By Joseph Gauta, MD, FACOG –
Millions of people are affected by the loss of bladder control. Bladder control issues are not a normal part of life and they are not something you just have to live with. Of the over 33 million people in the United States that suffer from overactive bladder many of them do not seek help. Take control of your pelvic health and complete this short quiz to see if it’s time to reach out for help.
If you answered yes to one or more of these questions, consider talking to a Urogynecologist about your symptoms and available treatment options. Once you start talking it becomes easier. Your Urogynecologist is used to talking about sensitive issues and will help you become comfortable with the subject.
Diet Modification — Some people find that certain foods and drinks cause them to go to the bathroom more frequently. This includes drinks with caffeine (including soda), alcohol, spicy foods, acidic foods or beverages, and artificial sweeteners. Try temporarily eliminating one or more of these items to see if it reduces your symptoms.
Pelvic muscle exercises — Also known as Kegel exercises, strengthen the muscles involved in controlling urine leakage. Practicing these exercises on a regular basis may help to reduce urine leakage caused by stress incontinence.
Bladder training — Bladder training can help you learn to go to the bathroom less frequently by “retraining” your bladder to hold more urine. Bladder training has two components: going to the bathroom on a schedule while you are awake and using strategies to control sudden urges.
Prevent constipation — Constipation can worsen urinary frequency and urgency. Increasing the amount of fiber in your diet to between 20 and 30 grams per day can help prevent constipation.
Medications — In some people, urgency incontinence is more severe and a medicine is needed to get symptoms under control. Medications should be combined with bladder training. Some people take medicine temporarily, until symptoms improve, while others take medication indefinitely. It is important to continue doing bladder training, even if you are taking a medication.
Botox — Botulinum toxin A, also known as Botox, is a toxin produced by a bacteria that temporarily paralyzes muscles. Botox injections into the bladder are an effective treatment for urgency incontinence when people haven’t responded to medicine.
Electric stimulation — Office electrical stimulation involves placing a hair-thin needle into a nerve near the ankle. This nerve is connected to nerves in the lower back that affect your bladder. The needle is connected to a small device that sends electrical pulses to the nerve. The treatment is not painful. It is performed in the office once per week for six to twelve weeks.
Vaginal pessaries — A vaginal pessary is a flexible device made of silicone that can be worn in the vagina. A pessary can help to reduce or eliminate stress incontinence. A pessary is a reasonable treatment if you want to delay or avoid surgery. When fit properly, you will not feel any discomfort.
Surgically implanted stimulator — A sacral nerve stimulator (SNS) is a device, about the size of a pacemaker, which can be surgically implanted. The device is placed under the skin in the upper buttock, and is connected with wires to a nerve (the sacral nerve) in the lower back. The device sends electrical pulses to the sacral nerve. SNS therapy has helped many patients who have not responded to more conventional treatments.
Surgical treatments — Surgery offers the highest cure rate of any treatment for urinary incontinence. There are different procedures available to treat your particular symptoms. Each procedure has different benefits and risks. These options should be thoroughly explained by your Urogynecologist to decide what is best for you.
Take action and discuss with your doctor what treatment option is right for you. Together, you’ll be able to resolve your urinary control problem and return to the freedom you deserve.
Florida Bladder Institute
Are you urinating more than 7 times a day? Yes ___ No ___
Are you using the bathroom so often it disrupts your day? Yes ___ No ___
Do you get up more than once a night to use the bathroom? Yes ___ No ___
Do you sometimes lose urine if you sneeze or cough? Yes ___ No ___
Do you wear absorbent garments? Yes ___ No ___
Do you have difficulty urinating or emptying your bladder? Yes ___ No ___
Do you sometimes have accidents before reaching the bathroom? Yes ___ No ___
Are tampons too uncomfortable to use or do they fall out? Yes ___ No ___
Do you experience a pressure or bulging in your vagina, especially after standing for long periods?
Yes ___ No ___
Has your urine stream become weak or turned into a spray? Yes ___ No ___