Urinary incontinence is simply the loss of bladder control and it’s a far more common condition than you may realize. In fact, it’s very likely that you or someone you know—your mother, sister, or best friend is quietly coping with this potentially embarrassing problem. Unfortunately, many don’t realize that effective treatment options are helping women regain their comfort and confidence.
Types of Urine Incontinence:
• Stress Urinary Incontinence — Is caused by weakened or damaged pelvic floor muscles. If you experience unexpected accidents or loss of bladder control when you put stress on your bladder, especially when coughing, sneezing, lifting something heavy, or laughing at a joke—you may suffer from this condition.
• Urge Incontinence (overactive bladder) — Is the result of overactive muscles that contract frequently around the bladder. If you feel a sudden, overwhelming urge to use the restroom, even if you just went, and are unable to hold it long enough to get there, urge incontinence may be the reason.
• Mixed Incontinence — If both of these situations are familiar to you, you may have mixed incontinence, a combination of stress and urge incontinence.
Other, less common types of urinary incontinence include, overflow incontinence and transient incontinence.
Anatomy: Changes in your body can lead to urinary incontinence
Your body before urinary incontinence:
The muscles and ligaments of the pelvic area support the bladder and urethra in their normal positions. They also provide proper muscle control, alternately constricting the urethra to store urine or constricting the bladder to remove urine from the body.
Your body with stress urinary incontinence:
When the pelvic floor muscles and ring of muscles that surround the urethra (urinary sphincter) have been weakened or damaged by pregnancy, childbirth, menopause, aging, prior pelvic surgical procedure including hysterectomy, obesity, radiation therapy, trauma or some other medical problems, the urethra may relax from its normal position and be unable to close completely. So, if a woman coughs, sneezes, or laughs, the sudden pressure she places on her bladder may be too much for her weakened muscles to handle, and she may experience an embarrassing momentary loss of bladder control known as stress urinary incontinence.
Your body with urge urinary incontinence:
While the end result may be the same, urge urinary incontinence results from a very different set of circumstances. When nerve passages from the bladder to the brain are impaired by an infection or a neurological injury, disease, or disorder, the brain may receive bad information—and indicate that the bladder should be emptied, even if it’s not full. The brain then directs the muscles surrounding the bladder to contract, sometimes so suddenly that there isn’t enough time to get to a restroom.
Non-surgical treatment methods:
Women who are just beginning to experience symptoms of urinary incontinence may opt for non-surgical methods as their first step. For women dealing with mild symptoms, these simple changes may be effective.
• Behavior therapies — By introducing simple lifestyle changes—like making frequent visits to the restroom, drinking fewer liquids at night, and limiting coffee and alcohol—some women are able to minimize the frequency and severity of their urinary incontinence symptoms. Evidence also suggests that postural changes (i.e. not crossing legs) may help minimize stress urinary incontinence symptoms, while weight loss can reduce symptoms of stress, urge, and mixed incontinence.
• Pelvic floor exercises — Known to many women as Kegels, they help strengthen the pelvic floor muscles for improved bladder control in women who suffer from stress urinary incontinence. They are easy to learn and perform, simply relax and contract the muscles you would use to halt your flow of urine midstream. However, in order for Kegel exercises to make an impact, they must be done correctly, regularly, and for an adequate duration.
• Vaginal pessary — Similar to the outer ring of a diaphragm, when placed into the vagina, a pessary can provide support to the pelvic floor and help relieve stress urinary incontinence symptoms. Pessaries and other urethral inserts must be fitted by your doctor to ensure optimal results. While these devices are an acceptable treatment for some women, others prefer a treatment option that doesn’t require daily intervention.
• Medications — For women who suffer from urge incontinence, daily prescriptions like DetrolLA® may restore bladder control. However, there are no medications currently available to treat stress urinary incontinence.
New minimally invasive procedures
For women who’ve decided to seek treatment for stress urinary incontinence, they’ll be glad to know that the options have changed dramatically since the days of their mothers and grandmothers. Now, more and more women are turning to minimally invasive treatment options. These new procedures are effective and often involve less pain and a shorter recovery time.
New Surgical Method of Treatment
Urinary incontinence slings
Known as urethral support slings by specialists, these soft and flexible surgical mesh systems cradle the urethra like a hammock, providing additional support and helping to restore it to its normal anatomical position.
Urethral support slings are proving to be an effective surgical procedure for stress urinary incontinence. In fact, clinical research shows that slings are up to 90% effective.
Benefits of slings:
If you’re considering a urethral support sling to treat stress urinary incontinence, consider these important benefits shared by women and their doctors:
• They’re effective for most women
• Many women regain complete bladder control within hours of their procedure
• In most cases, women can return to normal, non-strenuous activities shortly after the procedure
• Depending on the specific type of procedure, they may be performed under local, regional, or general anesthesia on an out-patient basis
• Incisions are small, reducing pain and recovery time
• The procedures can be performed in women who have scarring from previous pelvic surgeries
About the procedure:
While each sling procedure varies slightly, placing the mesh generally involves these steps:
• A small incision or incisions will be made in the vagina, the abdomen, or where the top of your thigh meets your pelvic area
• The mesh is threaded through the incision and positioned under the urethra to form a cradle of support
• The mesh allows your body tissues to grow into it, providing support to your urethra and securing the mesh in place.