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Incontinence

What is Incontinence?

Urinary incontinence is defined as the unwanted loss of urine. Urinary incontinence is very common, affecting millions of Americans. Urinary incontinence is not a necessary part of aging, and can happen in young men and women as well. Many people are too embarrassed to ask for help, and many men don’t realize that successful treatment is usually available.

Types of Incontinence

There are actually many different types of incontinence, and the successful treatment depends on making the most accurate diagnosis of the type of incontinence affecting the patient. In many patients, the types of incontinence seem to run together.

  • Urgency Incontinence is when there is a strong urge to go to the bathroom, but you cannot get to the bathroom quickly enough.
  • Stress Incontinence means that patients will have unwanted loss of urine when he exercises, or has any sudden movements, such as coughing or sneezing or laughing. It can be from any type of exercises, including simply getting out of a chair or walking.
  • Overflow Incontinence means the patient has a poorly emptying bladder and the urine leaks out uncontrollably, often in very small, frequent amounts.

Diagnosis

Several factors need to be evaluated in any person with incontinence, including the presence of a urinary tract infection, constipation and a full list of medications that are being taken. A complete medical history, physical examination and urinalysis are the most basic tests that start any evaluation for incontinence.

If the patient has had previous treatment for incontinence or any surgery on or around the urinary tract, those records or X-rays should be taken to the doctor for the evaluation.

The doctor may ask the patient to keep a voiding pattern chart to help make a firm diagnosis or to develop a treatment.

Other diagnostic tests that may be done by urologists include x-ray examinations of the urinary tract, telescopic examinations of the urinary tract, and nerve and muscle function testing of the bladder and sphincter.

Treatment

There are three major treatment areas – medications, surgery and behavioral techniques.

Medications
Medications to treat incontinence depend on the cause of the incontinence. If the patient’s bladder is contracting inappropriately, medicines can be used to slow down these contractions. Certainly, medications can be used to treat infections that may be stimulating the bladder to contract or causing irritation. Some medications help tighten the muscles of the sphincter area.

Surgery
Surgery is often needed to help incontinence for men. If the prostate gland is blocking the urinary channel, or a stricture or scar exists in the urethra, this may need to be dealt with surgically. In patients who have had prostate surgery, artificial sphincters can be placed to aid the patient’s own sphincter.

Injectable Collagen
Another development is the use of injectable collagen. Collagen is a safe material that can be injected just outside the sphincter to create increased resistance and hopefully achieve better control.

Behavioral Techniques
Behavioral techniques are now available that allow you to strengthen the muscles and get better coordination of urination function. Biofeedback is a way of learning exactly how the bladder muscles and sphincters contract and increase resistance.

Also pelvic exercises called Kegels can help strengthen the muscles around the neck of the bladder.

In some circumstances, cure is not possible, and products are available to help the patient manage incontinence. These include pads and diapers that are available at most health care suppliers and drug stores. In some patients, a catheter or tube can be placed into the bladder that drains into a bag that needs to be emptied when full.

If you are experiencing urinary incontinence call us to schedule an appointment for a complete evaluation to determine the best option for you.

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