Urinary incontinence, or the uncontrollable leaking of urine, affects millions of Americans every year. It’s one of the more common urologic conditions and can be caused by a range of different conditions or lifestyle habits. While doctors estimate that close to 13 million men and women across the United States suffer from incontinence, the real number is hard to know. Due to the embarrassing connotation that urinary incontinence is associated with, many people fail to seek treatment. However, there are things that you can do to overcome it. While doctors suggest working through lifestyle changes first, serious cases may require more invasive treatment. Here are some urinary incontinence treatment options if lifestyle changes aren’t enough.
Alternative Treatment Options
While many people find success in treating urinary incontinence through ongoing lifestyle changes, it doesn’t work for everyone. In severe cases, it may be more effective to look at surgery or other procedures to help treat symptoms. However, due to the increased risk of invasive treatment options, always try to work through behavioral changes first. It will take some time and guidance from your doctor, along with your commitment, but lifestyle changes have been shown to have a big impact on those suffering. If you’ve tried everything and gotten no relief, there are plenty of alternative treatment options.
Colposuspension
Colposuspension is a surgery that aims to treat urinary incontinence by lifting the neck of your bladder and securing it in a new position.1 There are two different types of colposuspensions that your doctor may suggest: open colposuspension (open surgery) and laparoscopic (keyhold) colposuspension. Both surgical options result in long-term treatment for stress incontinence for women.1 As with any surgery, there are a few complications that your doctor will discuss with you prior to moving forward.
Sling Surgery
In a sling surgery, an incision is made in your lower abdomen and vagina so that a sling can be placed around the neck of the bladder to support it.1 This helps to prevent and reduce incontinence and is considered an effective long-term solution. It can also be done in males by moving the incision between the scrotum and the anus. The sling is placed over the urethral blub in males.1
The sling itself can be made of different tissue. It’s either taken from your own body, another person, or an animal with compatible tissue. Slings made from your own tissue (autologous slings) are preferred for longevity.
After a sling surgery, some people report difficulty emptying the bladder completely and a small number of people have developed urge incontinence post-op.1
Vaginal Mesh Surgery
In the past, a transvaginal mesh surgery was available for women to treat incontinence and pelvic organ prolapse. During this surgery, a small strip of synthetic mesh was inserted behind the urethra for support.1 However, due to an increase in patients experiencing serious complications following vaginal mesh surgery, the FDA has currently put a ban on this incontinence treatment.
If you’ve already had a vaginal mesh surgery and are concerned about any problems or complications, don’t hesitate to contact your doctor. Just because you’ve had the surgery does not mean that you will develop complications, so make sure you’re actively monitoring things and report problems if they arise.
Urethral Bulking Agents
Urethral bulking agents involve injecting an agent into the walls of the urethra in order to increase their size.1 By enlarging the urethral walls, the urethra can stay closed more efficiently when the muscles are at rest. This, in turn, reduces urinary incontinence. This treatment is less invasive than other surgeries, but the effectiveness is not always as prominent. Over time, the agent will slowly wear off and you’ll need to repeat the process to continue benefiting. You may experience some complications and adverse effects of the injection, but most of them are only temporary.
Artificial Urinary Sphincter
Another option for urinary incontinence treatment is to have an artificial urinary sphincter fitted. This mimics your body’s natural sphincter and helps to control the flow of urine from your bladder during times of rest. This is more commonly performed in males and tends to be more of a temporary solution—it’s not uncommon for an artificial sphincter to eventually stop working.1 The artificial sphincter includes a circular cuff that surrounds the urethra, a small pump in the scrotum to control the flow of urine, and a small fluid-filled reservoir in the stomach.1 As with other treatment options, there may be some mild side effects. Talk to your doctor to determine whether or not you’d be considered a good candidate for this treatment.
Botulinum Toxin A Injections
While many people consider Botox a cosmetic injection, it actually has a fair number of functional uses. By injecting the botulinum toxin A (Botox) into your bladder, you can find relief from urge incontinence and overactive bladder. This process needs to be repeated to maintain effectiveness, but since it can be done quickly and easily without surgery, many people favor it as a treatment option. The one thing that you should understand is that Botox injections can sometimes make it difficult, if not impossible, to completely empty your bladder. If this is the case, you will need to supplement your treatment using intermittent self-catheterization to avoid infections.
Sacral Nerve Stimulation
This treatment involves the process of stimulating the sacral nerves, which are at the base of your back. Your sacral nerves carry signals to your brain dictating which muscles you need to use to urinate.1 In some cases of incontinence, the stimulation is not strong enough and thus results in problems. To produce long-term results from improved stimulation, your doctor will insert a device that sends electrical currents to the sacral nerve. Talk to your doctor to learn more about whether or not this treatment is right for you. You should also be aware that some people have reported it to be painful or uncomfortable.
Posterior Tibial Nerve Stimulation
Similarly, posterior tibial nerve stimulation works to stimulate the nerve that connects to your muscles in the bladder and pelvic floor. By stimulating this nerve, you may be able to better control the urge to urinate, urge incontinence, and overactive bladder. This is a lesser used treatment and is not recommended unless other treatments are not working.
Medications
If you want to try something less invasive than surgery, but more proactive than lifestyle changes, talk to your doctor about taking certain medications.
- Anticholinergics – these can help calm an overactive bladder and urge incontinence.
- Mirabegron – this works to treat urge incontinence through muscle relaxation and increased bladder volume.
- Alpha Blockers – these can help relax bladder neck muscles and prostate muscle fibers to reduce constriction during voiding.
- Topical Estrogen – this can increase muscle firmness in the urethra and vaginal areas in order to decrease incontinence.
Clean Intermittent Catheterization
If you’re still struggling from incontinence and treatment options don’t seem to be working, your doctor may recommend that you utilize clean intermittent catheterization. This involves using a catheter to empty your bladder at regular intervals throughout the day to avoid side effects from invasive treatments. While it might be intimidating at first, your urologist will work with you so that you understand how to perform self-catheterization and that you’re comfortable doing so while at home or on the go. Over time you’ll learn the steps to catheterization, and it becomes easier.
The frequency in which you use a catheter throughout the day will depend on your individual circumstances. If your incontinence is severe, it may be beneficial to use clean intermittent catheterization several times. If your incontinence is mild, you may only choose to use a catheter once. This treatment option gives you more control over potentially embarrassing leaks throughout the day and can help improve your overall quality of life without excessive risks.
Indwelling Catheterization
Another option for catherization is using an indwelling catheter. An indwelling catheter is inserted in the same manner as clean intermittent catheters, but you don’t remove it. Instead, it’s left in place and attached to a bag that collects urine throughout the day. With the options available today, there are plenty of discrete products for indwelling bags, but if you live a more active live, clean intermittent catheterization may be a better option. Talk to your doctor about catheterization and how it can help you manage your urinary incontinence.
Urinary incontinence is a common condition that many people suffer from but that doesn’t make it normal. It’s extremely important to treat urinary incontinence, so if you’re experiencing any signs or symptoms, make sure that you see your doctor for a proper diagnosis. For ongoing support, educational resources, and incontinence products, contact the professionals at Byram Healthcare today.
Source:
1 https://www.nhs.uk/conditions/urinary-incontinence/surgery/
