Letting Your Doctor Know How You Feel
Kathleen knew she wanted to get help for her leaky bladder. âOnce you have a problem with incontinence, it becomes all you think about,â she says. âEven something as simple as going to a store takes planning.Ã¢ She sought help early on, learned about her options, knew what she wanted to try first, and communicated her desires to her doctor.
Kathleen decided to have surgery to implant a urethral sling at Duke University Hospital in Durham, NC. Changes in the pelvic floor muscles can cause the bladder to move out of itâs normal position and a sling helps hold it back in. She was pleased with the results.
Fourteen years later, however, she noticed symptoms of stress incontinence again. Ã¢I was just leaking a little,Ã¢ she says. Ã¢But I knew about physical therapy and felt that if I worked on developing those muscles now, before it got really bad, I wouldnÃ¢t need to have surgery again.Ã¢ She also wanted to avoid taking medications, if possible.
Her doctor referred her to a urogynecologist, a specialist in urinary and associated pelvic floor problems. Ã¢I told him I wanted to try physical therapy first, unless it was something I couldnÃ¢t do because of prior surgery or other issues,â Kathleen says.
The urogynecologistÃ¢s exam turned up two issues adding to her stress incontinence â a weak urethra and a prolapsed, or dropped, bladder. He advised trying intensive pelvic floor physical therapy, including Kegel exercises, and referred her for nine weeks of treatment.
Fast Facts On Urinary Incontinence
- Urinary incontinence is more common in females than in males.
- There are a number of reasons why urinary incontinence can occur.
- Obesity and smoking are both risk factors for urinary incontinence.
Urinary incontinence is when a person cannot prevent urine from leaking out.
It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity.
The chances of it happening increase with age.
Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.
Treatment will depend on several factors, such as the type of incontinence, the patients age, general health, and their mental state.
Conditions Treated By Kidney Doctors
Kidney doctors care for people with a number of different types of kidney disease including:
- Acute kidney injury: Acute kidney disease refers to the rapid onset of kidney disease often related to conditions such as shock , dehydration, kidney problems related to surgery, or inadequate drainage from the urinary tract .
- Chronic renal failure: Chronic kidney disease can be caused by a number of different conditions
There is a wide range of medical problems that can affect the kidneys in different ways. Some of the more common conditions which can cause kidney failure include:
- Diabetes : Diabetes is the leading cause of kidney failure in the United States
- Kidney disease related to high blood pressure and heart disease
- Kidney stones which cause obstruction
- Congenital kidney problems such as horseshoe kidney
- Glomerulonephritis: Glomerulonephritis is an inflammation of the kidneys which can be caused by a number of different processes, including the bacteria which causes strep throat.
- Kidney disease related to lupus
- Polycystic kidney disease: Cystic kidney disease is hereditary, though the severity of the disease, as well as age of onset, can vary
- Autoimmune diseases such as IgA nephropathy
- Kidney failure secondary to liver disease
Chronic kidney disease is described by five stages based on the severity of the disease. Grade 1 kidney failure refers to a mild disease, whereas grade 5 renal failure usually indicates that dialysis or a kidney transplant will be needed.
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What Conditions Do Urologists Treat
Urologists can treat anything related to the urinary tract or male reproductive system. Some common conditions include, but are not limited to:
Urinary Tract Infections
A urologist will typically perform various tests to diagnose the condition, and may then suggest a number of different treatment options, potentially including surgery. Urologists are trained in performing specific types of surgery, such as sling procedures for urinary incontinence or prolapse, repairing urinary organs, removing blockages, vasectomys, removing tissue from enlarged prostates, or even removing the prostate all together.
What Your Doctor Needs To Know
The more open you are about your symptoms, the better. You have to be blunt about describing exactly whats happening and not get mired in the terminology. Tell your doctor whether you leak urine when you laugh, sneeze, cough, exercise, or have sex, or whether you frequently have the urge to urinate but when you go cant seem to empty your bladder completely.
Tell your doctor how long its been going on and what exactly is happening to you. Describe what situations seem to bring it on and what youve done to try to make it better. Put it in the hands of your doctor.
Starting a few days before your appointment, keep a bladder diary. This is a journal in which you write down everything you drink and how often and how much you go to the bathroom. If leakage is a problem, keep track of how much you leak and what you are doing when it happens.
Sharing this information with your doctor will help him diagnose your problem. He can determine whether you have urge incontinence, stress incontinence, overactive bladder, mixed incontinence, or something else urinary incontinence also can be a sign of other diseases and conditions such as diabetes, prostate problems, or multiple sclerosis.
Your doctor will also need to know your medical history, including any pregnancies youve had, any surgeries youve had, and any prescription medications or over-the-counter pills you take.
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Surgical Treatments For Incontinence
Currently there are several different surgical options for incontinence. However, these treatments are often only recommended if medication and behavioral modifications have not been effective. Different procedures are used for women and men.
