Bladder control problems are more common than many realize. Many people assume that this is something they must live with, or is just a part of life. Even worse, many believe that nothing can be done to fix the problem except invasive, painful surgery. While it is true that incontinence predominantly impacts older adults, it is not a natural part of aging. More women tend to be bothered by bladder control issues than men, but the underlying causes tend to be different. Your primary care provider (PCP) will often screen you for these conditions during your annual wellness visit, but occasionally this problem gets overlooked. There are solutions, and continual leakage is not something that one must live with.
Don’t suffer in silence. Discussing bladder control issues with your provider is the first step to regaining bladder control and improving your quality of life. Call AppUrology at (828) 264-5150 and we can help answer any questions or concerns.
What is Overactive Bladder (OAB)?
OAB is a constellation of symptoms that includes urinary frequency and urgency. Urge incontinence arises from being unable to control these factors and results in loss of bladder control. Factors that often go along with OAB include being female, post-menopausal, prior pelvic surgery, excessive fluid intake and caffeine intake. As with many health conditions, prevention is the best strategy. Maintaining a healthy weight and being active can help prevent bladder control issues.
Treatment options for overactive bladder
The first step in improving bladder control is to address this with your PCP. Often, symptoms can be controlled by changing behavior. Try reducing fluid intake, reducing or eliminating caffeine and doing “timed voiding,” which is a trick played on the bladder to empty it prior to the onset of “urgency.” For many, these steps are enough to regain bladder control.
If overactive bladder continues, there are several medications that can improve bladder control. For the patients that do not wish to take medication, or find them ineffective, more advanced treatments can dramatically improve bladder control and quality of life.
Your urologist may recommend sacral nerve stimulation, either with an implanted nerve stimulation device called Interstim, or with a noninvasive treatment called Percutaneous Tibial Nerve Stimulation (PTNS). Interstim is an innovative technology that involves modulating nerve signals to and from the bladder. A simple office test can tell if you may benefit from the technology.
PTNS involves placing a tiny acupuncture needle adjacent to the ankle and connecting a small nerve stimulator to it for a 30-minute session. The treatments are done weekly for several months, and then performed periodically for maintenance of the treatment effect.
Botox is a drug that many associate with injections for facial wrinkles. The reason that it smooths out wrinkles is that it relaxes the muscle, smoothing out the overlying skin. Botox injections can be done in the AppUrology office to relax the bladder muscle resulting in improved bladder control.
“I leak when I cough, sneeze, or exercise”
Stress Urinary Incontinence (SUI) is a condition that affects many women, particularly those that have had multiple vaginal child births. Women with SUI often void normally, but are bothered with the occasional loss of control with exertion. This robs many women of the ability to exercise, or to perform normal household activities. Occasionally, men are bothered with this condition following surgery for prostate cancer.
Treatment Options for Stress Urinary Incontinence
SUI occurs because the muscles that are involved with holding urine tend to become weak. Like any other muscle, this can often be improved with conditioning. Performing Kegel exercises, which involves contracting the muscles that you would use if you wanted to interrupt your urine flow, can improve bladder control. Like any exercise program, this requires some commitment and dedication. Just as having a personal trainer can improve strength training, physical therapists at The Rehabilitation Center can often improve success on pelvic floor therapy to improve bladder control.
Modern surgery for stress incontinence has evolved to minimally invasive, outpatient procedures with quick recovery. It no longer involves large incisions and extended recovery times. The surgery for stress incontinence is done through a ½ inch incision, takes about thirty minutes, and is highly successful.
For some women, SUI can be treated with a simple injection procedure where a drug is injected through a scope to “bulk” up the urethra.
For men that are bothered with SUI following prostate cancer surgery, sometimes simply a “tincture of time” can allow the body to recover naturally from surgery and improve bladder control. For others, implantation of an artificial urinary sphincter can often eliminate pad use.
Do you have bladder control concerns?
AppUrology can help! Call us at (828) 264-5150 today!
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