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Senior Health Week: Bladder Control
Health News You Can Use •

Latest Bladder Control News:

Behaviorial Therapy Program Significantly Cuts Incontinent Episodes: Researchers report success with a program that began with the importance of pelvic muscle strength and instructions on pelvic exercises, and details on how to keep a bladder control journal of daily voiding habits.


Recent Bladder Control News:

Combination of Therapies Effective for Many Patients: Researchers say 76 percent of women who completed a program of pelvic floor muscle rehabilitation and behavioral therapy were symptom free at the conclusion of the study.

Overactive Bladder Symptons Impact Sex Life and Intimacy: A poll found that the symptoms of overactive bladder can be severe enough to significantly affect the sex lives and intimacy of many people who have the condition.

FDA Approves Kegel Exerciser for Treating Stress Urinary Incontinence: The Kegel Exerciser™ has become the first progressive resistance trainer approved by the U.S. Food and Drug Administration for the treatment of stress urinary incontinence.

New Biomaterial Being Tested in Treatment of Stress Urinary Incontinence: Researchers say early results of a clinical trial now underway indicate 100 percent effectiveness, no infections, no rejections and no erosion of the implanted tissue.

Cell Transplants May Be Promising New Therapy for Urinary Incontinence: Researchers say skeletal muscle cell transplants in laboratory animals appear to offer a safer, more effective and longer lasting treatment for urinary incontinence.

Botox Injections May Help With Overactive Bladder: Researchers say the injections can offer many patients a safe, but temporary, solution to the problem of incontinence.

Study Shows Treatment Effective for Female Stress Urinary Incontinence: Four out of five users of FemSoft® Urethral Insert reported they never or rarely experience incontinence while the FemSoft Insert is in place.

Patent Issued for Female Incontinence Control Device: The Steridyne IVD™ promises relief to patients suffering from female urinary stress incontinence, which affects some 12 million women in the United States.

Embarrassment Keeps Many From Seeking Treatment for Overactive Bladder: Many people suffering from overactive bladder are too shy to get help and are needlessly living a life of inconvenience and isolation.

Debbie Reynolds Urges People to Seek Treatment for Overactive Bladder: Famed Hollywood actress is speaking out on her battle with overactive bladder, a condition affecting millions of Americans, as part of new public education campaign.

New Minimally Invasive Procedure Treats Stress Incontinence in Older Women: Researchers say the half-hour procedure, known as Tension-Free Vaginal Tape (TVT), is performed on an outpatient basis and has been found safe and effective.

70% of Women With Stress Incontinence Worry About Laughing in Public: Survey finds women also worry about coughing and sneezing for fear of having an accident.

Nursing Visits Help Older Rural Women Reduce Urinary Incontinence: Easy to use behavioral strategies work well, and once women know about the techniques, many can manage their own continence.

Sacral Nerve Stimulation for Incontinence to Be Covered by Medicare: Health and Human Services Secretary Tommy G. Thompson announced that Medicare coverage will be extended to include a surgical treatment known as sacral nerve stimulation for urinary incontinence.


Bladder Control Primer:

Bladder control problems, sometimes called urinary incontinence, are an inability to hold your urine until you get to a toilet. More than 13 million people in the United States--male and female, young and old--experience incontinence. It is often temporary, and it always results from an underlying medical condition.

Women experience incontinence two times more often than men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. Older women, more often than younger women, experience incontinence. But both women and men can become incontinent from strokes, multiple sclerosis, and physical problems associated with old age.

But incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages. If you experience incontinence, you may feel embarrassed. It may help you to remember that loss of bladder control can be treated. You will need to overcome your embarrassment and see a doctor to learn if you need treatment for an underlying medical condition.

What Are the Types of Incontinence?

