Treatment for Female Urinary Incontinence
Urinary incontinence is a condition characterized by loss of control of urine from the body.
Approximately 17 million women in the U.S. encounter urinary incontinence in their lifetime. This condition can occur in women of all ages and is often a result of the urethra not closing tightly to keep urine in the bladder. Symptoms vary from:
- an inability to prevent leaking urine when exercising or other involuntary actions such as coughing or sneezing
- an overwhelming urge to urinate that often causes urination before getting to a bathroom
Types of Urinary Incontinence
Urinary incontinence can be caused by a range of different issues. Because of this, incontinence can be categorized as follows:
Urge Incontinence
The sudden and unexpected need to urinate. If a woman can’t make it to the bathroom in time, urinary leakage can result.
Stress Incontinence
The involuntary loss of urine due to increased pressure on the abdomen and bladder.
Overflow Incontinence
Urine involuntarily leaks because the bladder holds too much urine all the time.
Mixed Incontinence
Mixed incontinence is extremely common. Patients exhibit symptoms of both stress and urge incontinence.
Functional Incontinence
There is no issue with the urinary system, but the patient is unable to make it to the bathroom in time due to mental or physical limitations.
Transient Incontinence
This form of incontinence is temporary and caused by a short-lived condition or treatment for a condition.
Total Incontinence
Total incontinence is the complete loss of urinary control due to a severe physical injury or urinary abnormality.
Non-Surgical Treatment Options
Behavior therapies: Behavior modification is used to train one’s bladder and sphincter muscles. Strategies include managing fluid intake and prompting or scheduling voiding.
Pelvic muscle exercises: Called Kegel exercises, these exercises commonly are intended to strengthen muscles surrounding the bladder.
Protective undergarments: Undergarments designed to absorb leaked urine.
Pessary: This device applies pressure to the urethra to help reposition it, permitting it to close tightly. It contains a stiff ring that is inserted into the vagina to exert pressure against the wall of the vagina and urethra.
Bulking injections: Bulking agents, such as collagen, are injected directly into the urethral lining to thicken it, allowing the urethra to close more tightly.
Medications: Several medications are available to treat incontinence caused by an overactive bladder (urge incontinence). However, there are no medications specifically for stress-related incontinence. For mixed incontinence, where both urge and stress components are present, drug therapy may help manage the urge aspect.
InterStim: InterStim therapy involves sending electrical pulses to the sacral nerve, which controls bladder filling and emptying. This treatment is administered via a small device implanted under the skin in the buttocks.
Several surgical options can strengthen, support, elevate, or restore the urethra and bladder, typically considered when other treatments are ineffective:
Retropubic Suspensions: Surgical procedures, such as the Burch procedure, aim to restore the urethra and bladder neck to a higher anatomical position.
Slings: Sling procedures are used to treat urethral hypermobility. A sling supports the urethra to prevent leakage during increased abdominal pressure.
Bone-Fixed Slings: These slings support the urethra using graft material attached to the pubic bone.
Self-Fixated Slings: These slings provide urethral support without requiring sutures or screws, as they are secured in place by friction and tissue ingrowth.
Addressing urinary incontinence is crucial for enhancing comfort and quality of life. With a range of treatment options available, from lifestyle changes and medications to surgical solutions, it’s important to consult a healthcare professional to find the most effective approach for your needs. Taking proactive steps can lead to significant improvements and better management of the condition.