New York, NY
August 6 , 2001
For more than 10 million Americans suffering from urinary incontinence, discussing their condition with their doctor or even family members can be embarrassing and uncomfortable. In fact, studies show that more than 90 percent of those living with urinary incontinence never seek treatment and instead choose to suffer in silence.
But it doesn't have to be that way. "There are many treatment options available to help incontinence sufferers regain the confidence necessary to take control of their lives and stay socially active," says Dr. William Keane, president of the National Kidney Foundation. "Seeking medical advice to determine the cause is one of the most important steps in the road to recovery. There are different types of incontinence, and finding the best treatment depends on making an accurate diagnosis." If you have incontinence, speak to your doctor about which of the following treatments may help:
- Kegel Exercises
These exercises help to strengthen the muscles that control urination, such as pelvic floor and sphincter muscles.
- Electrical Stimulation
Brief doses of electrical stimulation can strengthen muscles in a way similar to Kegel exercises. Electrodes are temporarily placed in the vagina or rectum to stimulate nearby muscles.
This technique uses measuring electronic devices or diaries to help patients track when their bladders and urethra muscles contract, ultimately This helps them gain control over these muscles. Biofeedback can be used in combination with Kegel exercises and electrical stimulation
- Timed Voiding and Bladder Training
In this technique, patients use a chart to record when they urinate and when episodes of leaking occur. By observing the patterns, patients can plan to empty their bladders before they would otherwise leak. Biofeedback and muscle conditioning, or bladder training, are used in conjunction with the chart.
Medications can reduce many types of incontinence. Some drugs relax the bladder and others help to tighten sphincter muscles. Estrogens are also believed to be helpful in some women.
Implants are substances injected into tissues around the urethra, which help to close the urethra and reduce leakage. Collagen and fat from the patient's own body have been used for this purpose.
A pessary is a stiff ring inserted into the vagina by a doctor or nurse. It helps to reduce leakage by pressing against the wall of the vagina and nearby urethra.
Surgery is only used as a last resort after other methods have been tried. Many types of surgery can be used depending on what is causing the incontinence.
Catheters are tubes that are inserted into the bladder to help drain the bladder completely. They are sometimes used in people who cannot empty their bladders because of poor muscle tone, past surgery or spinal cord injury. People who have long-term catheters placed in their bladders need to watch for possible urinary tract infections.
"Though incontinence is not a disease, it can sometimes be a symptom of one," says Dr. Keane. "Diabetes, multiple sclerosis and other nerve diseases can damage the nerves that control the bladder. Men can develop incontinence from problems such as cancer or overgrowth of the prostate gland, both of which can block the flow of urine. Pregnant women may also experience urinary incontinence during or after pregnancy due to the pressure of the baby against the bladder. Older women who have had children are more likely to develop incontinence due to weakening of the muscles that support the bladder," continues Keane.
For more information on urinary incontinence, call the National Kidney Foundation at 1-800-622-9010 or try our A to Z guide.