Sacral Nerve Stimulation Therapy
Sacral nerve stimulation is a treatment in which mild electrical impulses are sent to the sacral nerves near the lower back. A device — implanted in the upper buttocks under the skin — is used to provide electrical pulses that influence bladder function. The procedure to implant the device does involve surgery, but it is minimally invasive, and reversible.
What Is Urinary Incontinence
Many people experience involuntary leakage of urine from the bladder. This condition is called urinary incontinence. It affects nearly a quarter to a third of men and women in the United States. That is millions of Americans.
Urinary incontinence is the leaking of urine from the bladder that you cant control. There are different kinds of urinary incontinence, and not all types are permanent. An experienced doctor can help you find the best treatment for your urinary incontinence.
Stress urinary incontinence is when the muscles arent strong enough to hold urine in the body. SUI shows itself through physical symptoms, including involuntary leaking of urine through the bladder when active.
Overactive bladder is a strong sudden urge to urinate, which may or may not cause urine to leak from the bladder.
In some cases, people experience a combination of both SUI and OAB. This shows itself through physical symptoms. If this is the case for you, you will find involuntary leaking of urine through the bladder and strong sudden urges to urinate that you cant control.
Overflow incontinence is when the bladder isnt able to empty itself completely. Overflow incontinence shows itself through physical symptoms, including constant dribbling of small amounts of urine when the bladder is full.
These symptoms are not just physical. Urinary incontinence has emotional and psychological effects, too.
Tension Free Vaginal Tape
This is a procedure that can be done as day surgery but is not normally recommended for those who are considering having children in the future. This involves threading tape through a small incision of the vaginal wall so that it supports the urethra. Click to find out more about tension free vaginal tape.
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Pelvic Floor Muscle Exercises
The pelvic floor is layers of muscles that stretch from the pubic bone to the coccyx and then from side-to-side. These muscles help to support the bladder and bowel plus the womb in women. These muscles can become weak through trauma such as childbirth or surgery, changing hormones, persistent coughing or chronic constipation. When these muscles become slack it can weaken the opening to the bladder causing urine to leak out when placed under pressure. These exercises can help to strengthen the pelvic floor and reduce the occurrence of leaking. Click to read about pelvic floor muscle exercises.
Urinary Incontinence In Women: What You Need To Know
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Urinary incontinence is the accidental loss of urine.
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Over 25 million adult Americans experience temporary or chronic urinary incontinence.
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This condition can occur at any age, but it is more common in women over the age of 50.
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There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.
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Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.
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Nighttime Voiding And Incontinence
Nighttime voiding and incontinence are major problems in the older population. Women who have nocturia more than twice a night or experience nighttime bed-wetting may benefit from fluid restriction and the elimination of caffeine-containing beverages from their diet in the evening. Patients should restrict fluids after dinnertime so they can sleep uninterrupted through the night. In some cases, DDAVP can be used to decrease nighttime urine production and help reduce nocturia however use caution regarding the risk of hyponatremia, especially in elderly patients.
Finally, individuals who develop edema of the lower extremities during the day experience nighttime voiding because excess fluid from lower extremities returns to the heart when the person is in a recumbent position. This problem may be handled with a behavior technique, support hose, and/or medications.
Advise these individuals to elevate their lower extremities several hours during the late afternoon or evening to stimulate a natural diuresis and limit the amount of edema present at bedtime. Support hose or intermittent sequential compression devices used briefly at the end of the day can reduce lower extremity edema and minimize night time diuresis, thus improving sleep.
Who Needs Urinary Incontinence Treatment
Your pelvic floor muscles are responsible for much more than just keeping your bathroom breaks in check. These muscles can also increase feelings of pleasure, heighten mens staminaand performance, and reduce pain.
Some people dont tolerate minor degrees of incontinence. Others will put up with almost total urinary incontinence and still not seek medical help, Dr. Beatty said.
Overall, its advisable to have treatment, on medical grounds, if there is significant urine retention. If the bladder overfills the urine can back up into the kidneys and this can impair kidney function and cause renal failure.
So the best urinary incontinence treatments are for you if you frequently or occasionally experience bladder leaks when exercising, sneezing, or laughing.
If you have trouble making it to the bathroom, using one of the options listed here could be very beneficial.
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Cholinergic Drugs For Bladder Problems
This class of drugs includes bethanechol . Cholinergic refers to nerve cells or fibers that use a certain type of chemical to send signals within the body. Cholinergic drugs are used when the bladder is not emptied completely following urination. This problem is known as residual urine in the bladder.
- How cholinergic drugs work: These drugs contract the bladder, thus allowing complete emptying.
