Millions of women find themselves unable to control their urine flow as they once did. There is no single universal cause, but the feeling of self-consciousness is surely something they have in common.
With today’s treatments, most of them non-surgical, urologists can end the embarrassment by diagnosing and treating the problem. Urinary incontinence (UI) occurs more frequently with women than with men, especially as a result of pregnancy, childbirth, menopause and the anatomy of the female urinary tract itself. However, both sexes may develop leakage of urine due to nerve injury, multiple sclerosis, stroke, and certain conditions associated with getting older.
Incontinence is a medical problem, and urologists are specialists with solutions. There are different types of UI, and it is important to see a doctor to determine the cause.
Overactive bladder is a condition that creates the need to urinate frequently. Abnormal nerve impulses may be signaling the brain even when the bladder is not full.
Urge incontinence is the involuntary loss of larger amounts of urine after suddenly having the urge to urinate. It is usually caused by abnormal nerve signals that create bladder spasms. Certain medications and diuretics can worsen the problem, as can emotional states like anxiety. Neurological conditions can also lead to this symptom.
Stress incontinence is leakage that occurs when force is placed on the bladder (sneezing, coughing, exercise, laughing, etc.) while the pelvic floor muscles and surrounding supports have weakened. The amount of loss is generally small.
Mixed incontinence refers to both stress incontinence and urge incontinence happening together. This is the most common type of UI in women.
Other types of UI are much less common, and may be related to infection, a blockage, medication, cognitive impairment, and restricted mobility.
The first step in dealing with female UI is accurate diagnosis. Generally, this starts with an interview in the office. The patient may be instructed to keep a diary or log of urination habits and leakage at home. If this log does not clearly suggest a diagnosis, it at least points to which tests are in order.
Next, the doctor will conduct a physical exam for any medical condition or treatable blockage causing the UI. A weakening of the pelvic floor can lead to a condition called prolapse, where the vagina or bladder begins to protrude out of the body. There are several other tests that can be done, including a bladder stress test, laboratory urine analysis, ultrasound, urodynamics, and a cystoscope exam with a thin tube and tiny camera inserted gently into the urethra. Dr. Alarcon and his staff are sensitive to the emotions associated with UI and strive to make every patient comfortable. When the correct origin of the UI has been determined, appropriate treatments are discussed with the patient.