Where’s the Nearest Restroom?

By Terri L. Jenkins, ARNP

restroomUrinary incontinence (UI) and overactive bladder (OAB) are among the top 10 chronic conditions effecting American women today. For millions, incontinence is not just a medical problem. It is a problem that also affects emotional, psychological and social well-being. Many people are afraid to participate in normal daily activities that might take them too far from a toilet. Unfortunately, many of those with UI or OAB suffer in silence unnecessarily. They choose not to participate in various activities, which ultimately prevents them from living the life they want to lead. Incontinence issues oftentimes leave sufferers feeling embarrassed.  Many are under the false presumption that these conditions are a natural part of the aging process and that there is no effective treatment available. In reality, incontinence is successfully managed and treated in nearly everyone who seeks help. The following information should help you discuss this condition with your urologist and learn what treatment options are available to you.

Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine – water and wastes removed by the kidneys – in the bladder. The bladder connects to the urethra, the tube through which urine leaves the body. Some people may lose a few drops of urine while running or coughing. Others may feel a strong, sudden urge to urinate just before losing a large amount of urine; many experience both symptoms.

Women experience UI twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. Both women and men can become incontinent from neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging. A common misconception is that incontinence is inevitable with age.  UI is a medical problem with treatments and solutions. No single treatment works for everyone, but many women can find improvement without surgery.

There are various treatment lifestyle changes that can help manage incontinence.  Be mindful of limiting your intake of things that tend to act as stimulants for the bladder (carbonated beverages, spicy foods, citrus, alcohol). Smoking and excess weight can cause incontinence; so quit smoking if you do and maintain a healthy weight. Eliminating caffeine intake two to three hours prior to bedtime can reduce incontinence during the night. Also, establish a pattern of voiding every two to three hours to decrease the amount of stored urine in your bladder.

Other treatment options include Botox, Kegel exercises, biofeedback, and tibial nerve stimulation. Botox can also be injected into the bladder wall to increase bladder size and alleviate incontinence associated with uncontrolled frequency. When performed correctly, Kegel exercises rehabilitate the pelvic floor muscles through isometric contractions. Biofeedback uses instrumentation to provide information on how well the bladder is performing to control urgency incontinence, displayed in a form that the patient understands.  Biofeedback bladder training plans, generally consist of 45 minute visits for six weeks.  Tibial nerve stimulation is another alternative whereby the tibial nerve is stimulated with a tiny needle connected to a low voltage to help manage incontinence.

In addition to the treatment methods discussed above, oftentimes medications are used, especially in those with urgency and frequency of urination. Stress incontinence (loss of urine with activity) is surgically corrected with outpatient 20-minute surgeries that use small incisions. These surgeries, known as “sling” procedures, utilize revolutionary artificial support tapes that compress and support the urethra to prevent leakage. Patients often resume normal activities in less than one week in most cases.

Injection therapy using bulking agents or Botox is another option available, as well as sacral nerve stimulation.  All treatment options need to be discussed with your urologist to determine which would be the best for you.

If you are suffering from urinary incontinence or overactive bladder, please call Urology Partners at 941-792-0340 today. Don’t spend another day on the sidelines, letting life pass you by. You can successfully manage and treat your condition and get back in the game of life!

Terri L. Jenkins, ARNP

Theresa “Terri” Jenkins received her Bachelor of Science Degree in Nursing at Austin Peay University, Clarksville, Tennessee in 1986. She earned her Master of Nursing, Advanced Registered Nurse Practitioner at Andrews University, Berrien Springs, Michigan in 1998 the area of Adult Health.

Terri worked for 13 years at Sarasota Memorial Hospital, with 11 years on the Urology floor and two years on the Medical Surgical wing. She expanded her urologic knowledge base by contributing another 10 years of her career to Florida Urology Specialists in Sarasota.

With over 20 years living and working in the Manatee – Sarasota area, Terri has dedicated the last 4 years to Urology Partners assessing, diagnosing and treating patients with urological problems using the most advance diagnostic and treatment technologies available.

Terri’s areas of special interest include urinary incontinence, recurrent urinary tract infections, interstitial cystitis, female voiding dysfunction, female sexual dysfunction, bladder and pelvic pain.

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