Loss of bladder control (urinary incontinence) is a very common complaint, especially among women. An estimated one in five women experience urinary incontinence. It can be temporary or chronic and can occur due to pregnancy, childbirth, menopause, surgery or obesity.
Urine leakage at any age is not normal! With modern advancements in medications and minimally invasive surgery, this condition is highly treatable.
The most common types of urinary incontinence include:
- Stress Incontinence: Pressure is put on the bladder with a laugh, cough, sneeze or while lifting a heavy object or exercising
- Urge Incontinence (Overactive Bladder): Loss of bladder control after experiencing a sudden, uncontrollable urge to urinate; often this results in the leakage of urine before making it to the bathroom
- Mixed Incontinence: Both stress and urge incontinence are experienced.
Treatment for Urinary Incontinence and Overactive Bladder
First, your doctor will do a thorough exam to accurately diagnose your condition. A physical exam, urine tests, blood tests, stress tests, ultrasound, cystoscopy, x-ray and/or urodynamic tests may be performed.
Once your doctor has a clear diagnosis, a treatment plan will be created. It may include:
Anticholinergics may be used to alter the balance between the bladder pressure and sphincter tone; estrogen therapy may be used to strengthen the vaginal wall to treat stress incontinence treatment
Botulinum Toxin Injections
This prescription medicine is approved to treat overactive bladder symptoms when anticholinergics do not work well enough or cannot be taken. Botulinum toxin is injected through a cystoscope into multiple areas of the bladder muscle. There it works on the nerves to help block signals that trigger overactive bladder. It will help reduce daily leakage, treat the strong urge to urinate at once and reduce the number of times you need to empty your bladder. It begins to reduce daily leakage episodes after just 2 weeks. One treatment (which takes about an hour and can be performed in the office) often lasts for up to six months.
Surgical options may include retropubic suspension, pubovaginal fascial sling, suburethral sling, tension-free vaginal tape (TVT), transobturator tape (TOT),
Percutaneous Tibial Nerve Stimulation (PTNS)
This treatment for overactive bladder is a gentle and gradual way to treat overactive bladder (OAB). Mild electrical impulses are sent through an acupuncture-type needle placed near the ankle, which travel up the tibial nerve in the leg and reach the nerves responsible for bladder control. These treatments are performed during 30-minute in-office sessions. Typically, they are performed over 12 weekly sessions. Many patients see improvement after 6 treatments, but it can take up to 12 weeks to see results. After the first 12 sessions, most patients will need a treatment once a month but some can go longer between sessions.