At Urology Associates of Central Missouri, expert help is available to improve the quality of life for those with bladder control problems. Patients have the opportunity to be evaluated by experts in treating all aspects of male and female urinary incontinence in people of all ages. It is very important to determine which type of leakage or “incontinence” a person has in order to determine the best treatment for them.
Signs & Symptoms
- Urge Incontinence is leakage caused by an inability of the bladder to store or hold the urine. A person that leaks before they can make it to the restroom in time has urge incontinence.
- Stress Incontinence results from damage to the sphincter or valve that allows you to start and stop your urinary stream. This valve prevents urine from leaking out when you cough or exercise. The sphincter can be damaged during prostate or pelvic surgery or trauma.
- Mixed Incontinence is where both components are present. The most bothersome component is treated first.
Diagnosis & Treatment
This type of leakage is usually very apparent on review of the patients history and symptoms. I is important to know what pelvic surgeries a patient has had and any associated neurologic conditions as well as a history of radiation therapy. The following workup is required:
- determination of number of pads used per day or pad weight for leakage
- cystoscopy to rule out scar tissue or other bladder problems
- if there is a significant component of urge incontinence then urodynamic testing may be warranted to evaluate for bladder problems that could compromise effectiveness of treatments for stress leakage
Conservative treatments for stress incontinence include pelvic floor muscle exercises and biofeedback therapy. Surgical treatments include male urethral slings for moderate leakage and artificial urinary sphincters for severe incontinence.
The following workup may be indicated for urge leakage to determine the best treatment options:
- voiding diary
- uroflow testing and post void residual bladder ultrasound
Conservative treatments include dietary modification and biofeedback therapy. Medications can be used to relax the bladder muscles. When these treatments fail botox can be used to relax or paralyze overactive muscles in the bladder to prevent leakage. Interstim is a therapy that uses a bladder “pacemaker” to reprogram the nerves that go to the bladder. This allows the bladder muscles to relax so the patient can hold the urine longer and make it to the restroom before leakage occurs.