Exploring Urinary Incontinence Treatment Options for a Better Quality of Life

Millions of individuals deal with urinary incontinence (UI), a disorder that gets little attention but has a major influence on quality of life. Many factors, including aging, nerve damage, or weak pelvic floor muscles, can contribute to UI and other pelvic health issues.

About a third of women will experience this problem. Some people are embarrassed to discuss incontinence with their doctors, but treating UI is crucial for optimal pelvic health. Besides restoring control of your daily life, it can improve bladder function, strengthen the pelvic floor, and prevent other problems. The good news is that urogynecology and pelvic floor specialists can provide state-of-the-art, patient-specific urinary incontinence treatment options.

Types of urinary incontinence

Urinary incontinence often begins with the occasional need for absorbent products but can rapidly escalate into a more significant issue that disrupts daily life. As the condition worsens, treatments become necessary to manage symptoms and restore bladder control.

UI comes in several forms, each with its own set of causes and treatment requirements. To get the best therapy for your incontinence and improve your pelvic health, it is vital to know what kind of UI you have.

Stress incontinence

Stress incontinence occurs when the bladder is compressed and urine leaks out. Weak pelvic floor muscles or a damaged urinary sphincter, which controls the passage of urine from your bladder, often cause this condition. These structures become weaker because of things like hormone shifts, aging, or giving birth. As a result, pressure caused by coughing, sneezing, laughing, or physical exertion may cause leakage.

Urge incontinence (overactive bladder)

Urge incontinence, commonly referred to as an overactive bladder, is characterized by an overwhelming need to urinate. This may cause leakage if the sufferer does not have quick access to a restroom. Minor issues, like a bladder infection, and neurological problems, such as disorders and nerve injury, are common causes of this problem.

Mixed incontinence

With mixed incontinence, you must deal with the symptoms of both stress and urge incontinence, including an involuntary need to pee at any time, as well as urine leaks while exercising. Because therapies for mixed incontinence address each component separately, a holistic approach is necessary.

Overflow incontinence

Overflow incontinence happens when the bladder can’t empty all the way, which might happen because of blockages, damaged nerves, or weak muscles. A persistent dribbling of pee may be a sign that the bladder is still too full. Therapy options vary from basic measures like pelvic floor exercises and bladder training to more complex ones like catheterization or surgery.

Functional incontinence

This stems from an inability to make it to a bathroom on time, either because of physical problems like arthritis or mental impairment.

Treatment options for each type

A urogynecology specialist can create a custom-tailored treatment plan based on your symptoms and medical history. Some common treatment methods include:

Lifestyle adjustments

Individuals dealing with UI can take charge of their condition by implementing a number of lifestyle changes. Work with your doctor to determine the best choices for you and how to safely implement behavioral therapies.

• Bladder training. Scheduling pee breaks is an important part of bladder training. As time goes on, stretching the bladder increases its capacity to hold more pee and leak less. One way to do this is to gradually increase the length of time between trips to the toilet. Your doctor may also recommend timed voiding — in which you go to the restroom at certain intervals.
• Dietary changes. Dietary adjustments, such as cutting down on coffee and alcohol, may reduce bladder discomfort and the frequency of leaks. Weight management might be necessary as well, because weight is a risk factor for UI. Drinking less fluid before bedtime may also reduce nighttime bathroom visits. However, keeping yourself properly hydrated is key to having optimal bladder health, so it’s important to speak with your doctor about fluid management.
• Pelvic floor exercises (Kegels). The pelvic floor muscles are crucial for regulating urine flow and avoiding leaks. Kegel exercises can help you strengthen these muscles. The benefits of pelvic floor training for men and women alike have been well documented, with some studies demonstrating a significant decrease in incontinence episodes. Your doctor might recommend working with a physical therapist or using biofeedback to help you identify and contract the right muscles.

Medications

In terms of medication, doctors have a variety of urinary incontinence treatment options to choose from. Here’s a closer look at medication options for UI:

• Anticholinergic drugs assist with overactive bladder and urge incontinence by blocking the activity of acetylcholine, which causes the bladder to contract.
• Mirabegron and Vibegron. This medicine can help alleviate UI by relaxing the bladder muscle and increasing its capacity.
• After menopause, stress incontinence symptoms might worsen. Topical estrogen can help with this condition by rebuilding tissues surrounding the bladder and urinary tract.
• This drug can help with mixed incontinence, especially nocturnal leaking, by relaxing the bladder muscle.
• Alpha blockers. These drugs can help men empty their bladders by relaxing bladder and prostate tissues.

Minimally invasive procedures

When medicines, pelvic floor exercises, and behavioral modifications have failed to alleviate UI symptoms, or when the disorder has a major influence on the patient’s standard of living, the doctor may recommend a minimally invasive treatment option.

• Urethral bulking agents. Injectable urethral bulking medications provide short-term relief for stress incontinence symptoms.
• Botox injections. Botox injections relax the bladder, allowing for a larger pee capacity and less likelihood of leakage.
• Peripheral Tibial Nerve stimulation. Nerve stimulators can alter messages sent to the bladder and help regulate the nerves. It involves inserting a needle into the skin close to the nerve and then stimulating it with tiny electrical pulses.
• When pelvic organ prolapse displaces vaginal tissue, doctors may insert a nonsurgical device known as a vaginal pessary into the vagina. The device helps alleviate pressure when coughing, laughing, and sneezing.

Surgical options

Surgical treatments are often last-resort urinary incontinence treatment options but can be of the utmost help for those with severe symptoms.

• Sling procedures. If you need support for your urethra, a urethral sling, made of medical-grade permanent mesh, might be ideal. This treatment option can be especially helpful for those with stress incontinence.
• Sacral neuromodulation. This method involves surgically inserting a device close to the spine and a battery into the buttocks region. The electrical stimulation helps by activating the sacral nerves, which control bladder function.
• Artificial urinary sphincter. Men who suffer from stress incontinence, especially those who have had prostate surgery, may benefit from this implanted device, which allows them to urinate more predictably and safely.

Urinary incontinence treatment options

Urinary incontinence is a serious medical condition that requires immediate attention. There is no need to suffer with UI when many effective treatments are available to control symptoms and improve your overall comfort. At Florida Medical Clinic Orlando Health, we offer a specialized form of continence care called behavioral therapy to help with symptom management. Our Urogyencology department also offers medications, pelvic floor muscle training, and several surgical treatments for UI.

Dr. Nyarai Chinyani Mushonga’s focused approach to treating urinary incontinence involves addressing the root causes of each patient’s needs and delivering personalized solutions. Dr. Mushonga can help with a combination of lifestyle changes, advanced therapies, and holistic care.

About Dr. Mushonga

Dr. Nyarai Chinyani Mushonga uses her training and education to help patients improve their pelvic health. She specializes in a variety of pelvic floor disorders, including urinary incontinence, bowel control issues, and pelvic organ prolapse.

Following her graduation from medical school at Rutgers University, Dr. Mushonga completed a residency at Atlantic Health – Mount Sinai School of Medicine in reconstructive surgery and female pelvic care. She is a specialist in pelvic floor issues and uses her knowledge to create individualized treatment plans for her patients.

Request an appointment with Dr. Mushonga by calling (727) 553-7461.