The most common surgical treatments for incontinence in women are:
- Retropubic Suspension: If the bladder falls out of place due to a weakening of the vaginal wall, this procedure can be used to situate the bladder back in the correct position. One or more incisions are made in the lower part of the abdomen. Surgical instruments are inserted through the cut, allowing for the bladder, part of the vaginal wall, and the urethra to be sutured to the pelvic bones and ligaments. This raises the urethra and the bladder.
- Pubovaingal Fascial Sling: In this procedure, a material known as fascia is placed around the neck of the bladder to stop urine from involuntarily leaking.
- Suburethral Sling: This procedure involves placing a sling under the urethra to support the neck of the bladder and prevent leakage.
- Tension-Free Vaginal Tape : TVT is a mesh that is placed around the neck of the urethra to provide additional support and stop urine from leaking.
The most common surgical treatments for incontinence in men are:
- Male Sling: The male sling involves placing a strip of material underneath the urethra to stop the urethra from opening involuntarily.
How Does The Functional Anatomy Of The Pelvic Floor Translate Into Clinical Practice In Athletes
There are two opposing theories about how physical activity may affect the pelvic floor: physical activity strengthens the PFMs exercises overload and weaken the pelvic floor. However, neither of them has been proved to date . Athletes report more intense leakage at the end of training or competition. This suggests that they suffer from a lack of muscular endurance of the pelvic floor. Being a former elite athlete is probably not associated with later UI risk, but when performing sport UI is strongly associated with persistent urinary incontinence in future . It is also uncertain whether high-impact sport causes a PFM imbalance with abdominal muscle fatigue or whether it damages the PFMs and leads to SUI. This question should be answered in well-designed studies. The more frequent the impact associated with increased intra-abdominal pressure, the greater should be the restraint and support of PFMs, which must be strengthened to prevent SUI and preserve the function . Moreover, eating disorders, including sport anorexia, among athletes such as long-distance runners can be associated with UI .
When Should I Ask My Gynecologist About Incontinence
While one or two incidents of urine leakage may be embarrassing, it is not a definitive sign of urinary incontinence. If the problem occurs with frequency, or it impacts your quality of life, then it is time to discuss it with your gynecologist.
Before your appointment, keep notes about the day and time of each instance of urinary leakage including the amount , frequency, and activities that may have caused the issue, like physical stress from lifting something.
You Generally Need A Referral To See A Urologist
When patients notice something unusual, whether it be an issue with bladder control or an enlarged prostate, their first thought should be to see their primary care doctor. A GP can do an initial evaluation and decide whether you need to be referred to a specialist, which in this case would be a urologist. Different health care plans have varying requirements for seeing a specialist, but in many cases you will need a referral from your primary care doctor.
Patients may also choose to skip their GP and come direct to a specialist. This may happen if they had some acute issue in the emergency, or have an issue they feel more comfortable speaking about directly with a urologist, such as erectile dysfunction.
In most cases other than acute emergencies , a direct referral may be necessary. But even in these cases if often best to go through your GP or the emergency room.
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Know The Proper Steps To Take For The Quickest Relief From Urinary Tract Infection
The lower urinary tract can provide access for infectious bacteria to enter the body, sometimes resulting in urinary tract infections. A urinary tract infection may cause one or more symptoms, such as a persistent sense of need to urinate, a burning sensation during urination, frequently passing only small amounts of urine, or urine that appears cloudy, bright red, pink, or brownish.
If you experience any of the above symptoms, see your doctor to find out which of the following methods of diagnosis and urinary tract infection treatment is appropriate for your needs.
When To See Your Doctor
Itâs time to get things checked out if:
- You have to go to the bathroom a lot more than usual, and often canât hold in your urine until you get to the toilet
- You leak when you sneeze, cough, or even stand up
- You leak at random times, even if you didnât cough or sneeze
- You feel like your bladder still has urine in it, even after you go
- Your stream of urine is weak
- You have to strain when you urinate
- It hurts to urinate
- You feel pressure in your lower abdomen
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Signs And Symptoms Of Urinary Incontinence
The signs and symptoms of urinary incontinence vary by the type of incontinence you have. Symptoms may include:
- Leaking urine during everyday activities, such as lifting, coughing, bending, or exercising
- Leaking urine without warning or any sense that you needed to pee
- Having the sudden, strong urge to urinate that causes you to rush to the bathroom
- Being unable to physically reach the toilet in time
- Wetting your bed at night
- Leaking urine during sex
If you are having any of these symptoms, it is important to seek help from a qualified healthcare provider.
Dont Wait To Get Incontinence Help
When experiencing symptoms, the best thing you can do for your physical and mental health is to seek help for incontinence as soon as possible. Toning and strengthening the pelvic floor is often key to controlling bladder leakage. And the longer you wait, the more difficult it is to regain control of bladder leaks. Your physician will work with you to determine the best course of action and treatment option for your body.
