Women‘s Urinary Health Problems

The Integral Theory of Pelvic Floor Dysfunction

brings a new perspective to the management of dysfunction in the female pelvic floor. It emphasizes the role of the connective tissue of the vagina and its supporting ligaments in both function and dysfunction.

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Urinary Incontinence 

Million people suffer from urinary incontinence or overactive bladder (OAB).

This condition is far more prevalent in women than men. In the general population, age 15 to 64 years, 10-30% of women, versus 1.5% of men are affected. Those with OAB often experience urgency at inconvenient and unpredictable times and sometimes lose control before reaching a restroom. OAB, therefore, interferes with work, daily routine and intimacy, causes embarrassment, and can diminish self-esteem and quality of life.

What is incontinence? Incontinence, is a symptom – not a disease in itself.

A broad range of conditions and disorders can cause incontinence, including birth defects, pelvic surgery, injuries to the pelvic region or to the spinal cord, neurological diseases, multiple sclerosis, poliomyelitis, infection, and degenerative changes associated with aging. It can also occur as a result of pregnancy or childbirth.

Incontinence is a problem of the urinary system, which is composed of two kidneys, two ureters, a bladder, and a urethra. Normally, the bladder stores the urine that is continually produced by the kidneys until it is convenient to urinate, but when any part of the urinary system malfunctions, incontinence can result.

One in five adults over age 40 are affected by overactive bladder or recurrent symptoms of urgency and frequency, a portion of whom don’t reach the toilet before losing urine. At least half of all nursing home residents are incontinent of urine and many of them experience loss of bowel control as well.

In sum, the problem is widespread and affects people of all ages including children and young adults Incontinence sufferers may experience emotional as well as physical discomfort. Many people affected by loss of bladder or bowel control isolate themselves for fear of ridicule and lose self-esteem. Adults may find employment impossible or compromised.

Treatment Options for Incontinence Approximately 80% of those affected by urinary incontinence can be cured or improved. It is imperative to first obtain a diagnosis because there are different types of incontinence with different treatment options.

Diagnosis includes a medical history and a thorough physical examination. Tests such as Urodynamics ,X-rays, cystoscopic examinations, blood chemistries, urine analysis, and special tests to determine bladder capacity, sphincter condition, urethral pressure, and the amount of urine left in the bladder after voiding may be required.

Because incontinence is a symptom and not a disease, the method of treatment depends on diagnostic results.

Sometimes simple changes in diet or the elimination of medications such as diuretics can cure incontinence. More frequently, incontinence treatment involves a combination of medicine, behavioral modification, pelvic muscle re-education, collection devices, and absorbent products. Despite the high success rates in treating incontinence, only one out of every twelve people affected seeks help.

Many types of treatment are available for incontinent people.  After considering your specific case, a qualified specialist can recommend the treatment that is appropriate for you.

The three major categories of incontinence treatment are: behavioral, pharmacological, and surgical. Behavioral techniques sometimes include the following: • Scheduled Toileting – The care giver prompts the incontinent patient to go to the bathroom every 2-4 hours. This puts the patient on a regular voiding schedule. The goal is simply to keep the patient dry and is a frequently recommended therapy for frail elderly, bedridden or Alzheimer’s patients. • Bladder Retraining – Bladder retraining involves scheduled toileting but the length of time between bathroom trips is gradually increased. This therapy trains the bladder to delay voiding for larger time intervals and has been proven effective in treating urge and mixed incontinence. • Pelvic Muscle Rehabilitation – This technique involves pelvic muscle exercises (PMEs), also known as Kegel exercises. PME may be used alone or in conjunction with biofeedback therapy, vaginal weight training, pelvic floor stimulation, and magnetic therapy.

Pharmacological therapy (medications or drugs) is another common treatment for incontinence. Physicians can prescribe medications to help control incontinence, and sometimes they will take a person off a drug that is causing or contributing to incontinence. Of course, only your Urologist should tell you to stop using a drug he/she has prescribed.

Surgical treatment should be performed only after receiving a thorough diagnosis from a healthcare professional. All appropriate nonsurgical treatments should be tried before deciding on surgery. There are many different surgical procedures that may be used to treat incontinence.All are minimal invasive procedures and the patient stays in Clinic for a few hours to a night.

The type of operation recommended depends on the type and cause of your incontinence. Some of the more common procedures performed to treat urinary incontinence include, bladder neck suspension or sling procedures, periurethral bulking injections (collagen injections around the urethra), or implantation of an artificial urinary sphincter or sacral nerve stimulator.