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Overactive Bladder
 You're not alone if you're frustrated by bladder control problems. Millions of people experience bladder issues at some time. That's why we used our expertise in sacral nerve stimulation to develop an innovative overactive bladder treatment for patients who have failed or could not tolerate more conservative treatments.
Please click on the link below for more information on Robotic Surgery
Overactive Bladder
Incontinence
This is an abbreviated version of the complete article.*
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| Basic Facts |
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Incontinence, the involuntary loss of urine, is often associated with an underlying medical condition. |
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One-third of people older than 60 have some loss of urinary control. |
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Most incontinence is caused by genetics and life event factors, such as obesity, smoking, and childbirth. |
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| The female genitourinary tract. |
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Incontinence-the involuntary release of urine-is a medical condition that is well-known but rarely discussed. Although it becomes more common as people age, it is not a normal part of aging. Because it can be socially embarrassing and isn't life-threatening, many people with incontinence avoid mentioning the condition to their physicians. Their silence is unfortunate because many treatments can help incontinence.
Incontinence takes several forms: stress, urge, reflex, overflow, and functional.
- Stress incontinence, the most common form, refers to urine that leaks following activities like exercise, coughing, laughing, or sneezing.
- Urge incontinence is the frequent, sudden, and uncontrollable urge to urinate.
- Reflex incontinence refers to leaking urine without realizing it. People with this disorder usually do not sense that their bladder is full.
- Overflow incontinence results from an inability to completely empty the bladder. A person may frequently feel the urge to urinate but void only a small amount of urine.
- Functional incontinence refers to the inability to physically get to a toilet.
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| The male genitourinary tract. |
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CAUSES AND RISK FACTORS
Each form of incontinence has specific causes and risk factors.
- Stress incontinence arises when the bladder sags because the pelvic muscles are weak. It most often strikes women, whose risk factors include childbirth, menopause, age, and obesity. Prostate surgery can increase a man's risk for stress incontinence.
- Urge incontinence typically appears in older women who have a hyperactive bladder (a bladder that contracts uncontrollably). Other causes include anxiety, infections, nerve damage, neurological diseases such as multiple sclerosis and Parkinson's, and in men, prostate surgery.
- Reflex incontinence causes include diabetes, neurological diseases, or stroke.
- Overflow incontinence is common in men who have an enlarged prostate. Other causes include constriction of the urethra, inflammation, nerve damage, and tumors.
- Functional incontinence occurs when a debilitating disease like arthritis, Alzheimer's disease, or severe depression prevents a person from physically getting to a toilet. People with this condition may have normal bladder control and urination.
DIAGNOSIS
To determine the type of incontinence a patient has, a physician may order one of the following tests:
- Bladder diary: The patient records day-to-day information like fluid intake and frequency of urination.
- Post-void residual urine volume: The physician measures the urine left in the bladder after voiding.
- Urodynamic testing: A series of tests measure the bladder's ability to retain urine, the nerve activity of pelvic muscles, and other factors.
- Bladder stress test (Marshall test): Used to diagnose stress incontinence, this test involves filling the bladder, asking the patient to cough forcefully, and looking for leakage.
TREATMENT APPROACH
Treatment for incontinence depends on the type of incontinence and can be mild to invasive. Therapies include:
- Kegel exercises (identifying and squeezing the muscles that stop urination);
- Vaginal cones (weights that improve pelvic muscle tone);
- Biofeedback;
- Urinating on a schedule;
- Barriers or pads (such as pessaries, patches, or urethral plugs);
- Catheters;
- Medications such as calcium channel blockers, estrogen, or some decongestants; and
- Surgery.
LIFESTYLE
Managing incontinence also means making lifestyle changes. These include:
- Limiting consumption of alcohol and caffeine, which spur urination;
- Spacing drinks throughout the day;
- Maintaining an appropriate weight;
- Exercising regularly; and
- Avoiding smoking.
Medical Review Date: June 26, 2009
*If you would like to read this article in its entirety, please call our office and ask to meet with one of our specialists to receive a Prescription Pad form.
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