Urinary incontinence can be more than an inconvenience. Worrying about bladder control can affect your daily routine and interfere with social interactions. Unfortunately, many women become too embarrassed to discuss the condition so they suffer without treatment. Overall, urinary incontinence affects about 10% of American women under age 65 and 35% of those over 65.

Whether you suffer occasional leaking or sudden strong urges, you can be free from the frustration of urinary incontinence with appropriate treatment. Board-certified OB/GYN John Macey, MD, provides expert urogynecology services in his practice based in Nashville, Tennessee. After determining the cause and type of your urinary incontinence, Dr. Macey devises a treatment plan designed to restore normal function and improve your quality of life.

How do I begin treatment for urinary incontinence?

Effective treatment for urinary incontinence begins with an accurate diagnosis. In addition to a detailed medical history and physical examination, Dr. Macey uses urodynamic studies to assess how well your bladder, sphincters, and urethra function together. The tests can also help identify the source of leakages or blockages.

The results of these studies help determine the cause and type of urinary incontinence you’re experiencing. For women, the two most common types of urinary incontinence are stress incontinence and urge incontinence. Accurate diagnosis is key because each type has different causes and treatments.

Stress incontinence is the most common type of incontinence in women. It occurs in women of all ages because of weak pelvic floor muscles. During certain activities, these weaker muscles put additional stress or pressure on the bladder and urethra. If you have stress incontinence, you’ll notice urine leakage with physical exertion, laughing, lifting, sneezing, or coughing.

Urge continence, or an overactive bladder, occurs as a sudden and strong urge to urinate. The sensation may feel so intense that it prevents you from holding your urine long enough to make it to a restroom. Women who have urge continence experience episodes at least eight times per day and two times per night. This condition occurs more often among older women.

What non-invasive treatments help urinary incontinence?

Your treatment plan for urinary incontinence depends on your age, severity of symptoms, and overall physical health. A combination of medication, behavior changes, and medical devices may provide relief for less severe cases.

Conservative treatments for urinary incontinence can include:

  • Performing Kegel exercises to strengthen your pelvic floor and urinary sphincter
  • Limiting the fluids you consume
  • Avoiding caffeine and alcohol, which can stimulate urine production
  • Taking medication specific to your type of urinary incontinence
  • Losing weight to avoid extra pressure on your bladder
  • Voiding on a schedule to train your bladder to extend the time between bathroom trips
  • Using a vaginal pessary, a soft internal device that helps support your bladder
  • Using urethral inserts, tampon-like devices that can prevent incontinence during a specific activity

What surgical procedures can help urinary incontinence?

Surgical intervention can provide more predictable and permanent solutions for severe symptoms of urinary incontinence. The specific surgical procedure used depends on the type of urinary incontinence you experience.

The most common surgical technique for treating stress incontinence involves the use of a sling. In this quick-recovery, outpatient procedure, your tissue, synthetic mesh, or animal or human donor tissue is used to create a sling or hammock-like fixture. The fixture supports your urethra and removes pressure from your bladder.

Dr. Macey may recommend one of two types of surgical treatments for urge incontinence. One technique uses the InterStim™ neuromodulator. The process involves surgically implanting the neuromodulator at the base of your spine. The device sends mild electrical pulses to the sacral nerves, which control the contractions of your bladder muscle.

These normalized pulses work to prevent the bladder from sending faulty signals between your bladder and brain. This process helps to reduce the frequency of urination as well as uncontrolled urgency. The InterStim neuromodulator doesn’t work for everyone, so you’ll wear the device for a test run before it’s permanently inserted.

Posterior tibial nerve stimulation (PTNS) can also help reduce urge incontinence. PTNS involves the insertion of a thin needle under your ankle near the tibial nerve, which is a branch of your sciatic nerve. Your sciatic nerve runs from your lower back down the back of each leg.

A stimulator on the outside of your body sends pain-free electrical impulses through the needle to the tibial nerve. The impulses travel from the tibial nerve up to other nerves in your spine that control your bladder.

Each PTNS session lasts about 30 minutes. You’ll attend in-office sessions once a week for 12 weeks or more until your symptoms get better.

Urinary incontinence can improve with accurate diagnosis and appropriate treatment. Schedule an appointment online or call our office to arrange an evaluation of your symptoms.

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