Incontinence

Urinary incontinence is the loss of control over your urine in both men and women. This could be a drip here and there or no control at all. It is estimated that over 25 million Americans have some type of incontinence, but likely this is an underestimate because many people are embarrassed to talk to their doctor about it. It tends to be more common in women and can happen at all ages of life, but it tends to be more common as we age. It should not be considered a normal part of aging because there is usually a cause and treatment available.

Urinary incontinence is usually a sign of an underlying condition, so it is important not to ignore it. If this condition goes untreated, you may miss the opportunity to cure the incontinence and it may become a permanent worsening condition. Dr. Shaba can help improve and resolve many causes of incontinence with simple testing and treatments that can be as easy as medication or a simple procedure with quick recovery.

There are 3 main types of incontinence:

Stress incontinence- Leaking of urine associated with increased abdominal pressure or movement (coughing, sneezing, laughing, lifting, straining, etc)

Urge incontinence- Leaking of urine associated with a severe urge to urinate followed by involuntary release of urine before making it to the bathroom

Overflow incontinence- Leaking of urine because your bladder is completely full, so the urine just dribbles out

Symptoms:

Urinary incontinence is basically any leaking of urine when you are not actively trying to urinate.

Causes:

There are a multitude of causes for incontinence and differ depending on what type of incontinence you have and whether you are male or female.

• Surgery- Any type of pelvic surgery- most commonly prostate surgery in men and hysterectomy in women
• Infection- urinary tract infections (UTI) are most common
• Pregnancy
• Obstruction of the urinary tract by cancer, BPH in men, kidney stones, urethral strictures
• Prolapsed bladder
• Neurologic disorders- Alzheimer’s, Parkinson’s, Multiple sclerosis, stroke
• Constipation
• Diabetes
• Over consumption of liquids
• Bladder irritants- caffeine, sodas, energy drinks, spicy food, alcohol
• Dehydration

Evaluation and Diagnosis:

A good history and physical can usually determine what type of incontinence a person has. Dr. Shaba will also usually do a few tests to confirm and make sure no other underlying causes are there.

These may include:

• Urinalysis and culture- urine test to rule out infection
• Post void residual- An in-office ultrasound to see how much urine is left over in the bladder after urination. Sometimes this can be done with a catheter as well.
• Bladder diary- sometimes the patient is asked to write down when they urinate, the volume or urine and what they ate and drank that day.

Sometimes Dr. Shaba will also do further testing:

• Cystoscopy- a small flexible camera of the urethra and bladder done in the office with local anesthesia
• Imaging with CT scan or ultrasound
• Urodynamics- measurement of electrical activity of the bladder

Treatment:

The treatment of incontinence depends on the type you have and the severity. Some of the treatments Dr. Shaba offers are:

• Bladder training
• Kegel Exercises
• Pelvic Floor physical therapy
• Lifestyle changes and fluid management
• Oral medications
• Botox injections for the bladder
• Minimally invasive procedures
• Sling procedures
• Surgery- Artificial urinary sphincters (AUS) or male sling

For more information please visit: https://www.urologyhealth.org/urology-a-z/u/urinary-incontinence