prolapsed), we may prescribe this option for you.
We will fit and insert the device in our office, but you will be able to remove, clean, and insert it yourself whenever needed. In addition to this ring-shaped device, which is often the first type recommend, other pessaries with varied shapes exist for patients exhibiting signs of more advanced prolapse.
Electrical Nerve Stimulation
Stimulating your bladder and altering how it reacts is the goal of electrical nerve stimulation. Both types of stimulation–sacral nerve stimulation and tibial nerve stimulation–apply only to patients with urge incontinence. Essentially, electrical nerve stimulation treatments help curb the need to urinate.
Sacral nerve stimulation involves implanting a stimulator under the skin of the lower back where the sacral nerve is located. Functioning much like a pacemaker, painless electrical impulses impede messages from the bladder to the brain that make you want to urinate. This type of stimulation also works to strengthen pelvic muscles and increase blood flow.
Tibial nerve stimulation, on the other hand, can be performed as an office procedure since it requires no anesthesia. Here, the stimulator triggers the tibial nerve at the ankle and sends an electric impulse to the spine, affecting the nerves controlling the bladder.
Of course, prior to recommending surgery as a possible treatment option, we will first explore other less invasive options. However, if surgery is prescribed, you can rest assured that this is an extremely successful remedy for incontinence. There are two different types of surgical options–the sling procedure and retropubic colposuspension–which your doctor may choose when recommending the best course of treatment for you.
The most common method of surgical treatment is the sling procedure. With this option, we will create a “hammock” using mesh and tissue, thereby supporting the urethra. This is an outpatient procedure that is performed using a local anesthetic.
Retropubiccolpo suspension may be performed if your bladder has prolapsed and may be recommended in addition to other measures. In this procedure, we will use stitches to lift up and support the tissues at the entrance to the bladder.
Obviously there may be some times when you may desire extra protection in conjunction with some of the treatment methods previously mentioned. While many of those treatments may get your incontinence under control, you may want an extra layer of confidence for special occasions and the like.
One easy remedy is the use of absorbable pads. Nowadays women’s panties and pads are fashioned much more discreetly, can be worn with nearly any garment, and can be found in numerous types of stores. Anytime you need them, they are there.
For those patients whose bladder does not empty all the way, a catheter is a viable option. With this treatment option, a soft, thin tube, a catheter is inserted into the urethra. You will be trained on how to insert it yourself and remove it for cleaning. You will be able to use the catheter whenever you think the situation calls for it.
Help Is on the Way
Since there are so many treatment options available to assist women suffering from female incontinence, there is no need for anyone to continue to experience the discomfort, annoyance, and embarrassment that frequently accompany this issue. Whether you are afflicted by stress incontinence or urge incontinence, there is a remedy for you.
Remember that any treatment begins with less invasive recommendations, such as learning effective elimination techniques, avoiding alcohol and caffeine, or losing weight, and only then proceeding to behavioral remedies including bladder training or pelvic exercises. If another treatment is prescribed, it can be performed safely and effectively. Whether medication, injection, a medical device, or surgery is recommended, you can be assured that relief from incontinence is possible.
If you are one of those many women suffering from female incontinence, the first step to that relief is to contact us at South Lake OB/GYN in Clermont, Florida today. With two convenient locations to serve you, we look forward to helping you treat your incontinence and opening the door to an uncomplicated, easier lifestyle that allows you to confidently live your life to the fullest.