April 17, 2023
Right now in the U.S., more than 33 million people experience bladder control issues that can cause “accidents” on the way to the bathroom. It can be a lonely plight. Even routine activities, like going to the supermarket, might require planning.
Incontinence Can Come on Suddenly
Incontinence is the result of a weakened sphincter, or muscle, that closes the bladder to hold back urine. Miscommunications between the nerves that control urination can also cause incontinence.
There are 3 forms of incontinence:
Stress incontinence (in men and women) – Leakage resulting from physical pressure on the bladder, such as sneezing, coughing, or athletic activities. Stress incontinence affects twice as many women as men, due to pregnancy, childbirth, and menopause.
Urge incontinence (overactive bladder, or OAB) – OAB is characterized by a sudden need to urinate because the bladder contracts involuntarily.
Overflow incontinence – A condition that occurs when the bladder doesn’t empty as it should and later leaks urine. Men with enlarged prostates may experience this due to tissue compressing the urethra.
Your Pathways to Treatment Options
There are many long-term solutions to manage incontinence.
Behavioral and Oral Treatments
- Lifestyle changes – Losing weight, reducing caffeine, smoking cessation, and pelvic floor exercises (Kegels) may improve urinary function.
- Biofeedback – A probe monitors your body’s squeezing activity and displays it on a computer screen. You learn to repeat the exercise at home and manage urine flow.
- Medications – Relax the bladder muscles and make urination less urgent.
- Pelvic floor stimulation – Small doses of electrical stimulation are sent to the nerves and muscles of the pelvic floor and bladder to help them tighten and strengthen.
- Pessary – A ring-like device is fitted inside your urethra, to support the base of the bladder and prevent leaks. It is especially helpful if you have pelvic organ prolapse.
- Botox therapy – Injections around the urethra and neck of the bladder can improve muscle functions.
- Injection therapy – A bulking agent is injected into the tissues around the urethra to help close the sphincter muscle without interfering with urination.
- Sacral Neuromodulation (Axonics, Interstim) – Like a little pacemaker for the bladder.
- Tibial nerve stimulation – Similar to InterStim, this method modulates the nerves to the bladder and reduces urgency and frequency.
- Mid-urethral synthetic sling – This is a common procedure for stress incontinence in men and women. The surgeon implants a surgical mesh that supports your urethra and neck of your bladder like a sling.
- Autologous fascial sling – Similar to the mid-urethral sling, this sling is made from your abdominal or thigh tissue.
- Artificial urinary sphincter – This procedure is typically reserved for men following prostate surgery. The surgeon implants a medical device around your urethra, which compresses it. When you need to urinate, the cuff can be relaxed.
You Don’t Have to Live With Incontinence
Incontinence is a health condition with many treatment options. If you or someone you care about is experiencing symptoms, calling a urologist is the first step to managing it. If one treatment option doesn’t work for you, we will help you find one that does.
If you’d like to consult a physician about urinary incontinence or other symptoms, find a provider near you here. To review all of our specialties and treatment options, click here.