Urge Incontinence

Millions of American women, particularly older women, deal with urinary incontinence. Urinary incontinence or UI is defined as a loss of bladder control. From minor leaking with a sneeze or laughter to more significant problems that warrant wearing adult disposable under-garments, urinary incontinence can certainly be bothersome. There are generally several types of UI including urge, stress, and mixed incontinence.

Women who have urge incontinence have a sudden, strong “urge” to urinate. This urge can come on very quickly, and many women may leak urine if they cannot reach a bathroom soon enough. In addition to a strong urge to urinate and leaking urine, other symptoms include increased frequency of urination and having to get up at night to go to the bathroom. This issue can be embarrassing and can greatly impact quality of life. Although urge incontinence is more common in older women, it should not be viewed as a “normal” part of aging. There are treatments for urge incontinence and steps you can take to reduce urine leaks.

In a normal bladder, sphincter muscles keep the urethra closed. For people who have urge incontinence, muscles in the bladder contract with enough force to override the sphincter muscles, causing urine to leak. These strong muscle contractions occur regardless of how much urine is in the bladder, so leaking can occur even if the bladder is not full. In many women, it is unknown why these abnormal muscle contractions occur.

If you are experiencing symptoms of urge incontinence, it is important to schedule an appointment with your healthcare provider. Your physician will need to hear your specific symptoms to rule out other types of incontinence or urinary issues. At your visit, you can expect your physician to perform a pelvic exam and order labs such as urinalysis and urine cultures. Other tests to diagnose incontinence may include bladder studies or a cystoscopy, a procedure where your physician examines the inside of your bladder with a small camera.

Treatments for urge incontinence include lifestyle changes, physical therapy, and medications and procedures that relax the bladder. You can work with your healthcare provider to find the right combination of therapies to regain control of your bladder.

Since urge incontinence is caused by abnormal contractions of bladder muscles, many treatments involve relaxation of bladder muscles. There are many different medications available to treat urge incontinence. Not every medication works for every person, so it may take a couple of tries to find the right medication for you.

In addition to medications, some in-office procedures are effective at minimizing symptoms of urge incontinence. Botox therapy is a newer treatment that has been shown to be effective. This is the same Botox that is injected into the face for cosmetic procedures. When injected into the bladder, the Botox makes the bladder muscles relax. The effects of the Botox injections can last from six months to a year. Patients report having less leaking and fewer episodes of urgency.

There are many foods and beverages that can worsen symptoms of urge incontinence. Avoiding spicy and acidic foods, artificial sweeteners, carbonated beverages, caffeine, and alcohol can help to decrease symptoms. Tobacco is another bladder irritant, so quitting smoking can help as well. If your symptoms include waking in the middle of the night to go to the bathroom, reduce the amount that you drink three hours before going to bed.

Practicing pelvic muscle exercises (Kegel exercises) can also help you regain control of your bladder. Strengthening these muscles can reduce urine leaks. Ask your doctor or nurse how to perform these exercises correctly. Once you have learned how to exercise these muscles, you can practice them daily. Kegel exercises can also be used to help retrain your bladder. It is natural to feel the need to rush to the bathroom when you have a sudden urge to urinate. However, constantly rushing to the bathroom can actually minimize your control over your bladder. Instead of hurrying to the bathroom, stay where you are, perform a few Kegel exercises, and take some deep breaths to relax. When the urge lessens, calmly walk to the bathroom instead of rushing. This process can take some practice, but it can help you have better control over your bladder.

Next month, I will discuss stress and mixed incontinence and the symptoms, causes, and treatment options. It’s important to know that you should be candid with your healthcare provider about your UI so they can help evaluate your problem and identify possible treatment plans.

Dr. Hardy practices obstetrics and gynecology at Atlantic Ob/Gyn with locations in Virginia Beach and Chesapeake. Please call 757-463-1234 or visit www.atlanticobgyn.com.

Timothy J. Hardy, M.D.

Dr. Timothy Hardy, M.D. has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB-GYN, in 1990, where he has been providing women with exceptional care ever since. Website: www.atlanticobgyn.com
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