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U Y B N What You Should Know About Urinary Incontinence

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U Y B N What You Should Know About Urinary Incontinence P ATIENT G UIDE What you should know OBGMANAGEMENT about urinary incontinence What is urinary incontinence? rinary incontinence is a condition in Uwhich a person unintentionally leaks Kidneys urine. She may uncontrollably urinate when she laughs, coughs, or exercises. Or she may find she cannot wait to reach the bathroom. These problems, which may be Ureters temporary or permanent, can be caused by a number of conditions, including urinary tract infections, bladder weakness, or a blocked urethra (the canal that transports Urine urine from the bladder). Bladder Is urinary incontinence common? muscle Bladder es, it is very common, especially among neck Ywomen. Seventeen million people in Urethra the United States experience incontinence Pelvic floor Sphincter at some point in their lives, and approxi- muscles muscles mately 10% to 30% of women between the ages of 15 and 64 have this problem. That number may be even higher, since many Normal urine flow. Urine is produced in the kidneys, then travels through the women with incontinence are too embar- ureters to the bladder, where it is rassed to seek treatment. stored. During urination, the urethra carries the urine outside of the body. Does urinary incontinence affect only elderly women? ladder control problems are not a natu- Bral part of the aging process and can incontinence. It may cause women to affect women of all ages. lose urine as soon as they drink a small amount of liquid or have the urge to go Is all urinary incontinence the same? to the bathroom. It also may result in o, there are several different types of frequent urination (every half hour, for Nthis condition: example) or bedwetting. • Stress incontinence. Women with • Mixed incontinence. Patients with stress incontinence may leak urine this condition suffer from both stress when they exercise, cough, sneeze, and urge incontinence. laugh, lift, or put pressure on their • Overflow incontinence. Women abdomen. This often is due to weakness with overflow incontinence may feel in pelvic floor muscles and may be like they never completely empty their caused by childbirth or pelvic surgery. bladders. Some may pass only a small • Urge incontinence. This condition, amount of urine and feel like their blad- sometimes referred to as “overactive der is still full. Others may feel as if they bladder,” is the most common form of have to empty their bladders but can’t. CONTINUED December 2002 • OBG MANAGEMENT 81 ✁ What you should know about urinary incontinence • Transient incontinence. This is tem- What can I expect during a porary incontinence that occurs due to urinary incontinence test? certain conditions, including urinary tract infections, the use of some med- • Pad test: You’ll wear a pad for up to 2 ications, and restricted mobility. hours, then place it in a sealed plastic bag. A health-care provider will weigh the Are there tests for incontinence? bag to see how much urine the pad is f you think you have urinary inconti- holding. Inence, schedule an appointment with your doctor. He or she will talk to you • Cystoscopy: Your physician will look for about your medical history and urinary abnormalities in your bladder and lower habits, and may perform a physical exam- urinary tract by inserting a small tele- ination as well as a urine test. Other tests scopic tube into your bladder. will help find the cause of your inconti- nence and the best treatment for you (see • Postvoid residual measurement: A small, “What can I expect during a urinary soft tube or an ultrasound is used to incontinence test?”). measure the amount of urine left in your bladder after you’ve gone to the Is incontinence treatable? bathroom. here are many treatment options Tavailable for urinary incontinence. • Stress test: Your doctor will ask you to Speak with your doctor to find out if one cough, lift, or exercise to see if any of is right for you. these activities cause you to lose urine. Nonsurgical treatments • Urinalysis: A clinician will examine your • Pelvic muscle exercises—also call- urine for any signs of infection, blood, or ed Kegel exercises—help strengthen other abnormalities. weak muscles around the bladder. • Bladder training can help you resist • Uroflowmetry: This measures urine the urge to urinate by having you go to speed and volume. Special equipment the bathroom only at certain, desig- is used to show any changes in the nated times. flow rate. • Medications can influence bladder contraction and improve the tension of • Urodynamics testing: Your doctor will certain muscles and the urethra. take a closer look at the filling and emp- tying process by placing pressure-meas- Surgical treatments uring instruments in the bladder. • Slings—made of mesh tape or a per- son’s own tissue—are used to restore • Functional incontinence. Women support to the bladder neck, which with functional incontinence cannot allows the bladder to hold urine. get to the toilet or use a bedpan in time • Bladder neck suspension is a proce- to urinate. The urinary system works, dure in which a doctor places stitches but physical or mental disabilities pre- in the wall of the vagina, beside the vent normal bathroom use. urethra, to provide extra support. ■ 82 OBG MANAGEMENT • December 2002 ✁.
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