Incontinence Can Often Be Cured, And It Can Always Be Managed

Stress incontinence is usually described as the involuntary loss of urine while coughing, sneezing, laughing, or lifting heavy objects. Stress incontinence is caused by the bladder neck dropping too low in the pelvis (bladder drop), which may occur as a result of aging or having given birth several times. Stress incontinence is also more common in women who are obese. Stress incontinence is diagnosed by bladder testing.

Some women won’t even leave their house because they have to wear bulky undergarments to prevent leakage, which can lead to social isolation and depression. To prevent humiliation due to wetness or odors, people with incontinence may have to alter their way of life. Many products are now available that help patients avoid embarrassment and, in some cases, prevent leakage.

In a strange coincidence of biology, pregnant women think about visiting the bathroom roughly as often as the average man thinks about sex — every 17 seconds. Bladder and bowel control is dependent on having a properly functioning bladder, urethra, bowel and digestive system; a sound neurological system; efficient urine and stool production and elimination; and the desire and capability to go to the toilet alone or with personal assistance.

Bladder retraining and education regarding healthy bladder habits may be needed to restore normal bathroom habits. Up to 60% of women with stress incontinence, pelvic floor (Kegel) exercises can result in better control of the bladder when coughing, laughing, sneezing, orexercising. Surgery to add support forthe bladder neck is usually needed for severe stress incontinence that does notrespond to medication or exercise.

Doing Kegel exercises during and after pregnancy can decrease the risk of developing stress urinary incontinence after childbirth. Kegel exercises, also called pelvic floor exercises, strengthen the pelvic muscles involved in urination. To do Kegel exercises, pretend you are trying to stop the flow of urine ortrying not to pass gas. During these exercises, you use the muscles that control urinary flow-tighten and hold them for 3 seconds, then relax them for 3 seconds. While doing these exercises, try not to move your leg,buttock, or abdominal muscles. In fact, no one should be able to tell that you are doing Kegel exercises.

With current therapies, including behavioral techniques, biofeedback, medications, collagen injections and surgery, 90 percent of people can be cured or significantly improved. Mild to moderate stress incontinence may beeffectively treated with exercise therapy, medications, or both. Treatment with medications tends to be more successful in patients with mild-to-moderate stress incontinence. Medications used to treat stress incontinence are aimed at increasing the contraction of the urethral sphincter muscle. The most effective medications are ephedrine, pseudoephedrine, phenylpropranolamine hydrochloride and imipramide. Medications may have side effects, such as sleepiness,dry mouth, blurred vision, and anxiety or agitation. Other treatment options include a pacemaker for the bladder that can be used when more conservative treatments, such as medications or behavioral modification, are not effective.

Foods and medications that cause the body to shed water may increase a person's frequency and urgency to urinate and lead to incontinence. In addition to medical problems, certain medications can cause or contribute to an incontinence problem.

Other medications and substances that increase the risk for incontinence are caffeine, sedatives, antidepressants, antipsychotics, and antihistamines. More important, medications with anticholinergic effects or beta-adrenergic effects can exacerbate overflow incontinence due to hypotonicity and should be discontinued if possible.