An Embarrassing Problem

Incontinence can be an embarrassing problem, but sufferers don’t have to simply accept it. There are treatments that can help people live without fear, confident they won’t have an incontinence problem in public.

There are several type of incontinence. Stress incontinence is a loss of control associated with bladder stress, such as laughing or coughing. Urge incontinence is a sudden intense need to urinate, with only a few seconds warning before needing to use the toilet. Patients with overflow incontinence frequently dribble but only have a weak stream when in the bathroom. All these problems can be treated.

For many patients, behavioral treatments are sufficient. Bladder training helps by having patients practice delaying urination and controlling urination urges. Learning or relearning to hold urine can help patients with urge incontinence use the bathroom on a schedule, while those with overflow incontinence are often helped by double voiding, or urinating and then doing so again shortly afterward. Going on a schedule can also help, as the body may gradually start to conform to that schedule.

Physical therapy can also provide some assistance. Pelvic floor muscle exercise help strengthen the muscles that hold urine back and make it possible for people to wait. This can help stress incontinence and urge incontinence. The exercises, also called Kegel exercises, entail using these muscles even when no need to urinate presents itself.

Pharmaceutical treatments are also available when behavioral changes don’t help. A class of medications called anticholinergics help relax the bladder, alleviating urge incontinence. In recent studies, Botox has been found to be successful in treating incontinence, though this usage has not yet been approved in the United States except in a limited number of cases.

People experiencing incontinence should consult a health care provider to determine the best treatment option.

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