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Urinary Incontinence - Causes and Options

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By Dr. Kristi Wrightson, ND, MS, RD • www.ProHealth.com • October 3, 2008

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Q: Doctor, what can be done for incontinence and bladder leakage? - Dorothy

A: Millions of women suffer from varying degrees of urinary incontinence. From losing a small amount of urine while laughing or coughing to losing large amounts of urine, all of the symptoms can be embarrassing and difficult to deal with. The risk of incontinence is higher in women due to pregnancy, childbirth, menopause, obesity and the structure of the female anatomy.

Incontinence can occur because of problems with the muscles and nerves that work together to help hold the urine in the bladder:

• During urination, muscles inside the bladder contract to allow urine to pass to the urethra.

• Next, the sphincter muscles around the urethra relax in order for urine to flow out of the body.

If the bladder muscles contract suddenly or the sphincter muscles are damaged incontinence may occur.

Fortunately, there are many options to help treat urinary incontinence, depending on the severity. The first step in treatment is to see a doctor who specializes in diagnosing the kind of incontinence that is occurring. Start by speaking with your gynecologist, and he/she could refer you to a specialist, such as a urologist or urogynecologist.

After full examination and possibly several tests, they may suggest any one of the following treatments:

Behavioral techniques, such as timed voiding (simply going to use the restroom at specific intervals) or Kegel exercises (meant to strengthen the pelvic floor muscles used to stop urine flow).

Medications for an overactive bladder (caused by overactive nerve signals that increase urgency and frequency of urination), which help to relax bladder muscles and decrease muscle spasms leading to incontinence.

Therapies such as biofeedback, and neuromodulation (which uses gentle electronic stimulation) to normalize stimulation of nerves that are involved with urination.

Vaginal devices which can be inserted into the vagina to increase pressure to reposition the urethra and decrease stress leakage.

Injections, such as collagen, near the urinary sphincter to increase the thickness of the bladder opening and reduce incontinence.

• And the last option, surgery, may be used in situations where the bladder needs support to return to its original position.

- Dr. Kristi Wrightson, ND, MS, RD

___

Resources:
1. See for example the MayoClinic.com summary of treatments & drugs for urinary incontinence.

Note: This information has not been evaluated by the FDA. It is generic and is not intended to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.



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