Urinary Incontinence Treatment in Bangalore

Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinary sphincter is either lost or weakened.

What is urinary incontinence?

Urinary incontinence is when a person cannot prevent urine from leaking out. It can be due to stress factors, such as coughing, it can happen during and after pregnancy, and it is more common with conditions such as obesity. The chances of it happening increase with age.

Bladder control and pelvic floor, or Kegel, exercises can help prevent or reduce it.

Symptoms

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Types of urinary incontinence include:

• Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
• Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.
• Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
• Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
• Mixed incontinence. You experience more than one type of urinary incontinence.

Causes

The causes and the type of incontinence are closely linked.

Stress incontinence

Factors include:

• pregnancy and childbirth
• menopause, as falling estrogen can make the muscles weaker
• hysterectomy and some other surgical procedures
• age
• obesity

Urge incontinence

The following causes of urge incontinence have been identified:

• cystitis, an inflammation of the lining of the bladder
• neurological conditions, such as multiple sclerosis (MS), stroke, and Parkinson's disease
• enlarged prostate, which can cause the bladder to drop, and the urethra to become irritated

Overflow incontinence

This happens when there is an obstruction or blockage to the bladder. The following may cause an obstruction:

• an enlarged prostate gland
• a tumor pressing against the bladder
• urinary stones
• constipation
• urinary incontinence surgery which went too far

Total incontinence

This can result from:

• an anatomical defect present from birth
• a spinal cord injury that impairs the nerve signals between the brain and the bladder
• a fistula, when a tube or channel develops between the bladder and a nearby area, usually the vagina

Other causes:

These include:

• some medications, especially some diuretics, antihypertensive drugs, sleeping tablets, sedatives, and muscle relaxants
• alcohol
• urinary tract infections (UTIs)

Treatment

Treatment for urinary incontinence depends on the type of incontinence, its severity and the underlying cause. A combination of treatments may be needed. If an underlying condition is causing your symptoms, your doctor will first treat that condition.

Your doctor is likely to suggest the least invasive treatments first and move on to other options only if these techniques fail.

Behavioral techniques

Your doctor may recommend:

1. Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every 2.5 to 3.5 hours.
2. Double voiding, to help you learn to empty your bladder more completely to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
3. Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
4. Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.

Medications

Medications commonly used to treat incontinence include:

1. Anticholinergics. These medications can calm an overactive bladder and may be helpful for urge incontinence. Examples include oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz), solifenacin (Vesicare) and trospium (Sanctura).
2. Mirabegron (Myrbetriq). Used to treat urge incontinence, this medication relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.
3. Alpha blockers. In men with urge or overflow incontinence, these medications relax bladder neck muscles and muscle fibers in the prostate and make it easier to empty the bladder. Examples include tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin (Cardura) and terazosin.
4. Topical estrogen. For women, applying low-dose, topical estrogen in the form of a vaginal cream, ring or patch may help tone and rejuvenate tissues in the urethra and vaginal areas. Systemic estrogen — taking the hormone as a pill — isn't recommended for urinary incontinence and may even make it worse.

Absorbent pads and catheters

If medical treatments can't completely eliminate your incontinence, you can try products that help ease the discomfort and inconvenience of leaking urine:

• Pads and protective garments. Most products are no more bulky than normal underwear and can be easily worn under everyday clothing. Men who have problems with dribbles of urine can use a drip collector — a small pocket of absorbent padding that's worn over the penis and held in place by close-fitting underwear.
• Catheter. If you're incontinent because your bladder doesn't empty properly, your doctor may recommend that you learn to insert a soft tube (catheter) into your urethra several times a day to drain your bladder. You'll be instructed on how to clean these catheters for safe reuse.

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