Regain control with solutions for incontinence

If you are one of the 13 million Americans with incontinence, you know how distressing it can be. An out-of-control bladder can impact life in ways you never could have imagined in your younger years.

Although it can stem from neurologic injury, birth defects, strokes and multiple sclerosis, urinary incontinence is most often associated with advanced age.

According to Katie Roberts, physician assistant for Triangle Urology of Pittsburgh, a major problem with the elderly can be their inability to empty the bladder efficiently, a condition known as overflow incontinence.

“This happens in poorly controlled diabetics, those who struggle with constipation or are debilitated, and in men who have enlarged prostate glands,” she says. “The bladder gets lazy and won’t empty well.”

Other types of incontinence include:

• Stress incontinence, caused by coughing, laughing or sneezing
• Urge incontinence, which is the sudden urge to urinate, often due to inappropriate bladder contractions
• Functional incontinence, where the ability to recognize or communicate the need to urinate is impaired

The first step is determining which type of incontinence you are dealing with, which is best left to a urologist, a physician who specializes in diseases and conditions of the urinary tract. From there, you have some options for treatment.

Drug-free solutions

Behavior modification is often the first course of treatment. Eliminating irritants to the urinary tract, like coffee and caffeinated sodas, can make a significant difference. Timed voiding or bladder training involves charting voiding and leaking. This method can help the individual plan to empty their bladder before they would otherwise leak.

You can do Kegel exercises, during which you contract and relax the pelvic floor muscles, individually or with the help of a physical therapist to regain strength and tone the pelvic floor muscles that can help counteract leaks.

Intervention with medication

A variety of medications are available to treat incontinence, including those developed to inhibit contractions of an overactive bladder. A new agent, Myrbetriq, relaxes the bladder muscle to increase the amount of urine the bladder can hold. It also increases the amount of urine a person can urinate at one time, helping to empty the bladder.

Injections of Botox into the bladder muscle have also been proven effective in treating overactive bladder in people who haven’t responded to other medications. The effects of Botox can last for several months.

Implantable devices, such as InterStim can be placed in the lower back and act to modify the nerve stimulation that controls bladder activity.

Surgical solutions

If all other treatments fail, there are surgical options available that have high success rates. One common procedure treats bladder prolapse (sagging or falling) by pulling it up to a more normal position. For severe stress incontinence, a surgeon may use a wide sling to hold up the bladder while compressing the bottom of the bladder and the top of the urethra to prevent leakage.

Don’t be silent

Roberts’ advice to anyone suffering with incontinence is to seek help.

“Many ailments can, unfortunately, cause patients to suffer in silence due to social stigmas and embarrassment. Urinary incontinence is one of those,” she says. “However, there are so many options to correct the problem. Patients should consider discussing their symptoms with their medical providers. I see many success stories in my practice and it can be a real life changer.”