One of the most effective devices for treating SUI is an easy-to-use, nonvaginal device that uses gentle electrical stimulation to tighten your pelvic floor muscles. FDA-cleared ELITONE is worn externally like a pad and can be used in the comfort of your home. Learn more by for incontinence help in women.
ELITONE stress incontinence help:
- Nine out of 10 gynecologists said they would prescribe ELITONE.
- 100% externalnothing goes inside you.
- Youll notice fewer leaks in as little as 6 weeks!
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Causes Of Female Incontinence
Incontinence can be caused by multiple factors including lifestyle habits, physical problems and medical conditions. Causes of temporary and persistent urinary incontinence include:
- Bladder irritation caused by infection, dietary irritants or kidney stones
- Diseases and disorders of the nervous system
- Weakness of certain muscles in the pelvis
- Weakness of the tissues holding the bladder in place
- Weakness of the sphincter muscles surrounding the urethra
- Pain related to urination without a proven bladder infection
- Increased rate of urination without a proven bladder infection
- Frequent bladder infections
- Progressive weakness of the urinary stream
- Needing to rush to the restroom and/or losing urine
- Abnormal urination or changes in urination related to a nervous system problem
- Leakage of urine that prevents activities
- Leakage of urine that began or continued after surgery
- Leakage of urine that causes embarrassment
How Do I Do Kegel Exercises
Kegel exercises are a simple way to build strength in your pelvic floor muscles. These exercises are done by lifting, holding and then relaxing your pelvic floor muscles. You can find these muscles by stopping the flow of urine mid-stream while youre urinating. Only do this until you learn how to find the muscles stopping the flow of urine mid-stream isnt healthy over a long period of time.
When youre doing Kegel exercises, start small. Only hold it for a few second. Over time you can slowly work your way up to longer and longer stretches of holding the muscles tight.
Unlike other types of workouts, no one can tell when youre doing Kegel exercises. Aim to do several sets of Kegel exercises twice a day.
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Visiting The Doctor For A Uti Heres What You Need To Know
If you think you might have a urinary tract infection , its important get a check up from your health care provider. Heres what you need to know before the visit.
The best way to prepare for your appointment is to know your symptoms and medical history, such as past UTIs, what kinds of antibiotics you took, and any allergies to medications. According to Stanford primary care physician Kim Chiang, MD, these conversations can be very personal, but its critical to tell the doctor the whole story.
Video visits are becoming more popular for UTIs, offering a similar appointment, but without the possibility of an in-person physical exam or urine test. Knowing what to expect can prepare you to help your doctor to provide the best possible care.
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Types Of Urinary Incontinence
Its important to visit your urologist to determine what type of urinary incontinence you are experiencing. Your urologist will be able to examine symptoms and recommend next steps and treatment for your individual symptoms. Additionally, a urologist will be able to determine the cause of urinary incontinence, which may be:
- Hormone and weight changes during or after pregnancy
- A weakened pelvic floor
- Urinary tract obstruction
- Neurological disorders
Now that we have defined what UI is and its symptoms, lets dive deeper into the recent study of urinary incontinence.
Related Conditions And Causes Of Urinary Incontinence
Fecal incontinence is light to moderate bowel leakage due to diarrhea, constipation, or muscle or nerve damage.
As described in the section above on causes of urinary incontinence, common conditions may contribute to chronic urinary incontinence, including: urinary tract infection , constipation, interstitial cystitis or other bladder conditions, nerve damage that affects bladder control, side effects from a prior surgery, and neurological disorders.
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Urinary Incontinence In Women: What You Need To Know
Urinary incontinence is the accidental loss of urine.
Over 25 million adult Americans experience temporary or chronic urinary incontinence.
This condition can occur at any age, but it is more common in women over the age of 50.
There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.
Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
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Treatment Of Urinary Incontinence
Treatment usually begins with bladder training and Kegel exercises. Avoiding physical stresses that cause loss of urine and losing weight may help control incontinence. Pseudoephedrine may be useful in women with bladder outlet incompetence. Imipramine may be used for mixed stress and urge incontinence Urge incontinence Urinary incontinence is involuntary loss of urine. Incontinence can occur in both men and women at any age, but it is more common among women and older people, affecting about 30% of older women read more or for either separately. Duloxetine is also used for stress incontinence. If stress incontinence is caused by atrophic urethritis or vaginitis, estrogen cream is often effective. For people with stress incontinence, urinating frequently to avoid a full bladder is often helpful.
For stress incontinence that is not relieved with drugs and behavioral measures, surgery or devices such as pessaries may be helpful. The vaginal sling procedure creates a hammock of support to help prevent the urethra from opening during coughing, sneezing, or laughing. Most commonly, a sling is created from synthetic mesh. Mesh implants are effective, but a few people with mesh implants have serious complications. Alternatively, doctors can create a sling using tissue from the abdominal wall or leg. In men with stress incontinence, a mesh sling or an artificial urinary sphincter implant may be placed around the urethra to prevent leakage of urine.