Urinary Incontinence

Urinary urgency can affect quality of life

Urinary Incontinence

As many as one in six U.S. adults live with this distressing condition, causing some to curtail social and work activities or even isolate themselves at home. Urinary urgency or incontinence is more common among women than men, occurring in 25% to 45% of women and 2% to 11% of men. The higher incidence in women is explained in part by the physical stress caused by pregnancy and childbirth, as well as urinary tract infections. There are many types of urinary urgency and urinary incontinence and many effective treatments.

Types of Urinary Urgency and Incontinence

Stress Urinary Incontinence (SUI)

Bladder leakage, or SUI, occurs during exercise, coughing, sneezing, or laughing. It can affect women following childbirth or menopause and men as a side effect of prostate cancer treatment, such as radical prostatectomy.

Urge Incontinence (Overactive Bladder)

Overactive Bladder, or urinary urgency, is characterized by the urgent need to urinate and being unable to get to the bathroom in time. This is typically caused by damage to the nerves that allow the bladder to communicate with the brain, resulting in a sudden bladder contraction that cannot be stopped.

Mixed Incontinence

Mixed incontinence may be the most common in this family of disorders and is marked by symptoms of both stress and urgency incontinence. A skilled and experienced urologist can assess a patient’s particular combination of symptoms and provide an effective combination of treatments tailored to address those symptoms.

Chronic Retention of Urine

Chronic retention of urine is characterized by a weak urine stream that stops and starts, straining to urinate, or a feeling that the bladder never empties completely. As the bladder remains full, the patient may experience incontinence, frequent urination, or waking in the night to urinate. This can be caused by an enlarged prostate in men or pelvic organ prolapse in women, as well as diabetes and spinal cord injuries.

Treatment Options for Urinary Incontinence

Just as there are many forms of this disorder, there are many approaches to treatment, from lifestyle changes to medication to surgery.

Lifestyle changes

The following lifestyle changes help many patients reduce the occurrence of urinary incontinence:

  • avoid caffeine and large amounts of liquid
  • empty bladder regularly, especially prior to physical activity
  • avoid lifting heavy objects
  • strengthen pelvic muscles with Kegel exercises

Medication

In addition, your urologist may prescribe one or more oral medications. Depending on patient symptoms, there are medications formulated to do the following:

  • relax bladder muscles
  • lessen bladder contractions
  • tighten bladder or urethra muscles

Interventional Therapy for Urinary Incontinence

Botox

If incontinence is caused by muscle spasms in the bladder, Botox (Botulinum toxin) may be the answer. Injected into the muscles of the bladder while the patient is under anesthesia, Botox blocks the chemicals that cause the spasms. Botox can provide relief for nine months to a year.

Bulking agents

Bulking agents such as collagen are space-filling materials that are injected under anesthesia into the tissue around the urethra to tighten the sphincter muscles and prevent leakage.

Sacral Nerve Stimulation (Interstim Therapy)

Sacral nerve stimulation is an advanced therapy that works as a pacemaker for the bladder, sending continuous electrical impulses to the sacral nerve. These impulses control the bladder’s voiding function, reducing or eliminating urge incontinence in most patients. The doctors at The Urology Place specialize in this procedure. They surgically implant a thin wire with an electrode tip near the nerve, connecting the wire to a subcutaneously implanted nerve stimulator. Dr. Naveen Kella is even able to place an initial test simulator in the office, allowing patients to experience what life would be like without the bothersome urgency before making the final decision on the implant.

The Urology Place is committed to helping patients achieve freedom from inhibiting urinary problems such as urgency and incontinence. The Urology Place in San Antonio is available to help with diagnoses and customized plans for resolution. At The Urology Place, our doctors have the skill and experience to help each patient resume normal activity and enjoy life.

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