Female Incontinence
Treatment for Stress Incontinence
- Kegel Exercises
- Biofeedback
- Medications
- Timed Voiding
- Injectables
- Surgery
Treatment for Urge Incontinence
- Kegel Exercises
- Biofeedback
- Medications
- Timed Voiding
- Dietary Changes
- Neurostimulator Implants
- Botox Injections
Treatment for Overflow Incontinence
Managing Mild Incontinence
- Make certain diet changes. Some foods may make you need to urinate more often. Drink less. Pour your cups half-full, and avoid coffee, tea, and caffeinated sodas. Caffeine is a diuretic, which creates more urine.
- Empty your bladder regularly, every two to four hours, even if you don't feel the need.
- Quit smoking.
- Lose weight.
Kegel Exercises
Because stress incontinence often stems from weak pelvic muscles, Kegel exercises are an excellent mechanism to strengthen the muscles around the urethral closure. Clench the muscles you would use to stop the flow of urine. Hold the squeeze for 10 seconds, then relax. Do three or four sets every day. As these muscles grow stronger, so will your bladder control.
As the pelvic floor muscles get stronger, small vaginal weights can help make Kegel exercises more effective. Holding the small weight in your vagina helps you contract the right muscles. You can speak to your urologist about vaginal weights.
Biofeedback
Biofeedback is a method that provides you real-time information about activity in your bladder and pelvic muscles. As you gain awareness of these functions, you may be better able to control them. A special tampon-shaped sensor is placed either just outside of or in your vagina or rectum. When you relax, your muscles give off signals and these sensors will read the signals. The technician can view them on a computer monitor and you will be able to see if, in fact, you are using the right muscles.
Collagen Injections
To boost the size of the urethra lining and create resistance against the flow of urine from the bladder, collagen injections are another alternative. Injections must be repeated every 12 to 18 months and are only helpful against stress incontinence.
Using Absorbant Products
Sometimes it may be necessary to use a product to absorb leakage. These are generally disposable and can be used, until your treatment begins to work, to help keep you more comfortable and dry.
Bladder Training
Bladder training can be effective against stress incontinence and urge incontinence. Begin by making a chart of the times you urinate and when you leak. You can train the bladder to hold out for longer and longer periods between bathroom visits. Try re-training your bladder by using Kegel exercises. When you feel the urge to urinate, try to stop the feeling by contracting your pelvic floor muscles. Try to hold your urine a little longer each time. Soon you will begin to see a pattern and can avoid accidents by heading to the bathroom before a leak is likely to occur.
Self-Catheterization
This procedure is painless and easy to learn, and when you drain your bladder on a regular basis, you will be able to control overflow incontinence. You will insert a thin tube through the urethra into the bladder, and drain the urine.
Neurostimulator Implants
Used for urge incontinence, a small stimulator device is implanted under the skin, either in your buttocks or midsection, which gives off electrical signals to the nerves that control your bladder. This helps your bladder work more normally by blocking abnormal nerve signals to and from the bladder muscle.
Medications for Incontinence Include:
- For urge incontinence: anticholinergic and anitspasmodic medications
- Alpha-adrenergics
- Estrogen
- Antibiotics (to treat urinary tract infections if one is present)
Surgery for Incontinence
An option for stress incontinence is to place a "sling," a piece of tissue or material that acts as a backstop for the hypermobile urethra and prevents leaks. Your urologist can also lift your bladder up to a more normal position (cystocele repair). For urge incontinence, surgery may be used to boost the bladder's storage capacity or to implant a device that controls bladder spasms with electrical signals, a so-called pace maker for the bladder. Surgery for stress incontinence is often done as an outpatient procedure.
Care for Your Skin
Urine can be very irritating to the skin. Your doctor may suggest special cleansers and protective ointments. Keeping yourself dry and clean will help reduce the possibility of a rash, as will using non-deodorant soap or harsh detergents on your skin.
Preventing Incontinence
There are ways to reduce your risk of developing incontinence. Maintaining a healthy weight and doing daily Kegel exercises top the list. Smoking can lead to chronic coughing, which can stress the bladder and trigger leaks.
- Plan your fluids: It's important to drink fluids to stay hydrated, but controlling when and how much will help incontinence.
- Drink fluids only when you know you have access to a bathroom, and drink during the day.
- Limit your fluids at night and when traveling and you know a bathroom is not close by.
What is Pelvic Floor Prolapse?
This refers to the drooping (prolapse) of any of the pelvic floor organs, including bladder, uterus vagina small bowel, or rectum. Some women notice no symptoms while others report pressure in the pelvic area, lower back pain, painful intercourse, urine leakage or feeling that something is falling out of the vagina.
Treatments for prolapse include Kegal exercises, mechanical treatments such as inserting a small plastic device into the vagina to support the drooping organs (pessary) or surgical treatment to repair the affected tissue or remove the organ (such as uterus by hysterectomy).
Dr. Daniel Katz specializes in female urinary incontinence. He sees patients in the Poughkeepsie office.