Five Innovative Approaches to Treating Urinary Incontinence

Urinary incontinence, the inability to control the bladder, affects many Americans and is not only embarrassing, but it can negatively impact daily activities. The severity can range from the occasional leak when you laugh or cough to an urge to urinate that is so strong that it is impossible to make it to the toilet in time. Fortunately, patients suffering from incontinence now have more treatment options than ever before.

Types of Urinary Incontinence:

Before discussing treatment options for urinary incontinence, it is important to understand the different types of incontinence. Certain treatment options may be appropriate for one type of incontinence but not another.

• Urge incontinence is characterized by a sudden, intense urge to void followed by involuntary urination. This is sometimes referred to as overactive bladder. The bladder muscle spasms with such force that the sphincter of the urethra relaxes and allows urine to pass.
• Stress incontinence occurs when the pelvic floor muscles or sphincter muscle are weak, or the sphincter does not open and close properly. This allows a small amount of urine to pass when you sneeze, cough, or the abdominal muscles place pressure on your bladder. This type of incontinence is common among women who have given birth.

Techniques for Treating Incontinence:

Surgery has long been the traditional method of treating urinary incontinence. Today, patients also have the option of minimally and non-invasive procedures that may eliminate the need for surgery:

• Bulking material injections involve injecting a synthetic material, typically collagen, into the tissue around the urethra. The material helps reduce urine leakage caused by stress incontinence by keeping the urethra closed.
• Botox® injections may improve symptoms of overactive bladder by relaxing the bladder muscle and reducing the frequency and intensity of bladder spasms.
• Nerve stimulation uses a pacemaker-like device implanted under the skin to directly stimulate the sacral nerves involved in bladder control. Nerve stimulation is most effective in treating urge incontinence.
• A number of medications have hit the market in recent years designed to reduce muscle spasms and improve bladder function. Examples include oxybutynin, tolterodine, fesoterodine, and mirabegron. Alpha blockers, including tamsulosin and alfuzosin, help relax the bladder and prostate muscles, which can improve urge or overflow incontinence in men. Low-dose topical estrogen may help reduce female incontinence by rejuvenating tissue around the vagina and urethra.
• Urethral inserts are now available over-the-counter to help women with stress incontinence. The device, which is similar to a tampon, is inserted into the urethra to prevent leakage and is removed to allow urination.

The above techniques may also be used in conjunction with behavior modifications, including bladder training, fluid management, double voiding, and scheduling regular toilet trips.

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