Variety of treatments available for urinary incontinence

You or a loved one might be one of the millions of Americans suffering from urinary incontinence – partial to complete loss of bladder control.

If you’re like many who feel embarrassed or uncomfortable discussing this with your doctor, you could suffer needlessly for several years – with disrupted sleep due to constant trips to the bathroom or avoiding social events for fear of losing bladder control.

Please know you are not alone. Urinary incontinence can affect males and females of all ages. Incontinence is not an inevitable part of getting older, although one form called stress incontinence tends to develop with age and is more common in women.

Stress incontinence is a leaking of urine during physical activity such as coughing, sneezing, laughing or exercising. With stress incontinence, the muscles beneath the bladder become weakened, causing urine to leak out.

This type of incontinence often is experienced by women after childbirth, menopause or even after surgery. Men may experience this type of incontinence after prostate surgery.

Stress incontinence often can be treated by performing Kegel exercises, designed to strengthen the muscles beneath the bladder. If that fails to produce desired results, a form of biofeedback called pelvic muscle therapy often is recommended.

With this therapy, the patient uses a monitor to determine whether the exercises are being done correctly. If more conservative measures do not produce the desired results or if the patient has difficulty performing the exercises, surgery may be recommended.

Another common form of incontinence is urge incontinence, in which the individual has a strong sense of urgency to urinate and the inability to hold urine. The causes of urge incontinence can include bladder infections, constipation, spasms of muscles low in the pelvis or nervous system diseases.

For urge incontinence, behavioral changes, including diet changes and timed bathroom breaks, can be a first step. Exercises, biofeedback or even medications may be included in the treatment plan.

If other measures fail to reduce certain types of incontinence to an acceptable level for the patient, a relatively new FDA-approved procedure called InterStim Therapy may be an option.

This procedure often is effective when other treatment options fail or when individuals cannot tolerate other forms of treatment. InterStim Therapy is covered by Medicare, as well as by many insurance companies.

InterStim Therapy is a two-stage process. Before proceeding to stage one, there are specific qualifying criteria to determine if the patient will benefit from the procedure.

If these criteria are met, the patient is brought into the operating room under general anesthesia for the “test phase,” and a small thin wire is placed in the sacrum (the triangular bone in the lower back).

The patient then is monitored for two weeks through the use of a control box that is connected to the wire. The testing determines whether this is the correct treatment for the individual.

If testing is successful, the patient then is brought back into the operating room and implanted with a device similar to a pacemaker. This device uses mild electrical pulses to stimulate the pelvic area, often relieving the symptoms.

With the many treatment options available for urinary incontinence, you don’t have to suffer needlessly. If you are incontinent, it’s important to let your health care professional know.

You may be referred to a urologist, a physician who specializes in treating problems of the urinary tract. With proper treatment, you can begin to live life more fully.

Diane Galutia is a public affairs associate at St. Joseph Healthcare.