While men experience urinary incontinence much less frequently than women, up to 11% of men in the United States currently have some form of urinary leakage or dribbling. At Hayle Aldren, MD, in Phoenix, Dr. Aldren can diagnose and treat your incontinence with the latest in proven treatment options, letting you live your life without worry. Aging, prostate problems, and other health factors can all lead to this embarrassing issue. To learn more, call Dr. Aldren to schedule your consultation today.
Urinary Incontinence Q & A
- What is urinary incontinence?
- What causes urinary incontinence?
- What is urinary incontinence?
- What are the common causes of nerve damage that lead to urinary incontinence?
- How is urinary incontinence treated?
Urinary incontinence refers to a condition where you no longer have complete control over your bladder. Incontinence isn’t a disease, but rather a symptom of other physical or medical conditions affecting your body. The threat of losing bladder control may cause sufferers to abandon friends and favorite activities. It is one of the most common reasons for placement in a nursing home or assisted living.
Some people with urinary incontinence also have rectal incontinence, where bowel control is lost and accidental spilling of feces occurs. Fortunately, this distressing condition can often be helped with the same therapies that are effective for urinary incontinence.
What causes urinary incontinence?
The number one symptom of urinary incontinence is either occasional or frequent leaking of urine. There are three main types of urinary incontinence based on the cause of your leaking:
Stress incontinence (SI or SUI)
This is the most common cause of urinary leakage and occurs when there is pressure on the bladder from coughing, sneezing, laughing, or physical exertion. This puts stress on muscles that are not strong enough to counteract the pressure, and urine leaks out as a result.
This kind of muscle weakness can be due to the loss of muscle that occurs throughout the body with age, or it can be caused by nerve damage that prevents muscles from working properly. Stress incontinence can be caused or made worse by hormone deficiencies, obesity, diabetes, chronic coughing or constipation, and by high-impact sports and heavy lifting.
A severe urge to urinate arrives suddenly and you might lose urine before you can get to a bathroom. It occurs as a result of faulty signals between the brain and the nerves that control the bladder. A mixture of stress and urge types of incontinence is fairly common.
Common causes of urge incontinence include overactive bladder syndrome (OAB), prostate enlargement, prostatitis, prostate surgery, bladder irritation or cystitis, and neurological diseases such as multiple sclerosis, Parkinson’s disease, stroke, dementia, and spinal cord damage.
Overflow incontinence (Urinary retention)
This happens when the bladder is unable to fully empty itself, and urine continues to fill the bladder until it overflows and involuntarily leaks urine. Common causes of overflow incontinence include nerve damage, an enlarged prostate or other kinds of urinary blockage, and various medications, including drugs intended for bladder treatment.
Among the other drugs able to cause urinary retention incontinence as a side effect are decongestants, antihistamines (Benadryl), sedatives, narcotics, anti-depressants, muscle relaxants, psychiatric medications, and anticholinergic drugs. Anticholinergics are used to treat stomach cramps, motion sickness, dizziness, Parkinson’s disease, and lung conditions.
What are the common causes of nerve damage that lead to urinary incontinence?
Damage to the nerves that control urination may be caused by common medical conditions, accidental injuries, radiation and surgery, and by poisoning or nutritional deficiency. Causes of nerve damage that lead to incontinence include:
- Multiple sclerosis
- Vitamin B12 deficiency (also caused by bariatric surgery for weight loss and by medicines for diabetes)
- Drinking too much alcohol
- Untreated STD’s (sexually-transmitted diseases)
- Herpes zoster
- Heavy metal poisoning
- Herniated discs
- Spinal surgery
- Prostate operations
- Arterial bypass surgery
- Parkinson’s disease
When nerve damage causes urge incontinence or overflow incontinence, it is called a neurogenic bladder. A neurogenic bladder can present as an overactive bladder (spastic bladder), or as an underactive bladder (flaccid bladder). The results of special tests called urodynamic studies can help determine the best treatment.
How is urinary incontinence treated?
Depending on the underlying cause, Dr. Aldren might choose one or several different treatment options for your urinary incontinence. Some of Dr. Aldren’s favored approaches include:
Pelvic floor exercises
Also known as Kegel exercises, these exercises strengthen the muscles you use to stop urination. Stress incontinence in particular benefits from this treatment, but urge incontinence may also be helped.
Electronic muscle stimulation (EMS)
One EMS treatment is the equivalent of doing 900 deep Kegel contractions in a row. It also reaches other muscles throughout the entire pelvic floor, which are impossible to activate and strengthen with Kegels.
Besides building up weak muscles, the deep and strong contractions help flush out fluid buildup (edema) which can aid the repair of damaged nerves in the area. When muscles contract this way, it stimulates increased blood flow and better circulation.
The advanced medical devices used for EMS stimulate powerful, yet comfortable, muscle contractions that are beyond what you would be able to do voluntarily. Depending on your incontinence, a series of electrode patches are placed on the legs, hips, feet, or back, and contraction waves pass back and forth to strengthen and tone these neglected muscles. The patient relaxes in between doing simple exercises to resist the contractions.
EMS also strengthens the vital muscles that are needed to help transform penile fullness into rigidity during erection, as well as to stabilize and maintain the angle of erection. This is important in effectively treating all types of erectile dysfunction, especially in venous leak ED. EMS is very synergistic with PRP in treating ED.
When incontinence is partly caused by nerve damage, nerves to other parts of the body are also frequently affected. This can result in peripheral neuropathy, where a malfunction in the nerves to the feet and legs causes pain, numbness, and abnormal sensitivity.
The good news is that EMS is one of the few treatments that treat the root cause of neuropathy, which is a lack of blood supply to the nerves. With electronic muscle stimulation, you can treat both your incontinence and peripheral neuropathy at the same time.
Drugs are not useful for stress incontinence. A variety of medications are available that help treat urge incontinence, such as alpha blockers and anticholinergics. It is important to weigh the risks of side effects against the possible benefits. When effective, these medications help relax bladder muscles and calm an overactive bladder.
Alpha blockers are also used in treating overflow incontinence. If using incontinence medication of any kind, it is recommended to add non-drug treatment to improve effectiveness and reduce side effects.
Lifestyle changes can help prevent leakages, including weight loss, avoiding alcohol and caffeine, avoiding spicy and acidic foods, and drinking smaller amounts of liquid more often during the day.
Urge incontinence can also be treated with biofeedback and sacral nerve stimulation. Sacral stimulation and biofeedback can be done non-invasively with an electronic device.
Sacral nerves in the upper buttocks and tailbone area might also be tested and treated in a way similar to acupuncture, or by shallow local injections. If sacral stimulation is beneficial but short-lived, you can be referred to a surgeon to place an electronic device under the skin.
Overflow incontinence may require intermittent self-catheterization to empty the bladder, and treatments to reduce prostate enlargement can help. You may want to change some of your medicines to ones with fewer side effects.
Are you experiencing regular bouts of urinary incontinence? Let the office of Hayle Aldren, MD, in Phoenix offer a treatment course that restores your control and quality of life. Call to schedule your consultation today.