- Who should not use these medications: Individuals with the following conditions should not use cholinergic drugs:
- Parkinson’s disease
- Bladder or bowel obstruction
Medications For Unspecified Oab
If your doctor cant find a cause for your OAB, dont worry. Drugs can still help ease your symptoms. Some of these drugs work by relaxing your bladder. They stop involuntary contractions that bring on the urge to urinate. Other drugs help strengthen the tissues around your bladder that may have become weak. The stronger tissue can help improve your bladder control.
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First Otc Drug Approved For Overactive Bladder
HealthDay News The FDA has approved oxybutynin as the first over-the-counter treatment for women 18 and older with overactive bladder.
Oxybutynin belongs to a class of drugs called anticholinergics that are designed to relax the bladder muscle. No agent in this class has been available over-the-counter before, the FDA said in a press release.
Oxybutnin will be sold as a patch to be applied to the skin every four days. Overactive bladder is characterized by symptoms including leakage, frequent urination, and feeling the sudden and urgent need to urinate. The condition affects some 33 million Americans, mostly older women.
Approval of the OTC formulation was based on results from nine studies involving more than 5,000 patients. Overall, results from these studies showed that consumers can understand the information on the label, properly select whether the product is right for them, and use the drug appropriately, the FDA said.
Side effects reported during clinical testing included skin irritation at the patch site, dry mouth and constipation.
The drug will remain available for adult men by prescription only, due to concerns that incorrect self-diagnosis could delay treatment for prostate cancer. Study findings showed men were relatively poor at correctly determining whether oxybutynin was the appropriate treatment for their urination problems.
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Pharmacologic Agents That Cause Urinary Incontinence
A variety of drugs have been implicated in urinary incontinence, and attempts have been made to determine the mechanism responsible based upon current understanding of the processes involved in continence and the transmitters that play a role. Each of the processes described previously can be manipulated by pharmacologic agents to cause one or more types of incontinence.
The drugs commonly pinpointed in urinary incontinence include anticholinergics, alpha-adrenergic agonists, alpha-antagonists, diuretics, calcium channel blockers, sedative-hypnotics, ACE inhibitors, and antiparkinsonian medications. Depending upon the mode of action, the effect may be direct or indirect and can lead to any of the types of incontinence. Taking these factors into account, it is important to consider a patients drug therapy as a cause of incontinence, particularly in new-onset incontinence patients and in elderly patients, in whom polypharmacy is common.11,12
On the other hand, a pharmacologic agent or any other factor that results in chronic urinary retention can lead to a rise in intravesical pressure and a resultant trickling loss of urine. In this way, drugs that cause urinary retention can indirectly lead to overflow incontinence.2
It is useful to note that many antidepressants and antipsychotics exhibit considerable alpha1-adrenoceptor antagonist activity.1
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Drug Increasing Bladder Capacity To Hold Urine
Two medications, in the beta-three adrenergic agonist class of drugs, have been studied in women with urgency incontinence. These medications work by improving the bladderâs capacity to hold urine and therefore increase the time between âurgentâ trips to the toilet.
Mirabegron and solabegron are newer drugs and have been designed to resolve urgency urinary incontinence without causing bothersome harms. However, fewer clinical studies have examined these drugs. Future research will help us to know more about the long-term safety of mirabegron and solabegron.
Incontinence And Alzheimers Disease
People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:
- Avoid giving drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
- Keep pathways clear and the bathroom clutter-free, with a light on at all times.
- Make sure you provide regular bathroom breaks.
- Supply underwear that is easy to get on and off.
- Use absorbent underclothes for trips away from home.
For more ways to deal with incontinence and other common medical problems in someone with Alzheimers, visit Alzheimers Disease: Common Medical Problems.
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Behavioral And Lifestyle Changes
Changing your lifestyle may help with bladder problems. Losing weight, quitting smoking, saying no to alcohol, choosing water instead of other drinks, and limiting drinks before bedtime can help with some bladder problems. Preventing constipation and avoiding lifting heavy objects may also help with incontinence. Even after treatment, some people still leak urine from time to time. There are bladder control products and other solutions, including disposable briefs or underwear, furniture pads, and urine deodorizing pills that may help.
Visit the National Institute of Diabetes and Digestive and Kidney Diseases for more information on urinary incontinence in men and urinary incontinence in women.
What Causes Incontinence
There are many different reasons that you could experience incontinence. These causes can vary depending on if youre a woman or man. Some causes are temporary health conditions that usually go away once treated. In those cases, your incontinence also usually stops once the condition is treated. Incontinence can be caused by long-term medical conditions. When you experience leakage issues because of a chronic condition, its usually something you will have to manage over a longer period of time. Even with treatment, chronic conditions usually dont go away. Incontinence may have to be managed over time as a symptom of your chronic condition.
