Where there’s a problem, there’s a solution
A small but inconvenient leak when you laugh or sneeze. An unfortunate accident because you couldn’t get to the bathroom in time. These scenarios describe one very common — and embarrassing — condition: urinary incontinence, or loss of bladder control.
According to Jerome Hoeksema, MD, a urologist at Rush University Medical Center who treats both men and women with urinary incontinence, one out of 10 people experiences some form of urinary incontinence after the age of 65. But you don’t have to be older than 65 to have it.
Urinary incontinence can occur for many reasons, including the following:
- Weakened pelvic muscles as a result of childbirth
- Miscommunication between the brain and bladder (common with neurological disorders, such as stroke, Parkinson’s disease and multiple sclerosis)
- An enlarged prostate gland or a prostate gland affected by surgery
- Cancerous or noncancerous growths in the bladder
- Thinning and drying of the skin in the vagina and urethra that can occur during menopause
- Urinary tract infections
- Lifestyle issues that may aggravate the bladder, such as drinking too much water, consuming caffeine and eating spicy foods
First step: diagnosing urinary incontinence
Although there are products available, such as absorbable pads and protective underwear, that can help with urinary incontinence, there are more long-lasting solutions — many of which are available at Rush. The first step is to seek help.
"Some people don't go to the doctor because they are embarrassed or they assume surgery is their only option, but this condition is very common and there are many ways to treat it," Hoeksema says.
Before determining a treatment plan, doctors must find the problem's source by performing a thorough physical exam, which can include the following:
- Obtaining a thorough medical history
- Doing a urinalysis
- Performing an ultrasound to determine if the bladder empties completely
- Using a cystoscope, a tube with a small camera, to get a closer look at the bladder
- Measuring bladder pressure with a test known as urodynamics
Customizing a treatment approach to urinary incontinence
Once the doctor identifies the type and cause of incontinence, he or she can work with you to find the best treatment approach. This could include diet changes and other behavioral strategies, medications (including those to relax the bladder) or one of the more than 200 different types of surgeries.
Here are some common approaches used by doctors at Rush.
- Timed voiding, in which patients use the clock, rather than their bodies, to tell them when to urinate
- Pelvic floor muscle exercises, called Kegel exercises, which can be learned with the aid of a physical therapist or urologist (for women only)
- Electrical stimulation procedures to strengthen pelvic floor muscles (for women only)
- Injection of materials, such as collagen, around the urethra to keep the sphincter muscles closed and stop urine from leaking
- Slings surgically inserted around the urethra to lift it into a normal position and exert pressure on it to help with urine retention
- Artificial sphincters (devices commonly used in men following prostate cancer treatment or because of enlarged prostate glands) fit around the neck of the bladder, keeping the urinary sphincter shut tight until it’s time to urinate, when patients push a button located under the skin
"Whatever the cause," Hoeksema says, "if you suffer from incontinence, just remember that you are not alone and there are options."