Urinary incontinence is the loss of bladder control, and no one likes to lose control over any of their body functions. There are several types of urinary incontinence. One of the most common is stress urinary incontinence. This is the type of leakage that occurs with sneezing, coughing, jumping, lifting, or sometimes with just movement. It is usually causes by changes that occur after childbirth, weight gain, and/or aging and falling hormone levels (menopause).
Another type of urinary incontinence is called urge incontinence. This leakage occurs when there is an urge to urinate, but the bladder contracts (and releases urine) BEFORE the person can make it to the restroom! There are varying degrees of this problem ranging from discomfort and frequency urination to pelvic pain to frank leakage. This type of incontinence responds best to dietary changes. To learn more about how diet affects the bladder, click here.
Mixed incontinence refers to having symptoms of both stress and urge incontinence. While most people believe that only surgery can help incontinence, the truth is that there are other very effective ways to improve incontinence. Dietary changes and weight loss can often make a huge difference.
Weight loss is one of the most powerful ways a person can improve urinary incontinence. The stress and pressure that extra pounds place on the bladder and pelvic organs is a huge factor. Relieving some of that pressure by simply losing weight often will help improve the condition of stress incontinence by up to 50%!
Kegel exercises (isolated contractions of the pelvic muscles) are also very beneficial if done correctly, often and long-term, but many patients are unable to do the exercises correctly or cannot remember to do them frequently. Home use devices are available to help improve compliance. These devices are vaginal weights as well as the InTone or Apex devices. These devices also much be used daily to be effective. Another option for pelvic relaxation and incontinence is biofeedback. This treatment is done several times weekly usually over a 6-12 week period. The treatment is done in the privacy of an examination room and usually by a physical therapist. The goal is to teach the patient how to isolate and contract the pelvic muscles.
The FDA has recently cleared a device called Emsella. Emsella is a device that uses high intensity focused electromagnetic energy. The patient simply sits on a chair (while fully clothed) with the pelvic muscles centered over the magnet. The device causes thousands of strong contractions of the pelvic muscles in a single session. The contractions feel like a cramp but are not painful. In as a little as 3 weeks, the patient will have significant improvement in both urinary stress and urge incontinence. The treatment can be used in men and women and takes just under 30 minutes per treatment. The treatments are painless and have no downtime at all. The patient can return to his or her normal activities immediately following the procedure. Studies are being done currently for this device in the treatment of fecal incontinence as well.
For women, vaginal lasers such as the MonaLisa Touch will often help with urinary incontinence as well. These lasers work by causing the body to generate newer, healthier tissue in the vagina and tissue supporting and surrounding the bladder. The treatments are not painful and are done in the office in as little as 6 minutes.
While dietary changes are vital for improvement in urge incontinence, medications can be used as well. These medications often cause significant side-effects, however. Surgery is an option for some types of incontinence as well. Surgery ranges from "bladder lifts" to slings, mesh, and more.
If you have exhausted all of the non-surgical options, then a visit to your doctor is in order for an examination and full discussion of what other options are available. Referral to a specialist is often needed.