Female Incontinence Solutions

Incontinence

33 million people in the United States suffer from bladder control problems. Below is a list of the various types of female incontinence:

  • Stress incontinence — Leakage occurs with sneezing, coughing, laughing, exercising, lifting heavy things, and other motions that put pressure on the bladder. It is the most common type of incontinence. It can be treated and sometimes cured.
  • Urge incontinence — Sometimes called "overactive bladder." Leakage usually happens after a strong, sudden urge to urinate. The sudden urge may occur when you don't expect it, such as during sleep, after drinking water, or when you hear running water or touch it.
  • Functional incontinence — Leaking because you can't get to a toilet in time. Patients with functional incontinence have mental or physical disabilities that keep them from urinating, although the urinary system itself is normal. Conditions that can lead to functional incontinence include: Parkinson's disease, Alzheimer's disease and other forms of dementia and severe depression.
  • Overflow incontinence — Leaking urine because the bladder doesn't empty completely. Overflow incontinence is more common in men.
  • Transient incontinence — Leaking urine for a short time due to an illness such as a bladder infection. Leaking stops when the illness is treated.
Incontinence Incontinence

Diagnosis

One of the first steps your doctor will take is to perform a history and physical. Your doctor will examine your abdomen and genital area carefully. Additional tests may include:

  • Voiding diary – you may be asked to keep a diary regarding what you drink and what your urine output is.
  • Urinalysis
  • Blood Tests

More specialized testing may include:

  • Postvoid residual test (PVR) - Your doctor can determine how well you empty your bladder by using an ultrasound or by inserting a catheter into your urethra and bladder to determine the amount of leftover (residual) urine. A large amount may indicate a blockage, or a nerve or muscle problem.
  • Pelvic ultrasound - Painlessly checks for abnormalities in the bladder, urinary tract or genitals.
  • Stress test - Your doctor looks for leaking urine when you cough or bear down.
  • Urodynamic test - a simple office test that helps determine the best treatment plan by assessing how your bladder functions and why you are having problems. Washington Urology and Urogynecology Associates, PLLC offers the latest in Urodynamics testing with fluoroscopy guidance. Washington Urology and Urogynecology Associates, PLLC is one of the few groups offering Video Urodynamics in the State. Learn more about diagnosing incontinence with urodynamics.
  • Cystogram - a special X-ray of your bladder.
  • Cystoscopy - a tiny instrument called a cystoscope is inserted into the urethra to look for and possibly remove abnormalities.

Treatment and Planning

Fortunately, most people can be treated successfully, allowing them to return to enjoying a normal life again. Your doctor may begin with non-surgical and less invasive treatments such as medication, behavioral changes, or physical therapy, and then move to medical devices and surgery if these treatments do not address your incontinence. Some cases must go directly to surgery, and your doctor will do the appropriate diagnostic testing to determine the best plan of care.

Below you will find a list of treatment plans:

  • Lifestyle Changes
  • Fluid and diet management - Avoiding caffeine or tomato-based food and drink, and drinking adequate amounts of water.
  • Bladder retraining - Creating a schedule for bathroom trips and gradually increase the length of time between them to improve your bladder control.
  • Pelvic floor (Kegel) exercises - techniques to strengthen your pelvic muscles.
  • Special absorbent pads and underwear

Medications

  • If you have the "urge" type of incontinence, your doctor may prescribe medication to relax your bladder muscles.
  • If you have frequency at night, you may need a medication that helps you urinate less at night.

Devices that are Non-Surgical

  • Urethral Pessaries: A rubber ring is inserted into the vagina by a healthcare professional, to cut down on leakage.
  • Stimulation Devices (electrical): electrodes are placed resulting in strengthening the pelvic floor muscles.

Surgery

  • Injection (bulking) - Your doctor may inject a thick substance called a bulking agent into the area around the bladder to support it. This outpatient procedure takes about 15-20 minutes.
  • Sling surgery - A minimally invasive surgery that takes about 20-30minutes, however because general anesthesia is used, you will be in the Ambulatory Surgery Center for 2 hours. A piece of your own tissue or a synthetic material is used to support the bladder neck and urethra.
  • Radiofrequency bladder neck suspension - A minimally invasive procedure in which the pelvic tissue is gradually and precisely heated; this allows for shrinking and stabilizing to keep the urethra from leaking.
  • Retropubic suspension - Your surgeon attaches the bladder to structures behind the pubic bone to provide additional support.

Diagnosing Incontinence with Urodynamics

Diagnosing Incontinence with Urodynamics

We use video urodynamics to diagnose certain incontinence conditions. Using this advanced equipment helps us to evaluate the severity and type of a patient's urinary incontinence by assessing the muscles used for urination, how the bladder stores urine and how the urethra releases it. After we make our assessment, we can then recommend the best course of treatment.

Here's how it works: A type of X-ray (fluoroscopy) is used to get images of the bladder while filled with a contrast dye. The patient's bladder is then emptied. We then watch the entire filling and emptying process on a video screen to see if the muscles are functioning properly and to watch for any abnormalities in the bladder or urethra. Using pressure catheters, we can also measure the pressure in the bladder by watching for contractions in the bladder wall.

Video Urodynamics can identify overactivity of the bladder, urethral function and bladder outlet problems. This allows us to diagnose problems with emptying the bladder (voiding) and counsel patients about best treatment options.

Call us today at 425-4548016 (Kirkland) or 425-454-8016 (Bellevue) to schedule an appointment or to talk to a Urologist.

If incontinence interferes with your daily routine or quality of life, seek help promptly. Our experienced board certified urologists can recommend many options and the latest treatments to help you get back to your daily routine worry free.