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Urinary Incontinence & Overactive Bladder

Urinary incontinence affects women of all ages, but particularly those in their childbearing years and older women. Approximately 20 million women suffer from urinary incontinence at some point in their lives. This condition can cause tremendous disruption in an individual’s life, along with emotional embarrassment from episodes of incontinence.

Overactive bladder is when you feel the frequent urge to urinate and many times can not make it to the bathroom in time, a problem which becomes more common as you age. Stress incontinence occurs when you leak after strain (such as with coughing, laughing, exercise, intercourse or lifting). The treatment for incontinence depends on the type of problem you have and what will best fit your lifestyle. The good news is there are a number of lifestyle changes that can be made to improve or prevent this condition.

Research has found that incontinence is related to obesity, smoking, sedentary lifestyle, poor diet and occupations that include chronic heavy lifting. Your diet should be carefully examined, since many foods can be irritants that stimulate an overactive bladder. These include spicy foods, corn sweetener, artificial sweeteners, caffeine, acidic juices (cranberry, orange and tomato) and fruits (apples, citrus, cantaloupes and grapes).

Strengthening your pelvic floor muscles is an important part of the treatment and prevention of urinary incontinence. Kegel exercises are, in simple terms, a physical workout for the pelvic floor and the least invasive way to treat stress incontinence. There’s no need to take time out of your day to perform these; they can effectively be done while at rest, for example while in the car or in the office. The muscles used in these exercises, however, can be hard to isolate, and the exercises may be counterproductive if not done correctly. Therefore, your Care Team may refer you to a physical therapist who specializes in pelvic floor disorders. Read more about Kegel exercises here.

Trans-Vaginal Tape

Several revolutionary procedures have emerged over the past 15 years, including a relatively pain-free and minimally invasive procedure that offers outstanding results. The tension-free vaginal taping procedure, or TVT, involves placing a small meshlike tape through a vaginal incision and under the urethra like a sling. It is designed to provide support for a sagging urethra in order to eliminate accidental release of urine. It is an outpatient procedure and you can be back to work in 3-5 days.

It is very common if you have incontinence to develop poor voiding habits. The strong urge of an overactive bladder can lead to more frequent trips to the bathroom. As these habits become ingrained, they serve to increase your symptoms of incontinence. Fortunately, these bad bathroom habits can gradually become unlearned. Bladder drills such as emptying your bladder on a specific time schedule and resisting the urge to urinate are an important part of the treatment of overactive bladder. Medications can also help with this retraining process; a number of medications are now available that effectively treat overactive bladder and have minimal side effects.

Botox® for Overactive Bladder

One treatment for loss of bladder control is Botox, the same medication that is used for cosmetic procedures. Approved for the treatment of overactive bladder in 2013 by the FDA, Botox helps symptoms of urinary frequency, urgency, and urge incontinence. In a procedure which takes about 30 minutes in our Women First office, lidocaine is used to numb the bladder and then Botox is injected into the bladder using a cystoscope. Botox serves to relax the bladder muscle, which spasms in overactive bladder, and the effects typically last about six months. Once symptoms start to come back, you simply return for a repeat injection.

Bladder Testing

Bladder testing may be recommended to evaluate urinary incontinence and determine the most appropriate course of treatment. Women First provides urodynamic testing in our office. Relatively painless, this procedure involves placing a catheter with numbing cream in the bladder, after which the bladder is slowly filled and the patient is asked to bear down. This test provides valuable information when surgical correction of incontinence is being considered.

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