Urinary incontinence is not a disease. It is a symptom of a wide range of conditions. Urinary incontinence is the uncontrolled leaking of urine. More than 30 million American men and women suffer from urinary incontinence.
Urinary Incontinence Diagnosis
A urologist or other health care provider will ask questions about your habits and fluid intake. He or she will also want to know about your family, medical and surgical history. A medical exam will look at reasons for leakage that can be corrected.
This includes impacted stool, constipation, and hernias. Your health care provider may recommend tests such as a cough stress test. He or she may conduct a urinalysis, which is a test of your urine sample that can show problems of the urinary system, or urodynamic testing, which includes several painless tests.
Some of the causes of incontinence are temporary and easily reversible. These include urinary tract infection, vaginal infection or irritation, medication, constipation and restricted mobility.
Although pads or diapers may prevent embarrassing leakage, other treatment options currently available can eliminate your need to wear such protection. The options listed here are good ways to start taking control of your bladder.
Urinary Incontinence treatment
If you have urinary incontinence you may need to keep track of the fluids you drink. You may need to reduce your intake of caffeine or other drinks that irritate the bladder. These include some fruit juices, colas, coffee and tea. You should also increase your water intake. This helps to produce an adequate amount of non-irritating, diluted urine. Six to eight glasses per day is a recommended water intake.
A bladder diary is the starting point for bladder training. You write down your fluid intake and urination times. You also record when urine leakage occurs. If you are someone who urinates infrequently, this information will help your health care provider instruct you to do “timed urination.” This is a way of learning to urinate every one to two hours while you are awake. With regular bladder emptying, you should have fewer leaks. Timed urination may help with both urgency and stress urinary incontinence.
If you urinate often, you may benefit from retraining your bladder. The goal of retraining is to increase the amount of urine that you can hold within your bladder. You keep a bladder diary to write down how often and when you urinate. You gradually increase the time between urinations by 15 to 30 minutes per week. The goal is to have you urinate every two to four hours while awake with less urgency and less incontinence.
Pelvic floor exercises
Known as Kegel exercises, these exercises can help strengthen the external sphincter muscle and the pelvic floor muscles. If you are able to contract and relax your pelvic floor muscles, you can improve their strength by doing the exercises regularly. The contraction of the pelvic floor with the Kegel exercise can interrupt a contraction of the bladder that would otherwise trigger the urge to urinate. This may stop or delay leaks.
You may need help from a health care professional to learn how to contract these muscles. Whether you have stress incontinence or urgency incontinence, you will benefit from Kegel exercises. Like any fitness program, you must continue to do the exercises to maintain their benefit.
Drugs that tighten the bladder neck can also treat stress incontinence. The decongestant pseudoephedrine causes constriction of the blood vessels in the nose. It also causes the muscles at the bladder neck to contract, helping to control bladder leakage. If you have a history of high blood pressure please discuss this option with your physician.
Anticholinergic drugs can treat urgency incontinence. They allow the bladder muscle to relax. These drugs work well to treat urgency incontinence but may have side effects. These may include dry mouth, confusion, constipation, blurred vision and an inability to urinate.
You may also be using other medications that cause the bladder muscle to relax or the smooth muscles at the bladder neck to contract, so you should mention these to your health care provider. If you have incontinence after menopause, you may benefit from hormone treatment. Hormone replacement may improve the health of the bladder neck and urethral tissues. This may help incontinence symptoms. There are some medical reasons not to use hormones. Speak to your health care provider about the best treatment options for you.
Adult Pediatric Urology & Urogynecology
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