TIM eMagazine Vol.3 Issue 2
You may also be asked to keep a voiding or bladder diary to assess your
baseline urinary habits. This is a record of the amount of fluid you drink, the
number of voids you make, and the amount of leakage that happens in a day.
What are the available treatment options?
Treatment depends on the type of incontinence that you have.
Conservative treatment is initially advised. This includes:
1.Lifestyle change – Certain food and drinks may cause you to urinate more
often. Avoiding caffeinated drinks like coffee, tea and cola may help control
frequency. If you have nocturia, avoiding too much fluid a few hours before you
sleep may also help. Weight loss may be beneficial in relieving extra pressure
placed on the bladder. Smoking has also been considered a bladder irritant so
cutting down on smoking may alleviate some symptoms.
2.Bladder training – The first step is by completing a bladder diary. This helps you
study your pattern of voiding and leaking, as well as assess how much fluid intake
you have and if it affects your urine frequency. With this information, you can time
when you have to go the bathroom, as well as adjust your intake in order to avoid
frequent voiding or accidental leakage.
3.Pelvic floor muscle exercises – this is called the Kegel exercise, and the most
essential part of the exercise is making sure that the right muscles are being used. Your
doctor may help to make sure you are squeezing the right muscles. Strengthening these
muscles and knowing the right time to squeeze them help in controlling the leaks that
occur due to urgency. Some symptoms of stress incontinence may also improve after 3 to 6
months of regular exercises.
4.Pessary – this is a device that is placed in the vagina. This may be worn to help control
leakage during activities that cause incontinence. This usually benefits women who have
stress incontinence associated with prolapse, those with mild stress incontinence, and those
who want temporary relief while waiting for definitive surgery.
Surgery may be indicated in some women who do not respond to conservative therapy.
The type of surgery will depend on patient-related factors (e.g., diabetes mellitus, cancer),
urethral function, and co-existing problems (e.g., prolapse, diverticulum, cancer). Surgical
options include:
1.Retropubic colposuspension – a transabdominal procedure wherein the periurethral tissues
near the bladder neck are sutured to a ligament of the pubis. This aims to return the bladder neck
to an intra-abdominal location preventing stress incontinence.
2.Periurethral/Bulking injections – a bulking agent (commonly made of collagen and water
based gels) is injected around the urethra narrowing the lumen and effectively improving urethral
coaptation.
3.Minimally invasive sling procedures – a suburethral sling (made of native tissue or synthetic
mesh) is placed at the level of the midurethra in a tension-free manner.
What are the possible complications of urinary incontinence?
Urinary incontinence basically affects your quality of life. Women who suffer from it may experience
emotional distress due to the inappropriate leakages, and at times, especially in chronic cases,
depression.
themedicalcity.com
At The Medical City, what are the related services available?
At The Medical City, we have a complete roster of competent urogynecologists who
can assess and treat patients with urinary incontinence. A comprehensive urodynamic
evaluation is offered for patients with Urinary Incontinence at the Pelvic Floor Center
with the following services:
1.simple office cystometrogram
2.uroflowmetry
3.multi-channel cystometry
4.urethral function test (urethral pressure profilometry)
5.electromyography (EMG)
6.pelvic floor ultrasound
7.bladder scan
8.cystourethroscopy
References:
•
Walters, Mark D and Mickey M. Karram. Urogynecology and Reconstructive
Pelvic Surgery Fourth Edition. Philadelphia: Saunders, 2015.
•
International Urogynecological Association (IUGA) website.
•
Department of Obstetrics and Gynecology – Section of Urogynecology
•
Center for Patient Partnership
Disclaimer: This information is not intended
to be used as a substitute for professional
medical advice, diagnosis or treatment. If
you or someone you know have any of the
symptoms mentioned above, it is advisable
to seek professional help.
Credits : medicalexpo.com
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