Temporary or short-term causes of incontinence can include:
- Urinary tract infections : An infection inside your urinary tract can cause pain and increase your need to pee more often. Once treated, the urge to urinate frequently usually goes away.
- Pregnancy: During pregnancy, your uterus places extra pressure on the bladder as it expands. Most women who experience incontinence during pregnancy notice that it goes away in the weeks after delivery.
- Medications: Incontinence can be a side effect of certain medications, including diuretics and antidepressants.
- Beverages: There are certain drinks like coffee and alcohol that can make you need to urinate much more often. If you stop drinking these beverages, your need to urinate frequently typically goes down.
- Constipation: Chronic constipation can cause you to have bladder control issues.
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Azo Urinary Pain Relief
Similar to the previous product by AZO, this one contains Phenazopyridine as an active ingredient, just a lower dose .
Therefore, AZO Urinary Pain Relief has the same side-effects and method of action. It is also purely analgesic, containing no antimicrobial ingredient, and is sold at a lower price, as it contains lessPhenazopyridine per dose.
There are no other ingredients that add value and the same possible carcinogenic effects associated with using Phenazopyridine.
What Is The Evidence For Effective Treatments For Urinary Incontinence
Women have several options to manage their urinary incontinence and these primarily include either drug or non-drug treatments. Many studies have shown that the majority of women improve their symptoms using non-drug conservative interventions and these include:
Intra-vaginal electrical or magnetic stimulation may help some women with incontinence . However, some women do not benefit from these non-drug treatments, or they are unable to access these treatments, or make the necessary lifestyle changes. In this case, doctors may suggest the use of drugs to help with incontinence problems. We review the current scientific evidence about the effectiveness of these drugs to help manage incontinence.
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Cleavers And Corn Silk
Cleavers, or sticky willy, is a plant that clings to everything, as its name implies. Cleavers tea is marketed as detoxifying and as providing lymphatic support, but no evidence documents its use to reduce OAB symptoms.
Corn silk, the strands you pluck from corn before eating it, is also used to make a tea. This tea is said to ease urinary tract infection symptoms, but no data backs up that claim. Nor is there scientific proof that corn silk would help OAB.
Who Suffers From Stress Incontinence
According to the National Institute of Diabetes and Digestive and Kidney Diseases , women are twice as likely as men to suffer from involuntary leakage. The most common causes of stress incontinence among women are pregnancy and childbirth, especially having multiple vaginal deliveries. During pregnancy and childbirth, the sphincter and pelvic muscles stretch out and are weakened.
Older age and conditions that cause a chronic cough can also cause stress incontinence. This condition can also be a side effect of pelvic surgery.
Some women only suffer from stress incontinence during the week before they get their period. The NIDDK explains that estrogen drops during this phase of the menstrual cycle, which can weaken the urethra. This is not common though.
Among men, prostate surgery is a common cause of stress incontinence. The prostate gland surrounds the male urethra, and its removal can result in the loss of support of the urethra.
Other risk factors for stress incontinence include:
- smoking due to chronic cough
- any other condition associated with chronic cough
- excessive caffeine and alcohol use
Treatment for stress incontinence varies according to the underlying cause of your problem. Your doctor will help you come up with a treatment plan using a combination of medications and lifestyle adjustments.
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Medications For Overactive Bladder
Drugs used to treat OAB block the abnormal contractions of the bladder muscle and can therefore also help ease the symptoms of urge urinary incontinence in both men and women. Youll find a list of OAB medications available in Canada on page 20. Generally speaking, these drugs fall into three categories:
Anticholinergics
Anticholinergic medications block the action of acetylcholine, a chemical messenger that tells the muscles of the bladder wall to contract. Unfortunately, acetylcholine acts in other parts of the body as well, so medications that block it can cause unwanted side effects like dry mouth, blurred vision, impaired cognition and constipation. New extended or prolonged release versions of anticholinergic medications reduce the incidence of side effects and improve compliance because they only need to be taken once a day to produce a steady absorption rate and constant blood levels of the drug.
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Meet The Expert: Dr David Beatty Md
Dr. David Beatty has been a doctor for over 30 years in England. A large part of this role has been around helping people make lifestyle changes. Recommending and educating people on healthy habits such as sleep, nutrition and weight loss has been crucial to his career.
Dr. Beatty has been featured in Healthline, Best Life Online, Up Journey, and much more. You can learn more about David and his qualifications here.
In fact, pregnancy and vaginal delivery are often responsible. Uterine or vaginal wall prolapse can also play a part.
If youre tired of wearing bulky pads or maybe even incontinence briefs, the best urinary incontinence treatments can help you regain your freedom.
Ill walk you through the 10 best urinary incontinence treatments. From convenient, non-invasive shorts to innovative pelvic floor exercisers, consider this your judgment-free guide to a leak-free life.
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