Urinary Incontinence (UI) is a more common problem than most people might think. We often associate it with getting older or after having a baby. The truth is that UI affects over 25 million adult Americans at some point in their lives. Recent consumer research reports that one in four women over 18, half of nursing home residents, 15% of men over 60, and half of men after prostate removal will experience UI. The general attitude of most folks is that “I have to live with it, because there is not much I can do about it.” Many men and women suffer in silence with a loss of self-esteem, social isolation, and employment difficulties. Despite the effects of UI, only 1 in 12 people report their symptoms and seek treatment.
The good news is that about 80% of UI sufferers can be cured or improved. Knowing what type of incontinence you have or what may be causing your incontinence is crucial for correct treatment. Your physician can determine the type of UI through examination and urological testing. Based on the findings, a qualified specialist can recommend the treatment that is appropriate for you.
Types of incontinence that are most common and can be treated with usually high rates of success include stress incontinence, urge incontinence, and mixed incontinence. Stress UI occurs with coughing, sneezing, lifting, or any activity that puts pressure on the bladder. It occurs due to weak pelvic muscles or problems with the urinary sphincter. It can affect women and men of all ages. Urge UI, also known to some as overactive bladder, is when the bladder contracts suddenly and the urge to urinate can’t be squelched. People with urgency often cannot make it to the bathroom on time. People with mixed UI have a combination of stress and urge UI. Treatment often depends on which symptom people find most troublesome.
Treatment for UI can be behavioral (think Physical Therapy), pharmacological, or surgical. The first choice of treatment if often behavioral therapy because it is the least invasive with the fewest side effects. Behavioral therapies include pelvic muscle rehabilitation, also known as “Kegels” which are exercises to improve the strength and timing of the muscles that help control urination. The exercises can be tailored to fit each patients needs and can be augmented with different forms of biofeedback therapy. Other behavioral methods include bladder retraining which involves urinating at particular intervals throughout the day to increase the time between voiding, decrease leakage, and decrease the urgency associated with incontinence. For the frail elderly, patients with Alzheimer’s, and bedridden patients scheduled toileting by the caregiver can be vital in keeping those persons drier.
Prescription medications can be helpful in the control of incontinence and can be prescribed by the healthcare provider. Adversely, certain medications can worsen symptoms and a healthcare provider can be of assistance in changing or stopping that medication.
Surgery for UI is usually considered after behavioral and pharmacologic treatments have been thoroughly explored. There are many different types of procedures for UI and the type of surgery a person may benefit from depends on the type of UI and other medical considerations.
The bottom line is that no one should be silent about their UI symptoms. Treatment is available. If you have symptoms of UI or know someone who does, find a health professional who specializes in the diagnosis and treatment of incontinence.