Urinary Incontinence

If you are experiencing incontinence, this means that you have uncontrollable urine loss (leaking). Muscles and nerves in and around your bladder work with your brain to control the storage and release of urine when your bladder is full.

Education and Diagnosis
Testing & Treatment

Education & Diagnosis

If you are experiencing incontinence, this means that you have uncontrollable urine loss (leaking). Muscles and nerves in and around your bladder work with your brain to control the storage and release of urine when your bladder is full. If these muscles or nerves aren't working correctly, this can cause you to have trouble controlling your bladder. Bladder control problems affect both men and women, however, incontinence is more like to occur in women than in men, due to the structure of the female urinary system.

Urinary incontinence is very troublesome, and embarrassing to those who have to deal with it on a regular basis, and oftentimes is associated with an undiagnosed medical problem.

There are different types of urinary incontinence:

  • Stress Incontinence is the leakage of urine during any range of physical activity.
  • Urge Incontinence is the leakage of large amounts of urine in conjunction with a sudden urge to urinate.
  • Overflow Incontinence is the unexpected leakage of small amounts of urine because of a full bladder. This happens when the bladder doesn't empty properly, causing it to spill over.

Many times, incontinence is referred to as an overactive bladder. This term is used to describe very frequent urination of greater than seven times a day.

Symptoms

Testing & Treatment

Every patient who is afflicted with incontinence will have their own array of symptoms, causes and a unique diagnosis. To rule out other conditions, your doctor will do a physical exam and discuss your medical history and symptoms.

Your doctor might perform tests such as:

  • Urinalysis: testing a sample of your urine for infection, blood or other abnormalities.
  • Urodynamic Testing: a series of tests to measure how well your bladder and urethra function.
  • Cystoscopy: your urologist looks inside your bladder by inserting a thin tube with a lens in it through your urethra.

Treatment—Women

Urinary incontinence in women is treatable, with both non-surgical and surgical options offered.

  • Non-surgical urinary incontinence treatments include behavioral modifications, kegal exercises, and pelvic muscle therapy.
  • Medication - If you have urge incontinence, depending on what's causing it, medicines may be able to help.
  • Bulking Injections - collagen injections are made near the urinary sphincter and are injected into tissues around the bladder neck and urethra. These injections strengthen the tissues making them thicker ultimately allowing them to reduce incontinence.
  • Neuromodulation - the use of mild electrical pulses to modulate the nerves and muscles that control the bladder in relation to urination.

For those who may need more advanced treatment options, SMU has several surgical options available, including:

Sling Procedures – There are many slings that are used today to help support the bladder neck, ultimately decreasing urine that is involuntarily lost by patients. In these procedures, the surgeon inserts a small rectangular patch of biological or synthetic material positioned underneath the urethra in order to provide support. When the patient experiences a bladder leak, the sling supports the urethra and closes the channel so urine will not escape.

Treatment—Men

Though men are much less likely to experience incontinence than women, men are still affected by this embarrassing and uncontrollable urological problem. Male treatment options vary from those for women.

  • The Artificial Urinary Sphincter is the most successful treatment of male incontinence. This surgery consists of inserting an inflatable cuff around the urethra. The cuff is attached to a small bulb that is placed in the scrotum. When the bladder is full, the patient must squeeze the bulb in order to deflate the cuff and allow for urination.
  • Male slings are commonly performed in men who experience urinary incontinence following prostate surgery. A synthetic mesh is used to compress the portion of the urethra that passes between the scrotum and the anus.

Prevention

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