Urinary Incontinence

(Overactive Bladder)
Urinary Incontinence (Overactive Bladder)

Urinary Incontinence

By definition, urinary incontinence means involuntary leakage of urine. This can be a distressing problem that affects one’s quality of life. There are different kinds of urinary incontinence, including stress incontinence, urge incontinence, overflow incontinence, and mixed incontinence. Involuntary leakage of urine may occur due to a number of reasons including excessive production of urine, bladder irritation, neurologic or muscular disorders, or prostate problems in men. We are able to do various studies in the office to determine the cause of your incontinence.

Types of incontinence:

Stress incontinence: leakage of urine with stress or an increase in abdominal pressure with activities such as coughing, sneezing, laughing, or exercise

Urge incontinence:  loss of urine after feeling a strong urge or need to urinate

Overflow incontinence: dripping of urine out of a bladder that is already filled to its capacity

Mixed incontinence: combination of other types of incontinence

Diagnostic studies:

A number of studies can be done to better understand the type of incontinence you have and what may be causing it. These studies include:

  • Physical exam: thorough exam of the entire body to look for signs of underlying medical problems that may contribute to incontinence
  • Urinalysis: the urine is tested for evidence of infection, blood, or other contributing causes
  • Ultrasound:  acoustic waves are used to better visualize the kidneys, ureters, bladder, and prostate
  • Cystoscopy:  camera is placed inside the urethra and bladder to visualize the lining of these organs: This allows the physician to diagnose tumors, stones, inflammation, or fistulas of the bladder / urethra.
  • Urodynamics:  procedure performed in the office to help us better understand the activity of the bladder. This modality studies the bladder pressure as well as the flow of urine

Treatment:

There are different ways to treat urinary incontinence depending on the type and cause of leakage. The most conservative treatment is behavioral modification. Often decreasing the amount of fluid you are drinking may decrease the amount of leakage. Avoiding bladder irritants such as caffeine, alcohol, and spicy foods may help as well. Treating underlying medical problems such as diabetes or an enlarged prostate is also useful in treating incontinence.

Physical therapy can be helpful for those with stress incontinence. A physical therapist can teach you the proper exercises to strengthen the pelvic floor muscles and thus eliminate or decrease the amount of leakage. Other options include injection of a bulking agent into the urethra or surgical placement of mesh (aka sling) under the urethra to give you more support.

There are many medications available by prescription to help relax the bladder and eliminate urge incontinence. Injection of Botox into the bladder is another treatment option for urge incontinence. A bladder pacemaker device called Interstim can be implanted to help with urgency and urge incontinence as well.

You will need an appointment with one of our board certified urologists to further discuss the best treatment option for you.