Incontinence

• Stress Incontinence: is leakage that typically occurs when a person strains, such as by laughing, sneezing, coughing, or picking something up. The sphincter muscle’s ability to squeeze and obstruct, or block, the urethra has been compromised.
• Urge Incontinence: is classically associated with the bladder muscle squeezing when it should not. It is often accompanied by a sense of urgency to urinate, but not always. It can occur with changes in hormones, bowel irregularity, nerve damage and with irritation of the bladder. Bladder irritation can be caused by something as simple as a person’s diet, like particular foods or drinks, to something as severe as bladder cancer.
• Overflow Incontinence: typically occurs when the bladder is not emptying well and the name describes exactly what occurs. The bladder is like a full cup that is too full and the urine just continuously dribbles out.

• Stress Incontinence: can sometimes be improved with Kegel exercises and timed voiding. There are surgical options to treat stress incontinence when the above conservative measures are not effective. Surgery can be in the form of injecting material into the urethra to help the sphincter close off the urethra, or by placement of a sling or lifting the urethra, in order to assist in kinking-off the urethra when you strain. Both of these treatment options are possible in men and women.
• Urge Incontinence: can be treated in a variety of ways, all looking to address what may be causing it. As alluded to above, there are a lot of reasons as to why urge incontinence occurs. Treatment can vary from diet modification to medicine that can be taken daily, to stimulating the nerves that go to and from the bladder.

To make matters even more complicated, a large portion of the time, the above incontinence types occur together, which is given the generic name of mixed incontinence. This is why a full evaluation of the individual is necessary, including a look in the bladder with a scope (cystoscopy), a genitourinary examination, and oftentimes a procedure called urodynamics.

These examinations and procedures, along with a collection of information from the patient, help the health care provider to determine how best to address the incontinence. It also is necessary in order to rule out other causes of incontinence, such as cancers, neurologic disease, etc.

Finally, there is overflow incontinence:

• This is typically due to either an obstruction, such as a large prostate, or an inability of the bladder to squeeze appropriately. Treatment can vary from resection of the obstructing item, for example, the prostate, or further evaluation as to the cause of why the bladder won’t squeeze. This latter scenario has been given the name of an “underactive bladder” and urologists across the country have been working to bring attention to this very prevalent problem.

Simple things that can be done to help reduce incontinence risk include taking the time to drink plenty of fluids, going to the bathroom regularly, rather than putting it off and damaging the bladder over time. In addition, learn to be aware of your pelvic floor muscles and practice squeezing them and relaxing them. You can help yourself to identify them by stopping and starting your urinary stream when you are going to the bathroom.