Incontinence is the inability to control the passage of urine or stool. Current figures indicate that a large percentage of people have involuntary loss of bladder control (urinary incontinence) and that some of these patients also have problems with bowel control (fecal incontinence).
Often, embarrassment and the stigma associated with incontinence prevent the person from seeking treatment, even when incontinence threatens his or her quality of life and that of his or her family.
Urinary and fecal incontinence can be cured or significantly improved once the underlying cause has been detected. However, it’s important to recognize that incontinence is a symptom and not a disease. Its cause may be quite complex and involve many factors. Your doctor should complete an in-depth evaluation before beginning treatment.
Getting help means taking the first step. See your doctor. Many patients can be evaluated and alone. Some patients require additional diagnostic tests. These tests can be completed in the treated even after a simple office visit outpatient setting and are not painful. Once these tests have confirmed the cause of your incontinence, your doctor can make specific recommendations for treatment, many of which do not require surgery. No matter how serious the problem seems, incontinence is a condition that can be significantly helped and, in most cases, cured.
Urinary incontinence can be caused by many different factors. Your doctor will suggest a treatment plan after considering these factors and your specific symptoms. Common treatments for urge and stress incontinence, two common types of incontinence, are described below.
Urge incontinence is an urgent desire to void, which is followed by an involuntary loss of urine. This condition can be caused by an “overactive” bladder and is commonly referred as OAB. Normally, strong muscles (sphincters) control the flow of urine from the bladder. The muscles of an “overactive” bladder spasm (contracts) with enough force to override the sphincter muscles of the urethra and allow urine to pass out of the bladder.
Medications can work very well to return normal function to the bladder. The type of medication used should also be chosen for your specific needs. Your doctor may prescribe a low dose and then gradually increase the dose. In this way, he or she can evaluate the how well the drug is working and reduce your risk of experiencing side effects. Your doctor should discuss with you the risks and benefits of using medications. Common medications used include:
Anticholinergic medications (These medications control muscle spasms in the bladder):
Aids used with self-help techniques
Your doctor may recommend surgery if other treatments fail to improve your symptoms .of overactive bladder. Surgical procedures for urge incontinence can be used to:
Stress incontinence occurs when an activity, such as a cough or sneeze, increases abdominal pressure on the bladder. Typically, a small amount of urine leaks from the urethra. This problem can result from a number of factors, including weak muscles of the pelvic floor, a weak sphincter muscle at the neck of the bladder, or a problem with the way the sphincter muscle opens and closes. Women who have given birth are more likely to have stress incontinence.
Self-help techniques and aids, as described above, can be used to treat mild stress incontinence.
Bulking agents are substances that are injected into the lining of the urethra. They increase the size of the lining of the urethra, which creates resistance against the flow of urine. Collagen is one bulking agent commonly used.
When these methods fail, surgery may be an option and is highly effective and durable. Surgery is now minimally invasive and performed on an outpatient basis in most cases without the need for a catheter after surgery. Surgery can be used to:
Kegel exercises, also called pelvic floor exercises, help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles, you can reduce or prevent problems such as leaking urine.
Imagine you are trying to stop the flow of urine or trying not to pass gas. When you do this, you are contracting the muscles of the pelvic floor and are practicing Kegel exercises. While doing Kegel exercises, try not to move your leg, buttock or abdominal muscles. In fact, no one should be able to tell that you are doing Kegel exercises.
Kegel exercises should be done every day. We recommend doing five sets of Kegel exercises a day. Each time you contract the muscles of the pelvic floor, hold for a slow count of five and then relax. Repeat this ten times for one set of Kegels.
© Copyright 1995-2018 The Cleveland Clinic Foundation. All rights reserved.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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