Incontinence

Urinary Incontinence: What You Should Know

By Scott D. Lauer, DO, FACOOG
Published in Nside Magazine & Victory Healthcare

Faucet drip’s in blue tone. Small depth of field. Have you ever wondered why you’re still “leaking” when you cough or sneeze, even several months after having a baby? While it’s very common among women after childbirth, they’re not the only ones who suffer from incontinence. In fact, 60 percent of women have incontinence during their lifetime. Urinary incontinence can be both embarrassing and debilitating as it affects your confidence and quality of life.

What is urinary incontinence?

Urinary incontinence is the involuntary loss of urine from the bladder and is caused by lost or weakened control of the urinary sphincter. It can be caused by structural or neurological damage or can even be a combination of both.

Who is most likely to suffer from urinary incontinence?

While urinary incontinence is most common in women, men are not immune. According to the U.S. Department of Health and Human Services, 13 million Americans suffer from the issues, and women experience urinary incontinence twice as often as men. Pregnancy, childbirth and menopause, as well as the structure of the female urinary tract are attributed to this difference.

It also is more common in older women than younger women, but it is not an inevitable part of aging. While physical problems affiliated with aging can cause incontinence, it can be a result of a congenital defect, neurologic injury, lack of estrogen, stroke or a procedure, such as bariatric surgery.

What types of urinary incontinence exist?

There are several types of incontinence, but the two most common are stress and urge incontinence. It also is possible to suffer from a combination of the two, which is very common.

  • Stress incontinence – Stress incontinence is caused by movements, such as coughing, laughing, sneezing, running or jumping, which put pressure on the bladder and cause leakage. This type is most common in women as it’s typically a result of physical changes related to pregnancy, childbirth and menopause. ◦One of the more common treatments to help with stress incontinence in the sling procedure. During this procedure, a synthetic mesh is used by a surgeon to create a sling under the bladder neck where the bladder connects to the urethra. The sling then helps support the urethra and keep it closed to prevent urine leakage.
  • Urge incontinence – Urge incontinence is caused by involuntary actions of the bladder muscles, causing leakage for no apparent reason and at unexpected times. This is more of a neurological problem as you know you have to go but then can’t avoid the uncontrollable urge. ◦Treatments for urge incontinence include medication a spinal cord stimulators. Surgery is more common for those who suffer from urgency incontinence.

For additional details on these and other types of incontinence, such as overactive bladder and transient incontinence, I recommend visiting the U.S. Department of Health and Human Services website.

Why is urinary incontinence so common among women?

Incontinence is common among women after childbirth, even those who deliver by C-section, as childbirth can cause damage to the nerves affecting the bladder. Incontinence is more common for those who deliver vaginally, but a C-section does not prevent the problem from happening. The major issue is that the child’s head has been sitting on the bladder for approximately nine month. While Kegal exercises will help prevent stress incontinence, it will not correct the issue.

The good news is that even though it is a common issue, for the most part incontinence is treatable.

What treatments are available?

As there are several types of incontinence, it’s important to work with a physician you feel secure with. Your doctor should perform a complete evaluation to help determine the type of issues you may be having and the proper course of treatment, which may include medication and/or procedures. In fact, according to Contemporary OB/GYN, one in five women will have a surgery for incontinence at some time in their life.

One of the latest procedure offerings includes implanting urinary spinal cord stimulators. The stimulators are made for urgency incontinence and are good for people who cannot take medications. Simply put, the stimulators help take the static out of the signal between the brain and the bladder to help the bladder function properly. Additionally, the stimulators have a dual function and can help amplify the signal if it is weak.

A proper diagnosis is key to helping you regain your confidence and restore your quality of life without urinary incontinence.

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