  • Overactive Bladder or Urge Incontinence: If you lose urine for no apparent reason while suddenly feeling the need or urge to urinate, you may have urge incontinence. The most common cause of urge incontinence is inappropriate bladder contractions. Medical professionals describe such a bladder as "unstable," "spastic," or "overactive." Your doctor might call your condition "reflex incontinence" if it results from overactive nerves controlling the bladder. Urge incontinence can mean that your bladder empties during sleep, after drinking a small amount of water, or when you touch water or hear it running (as when someone else is taking a shower or washing dishes).
  • Stress Incontinence: If coughing, laughing, sneezing, or other movements that put pressure on the bladder cause you to leak urine, you may have stress incontinence. Physical changes resulting from pregnancy, childbirth, and menopause are common events that cause stress incontinence. It is the most common form of incontinence in women and is treatable. Pelvic floor muscles support your bladder. If these muscles weaken, your bladder can move downward, pushing slightly out of the bottom of the pelvis toward the vagina. This prevents muscles that ordinarily force the urethra shut from squeezing as tightly as they should. As a result, urine can leak into the urethra during moments of physical stress. Stress incontinence also occurs if the muscles that do the squeezing weaken. Stress incontinence can worsen during the week before your menstrual period. At that time, lowered estrogen levels might lead to lower muscular pressure around the urethra, increasing chances of leakage. The incidence of stress incontinence increases following menopause.
  • Functional Incontinence: People with functional incontinence may have problems thinking, moving, or communicating that prevent them from reaching a toilet. A person with Alzheimer's disease, for example, may not think well enough to plan a timely trip to a restroom. A person in a wheelchair may be blocked from getting to a toilet in time. Conditions such as these are often associated with age and account for some of the incontinence of elderly women in nursing homes.
  • Overflow Incontinence: If your bladder is always full so that it continually leaks urine, you have overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Overflow incontinence is rare in women.

The first step toward relief is to see a doctor who is well acquainted with incontinence to learn the type you have.

How Is Incontinence Treated?

  • Exercises: Kegel exercises to strengthen or retrain pelvic floor muscles and sphincter muscles can reduce or cure stress leakage. Women of all ages can learn and practice these exercises, which are taught by a health care professional. Most Kegel exercises do not require equipment.
  • Electrical Stimulation: Brief doses of electrical stimulation can strengthen muscles in the lower pelvis in a way similar to exercising the muscles. Electrical stimulation can be used to reduce both stress incontinence and urge incontinence.
  • Biofeedback: Biofeedback uses measuring devices to help you become aware of your body's functioning. By using electronic devices or diaries to track when your bladder and urethral muscles contract, you can gain control over these muscles. Biofeedback can be used with pelvic muscle exercises and electrical stimulation to relieve stress and urge incontinence.
  • Timed Voiding or Bladder Training: Timed voiding (urinating) and bladder training are techniques that use biofeedback. In timed voiding, you fill in a chart of voiding and leaking. From the patterns that appear in your chart, you can plan to empty your bladder before you would otherwise leak. Biofeedback and muscle conditioning--known as bladder training--can alter the bladder's schedule for storing and emptying urine. These techniques are effective for urge and overflow incontinence.
  • Medications: Medications can reduce many types of leakage. Some drugs inhibit contractions of an overactive bladder. Others relax muscles, leading to more complete bladder emptying during urination. Some drugs tighten muscles at the bladder neck and urethra, preventing leakage. And some, especially hormones such as estrogen, are believed to cause muscles involved in urination to function normally. Some of these medications can produce harmful side effects if used for long periods.
  • Pessaries: A pessary is a stiff ring that is inserted by a doctor or nurse into the vagina, where it presses against the wall of the vagina and the nearby urethra. The pressure helps reposition the urethra, leading to less stress leakage. If you use a pessary, you should watch for possible vaginal and urinary tract infections and see your doctor regularly.
  • Implants: Implants are substances injected into tissues around the urethra. The implant adds bulk and helps to close the urethra to reduce stress incontinence. Collagen (a fibrous natural tissue from cows) and fat from the patient's body have been used. Implants can be injected by a doctor in about half an hour using local anesthesia. Implants have a partial success rate. Injections must be repeated after a time because the body slowly eliminates the substances.
  • Surgery: Doctors usually suggest surgery to alleviate incontinence only after other treatments have been tried. Many surgical options have high rates of success. Most stress incontinence results from the bladder dropping down toward the vagina. Therefore, common surgery for stress incontinence involves pulling the bladder up to a more normal position.
  • Catheterization: If you are incontinent because your bladder never empties completely (overflow incontinence) or your bladder cannot empty because of poor muscle tone, past surgery, or spinal cord injury, you might use a catheter to empty your bladder. A catheter is a tube that you can learn to insert through the urethra into the bladder to drain urine. Catheters may be used once in a while or on a constant basis, in which case the tube connects to a bag that you can attach to your leg. If you use a long-term (or indwelling) catheter, you should watch for possible urinary tract infections.
  • Other Procedures: Many women manage urinary incontinence with pads that catch slight leakage during activities such as exercising. Also, you often can reduce incontinence by restricting certain liquids, such as coffee, tea, and alcohol. Finally, many women who could be treated resort instead to wearing absorbent undergarments, or diapers--especially elderly women in nursing homes. This is unfortunate, because diapering can lead to diminished self-esteem, as well as skin irritation and sores.

Background information provided by: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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