Thousands of patients annually are plagued by urinary leakage, yet many feel reluctant to raise this sensitive issue with their doctor. Many patients have been led to believe this is a “normal part of the aging process” or “an unavoidable consequence of childbirth”. Although age and child bearing can impact the bladder, this is an area where there are a growing number of treatment options which can improve the quality of life.
It’s critical to understand there are two types of urinary leakage. And it’s important to differentiate between the two as the treatment options depend on the type.
Stress Urinary Incontinence is the involuntary passage of small amounts of urine that occurs when one laughs, coughs/sneezes or exercises. This is often experienced after pregnancy/childbirth but can also be seen with significant weight gain and conditions associated with chronic pushing/coughing such as chronic constipation or asthma. It may also be more noticeable after the onset of menopause.
Stress urinary incontinence is treated with physical exercises. When this fails, there are surgical options. Surgery for stress urinary incontinence is an outpatient procedure with excellent outcomes.
Conversely, Urgency and Urge Incontinence is the involuntary passage of urine that is accompanied by the desire to urinate. Individuals feel they are unable to “make it to the toilet in time”. Patients often describe specific triggers, such as “putting a key in their apartment door” or “opening the bathroom stall”. This condition is often more noticeable with age, and is often worsened by bladder irritants. The most common bladder “triggers” are caffeine, tobacco, alcohol and artificial sweetener.
For urgency and urge incontinence, counseling and behavioral modifications are sometimes all that is required to improve bladder symptoms. For some, bladder medications provide relief. There are many medications from which to choose, including a newer medication with fewer side effects. When these options fail to bring relief, patients may choose to have a Botox bladder injection which will relax the bladder and thus prevent the spasms which are responsible for the leakage. Or, they may choose to try a sacral neuromodulator which is a tiny device that sends an electrical impulse to the bladder to prevent involuntary bladder contractions and therefore improve leakage.
In 2017 we are fortunate to have many tools in our armamentarium to offer to those suffering with urinary leakage. Please give us a call or request an appointment online to see how we can help.