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Incontinence

Select from the following topics to learn more about common Incontinence conditions.

Contigen Implants

Many thousands of people feel they must resort to absorbent or sanitary products to avoid situations where embarrassing leakage may occur. Contrary to popular opinion, however, most incontinence is treatable and manageable. After tests have shown what type of incontinence you are experiencing, your doctor will be able to tell you if it is treatable and which treatment option is appropriate for you.

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Pelvic Floor Exercises For Men dr goldberg incontinence

Men experience a variety of problems with their urinary system, leading to unwanted leakage of urine. Some also have difficulty controlling wind or leakage from the bowels. Often this is due to a weakness of the muscles of the pelvic floor, which have an important function in preventing these troublesome conditions. In particular, pelvic floor exercises have been shown to be effective following surgery on the prostate and when men experience a dribble after passing water.

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Exercise and Urinary Incontinence

Stress urinary incontinence refers to the leakage of urine that occurs during physical activities, such as coughing, sneezing, walking and lifting. It is not surprising that many women lose urine during exercise given the impact exercise may have on the bladder, the urethra or the tube that allows urine to exit the body, and the pelvis. If women have urinary incontinence during exercise, it is not uncommon for many women to give up exercising entirely because of the social embarrassment associated with this condition. One-fifth of women who exercised recreationally stopped exercising because of the incontinence.

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Getting help for Incontinence

Incontinence may come on so gradually that you don't realize what a problem it has become. There is no magic formula, but as a rule, if you are incontinent more than once a month, you need a medical evaluation.

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Incontinence Help

When you feel the urge to empty your bladder

First: STOP and stand very still. Sit down if possible. Staying as still as you can will help control the urge. Second: TIGHTEN your pelvic muscles 3 to 5 times. Take a deep breath and as you let it out, allow your body to let go and RELAX. Think of something other than the bathroom. Third: WALK, when the urge has decreased somewhat, to the bathroom at a normal speed. If the urge happens again on the way to the bathroom, STOP and repeat the above steps.

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Incontinence - It May Be Your Medication

If you are showing signs of urinary incontinence (involuntary loss of urine) or if your incontinence problem seems to be getting worse, take stock of your medicine cabinet. Commonly recommended medications could be the cause of your incontinence, or at least contributing to them. If you suspect medications may be worsening or the cause of your urinary incontinence, describe your incontinence symptoms to your doctor and let him or her know about all the medicines you take, both prescription and over-the-counter. That way, your doctor can help determine whether these medicines should be adjusted or stopped, or if a treatment should be modified.

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Post-Prostatectomy Incontinence: The Problems and Solutions

Incontinence can be a complication of prostate surgery done for either benign or a malignant disease. I am going to concentrate on incontinence following surgery for prostate cancer, although many of the same principles apply for incontinence caused by surgery done for benign enlargement of the prostate such as TURP or open prostatectomy. The current quoted complication rate of incontinence following radical prostatectomy is between 4-8 percent Pre-existing conditions causing incontinence, especially certain neurological disorders, may inflate this number. Recent advances in the surgical technique in radical prostatectomy have improved this percentage. In the not too distant past, the figure was 20 percent or more. A better understanding of the prostatic anatomy, the neuro-physiology of continence and incontinence, and improved surgical technique have all contributed to the lower percentage rate of incontinence. We primarily have Dr. Patrick Walsh, at John Hopkins to thank for improvements in surgical technique.

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Urinary Incontinence - Urinary Leakage

Urinary incontinence is the uncontrollable and involuntary loss of urine that affects more than 10 million Americans. Incontinence can be very embarrassing as it can interfere with a normal, full life. Fortunately, today something can be done about it and in most instances it can be cured completely.

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Diagnostic Evaluation for Incontinence

The purpose of the evaluation is to identify the cause of the incontinence, to determine the damage to the bladder and kidneys, and to select the appropriate treatment for the specific cause of the leakage. All of the tests can be performed in the office or as an outpatient at the hospital. All of the tests are associated with minimal discomfort. You can resume normal activity immediately following the procedures. The evaluation of urinary incontinence can include any of the following tests or procedures:

Cystoscopy

A local anesthetic is inserted into the urethra (the tube that drains the urine from the bladder). A small telescope is inserted in the urethra to examine the inside of the bladder. In women, a pelvic examination is performed at the end of the procedure. The examination takes approximately 5 minutes. After the procedure there may be a small amount of bleeding or mild burning with urination.

Flow Rate

This is a procedure to measure the efficiency of the bladder and the muscles or sphincters that hold the urine in the body. You will be asked to drink several glasses of water. When you feel that you have to urinate, you will be asked to urinate over a toilet that contains a recording device. The device will measure the volume of urine and the time it takes to empty your bladder.

Cystometrogram (CMG)

This is a procedure in which a small catheter (a plaster or rubber tube smaller than a pencil) is inserted into the bladder. The catheter is used to deliver sterile water or gas (carbon dioxide) into the bladder. You will be asked to describe the first sensation to urine and also the strong urge to urinate. This procedure takes approximately 10-15 minutes. After the cystometrogram the catheter is removed and you will be asked to cough, strain and then urinate. This test is performed to determine the extent of leakage. You can expect some burning or passage of air with urination.

Voiding Diary

This is a record of the amount and time of day that urination takes place and when leakage occurs. (The amount of urination should be recorded in ounces.)

Voiding Cystourethrogram (VCUG)

This is an X-ray procedure in which a catheter is inserted in the bladder and the bladder filled with iodine. The catheter is removed and X-rays are taken while voiding.

Intravenous Pyelogram

This is an X-ray procedure that requires an injection of iodine into a vein and pictures are taken of the kidney at various time intervals. This determines the anatomy and the presence of damage to the kidneys. There is occasional nausea, bad taste in the mouth, or lightheadedness with the procedure. You will be asked to take laxatives before the procedure. (Please notify me or the radiologist if you are allergic to iodine or seafood.)

Not all of these diagnostic tests are required for each patient.

Reprinted with permission from Dialog Medical, dialogmedical.com.

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