Bladder & Urinary Problems
What is Urinary Incontinence?
Urinary incontinence is a type of involuntary urine loss that occurs when we laugh, cough or strain from activities such as exercise or without any apparent provocation. The most prevalent type of incontinence is stress urinary incontinence. While it can affect women of all ages, vaginal childbirth, aging, loss of estrogen, and weight gain all increase its incidence. Vaginal delivery of large babies and prolonged labor during childbirth are also common causes.
What is Urinary Stress Incontinence?
Urinary stress incontinence (USI) is a symptom of a condition called Hypermobile Urethra. The angle between the urethra, the tube that drains the bladder, and the bladder are changed in a way that allows the urine to escape with any small increase in intra-abdominal pressure that results from abdominal strain due to laughing or abdominal exercises.
What is the most common treatment for Urinary Stress Incontinence?
Treatment of Urinary stress incontinence is accomplished by the surgical placement of a special tape in such a way to prevent urine leakage. This procedure is called TVT- O (tension free transvaginal tape – obturator). As many as 90% of women suffering from Urinary Stress Incontinence report improvement of symptoms following this procedure.
Non-surgical approaches to decrease urine loss include:
- Mona Lisa Touch
- scheduled or prompted voiding
- bladder training
- pelvic muscle exercises called Kegels
Urinary urge incontinence is another major type of involuntary urine loss. It occurs due to the dysfunction of the bladder muscle (detrusor instability). The bladder muscle goes into involuntary spasms, forcing uncontrollable urine loss. Anticholinergic medications are the most effective way to treat this type of urine loss. Except for a common side effect of dry mouth, the medication is usually well tolerated.
Are There Any Other Causes of Urine Loss?
Often the cause of urine loss is not immediately clear, so a careful health history and physical examination are conducted along with in-office procedures termed urodynamics. This test examines how the bladder and urethra are performing their job of storing and releasing urine. Results of the full examination can determine the extent to which urinary stress incontinence and/or urinary urge incontinence are responsible for urine leakage. Maintaining a voiding diary (recording of fluid intake, voids and leaks) for three days also provides data regarding the severity of the symptoms of urine loss.
If you suffer from urinary incontinence, please contact Dr. Zilberstein’s office for a consultation to see what treatment options are right for you.