Urinary Incontinence

Urinary incontinence is a medical condition in which there is involuntary leakage of urine.

This condition affects personal hygiene as well as their social life in a way that can be very limiting.

There are several types of urinary incontinence found in women, and each of their causes varies.

WHAT ARE THE CAUSES OF URINARY INCONTINENCE?

There are several types of urinary incontinence found in women, and each of their causes varies.

Stress incontinence: This form of urine leakage occurs with increases abdominal pressure while sneezing, coughing, or laughing. Such a condition usually occurs as a result of pregnancy, childbirth, or the ageing process as the support underneath the urethra gets weakened.

Urge incontinence: In this condition, patients complain of leakage on the way to the bathroom as they cannot control it. This condition is caused by an overactive bladder, leading to symptoms like urinary frequency, urinary urgency, and urge incontinence. In this condition, an involuntary contractions of bladder causes the patient to go to the bathroom multiple times during the day or night. Patients may have a sensation of urgency on the way to the bathroom, and sometimes they may even leak urine on the way to the bathroom.

Mixed incontinence: As the name suggests, this is a combination of both stress and urge incontinence. Women with mixed incontinence may experience both types of urine leakage, making it more difficult to manage. 

Overflow incontinence: Overflow incontinence in women is a type of urinary incontinence that occurs when the bladder doesn’t empty properly and becomes overly full. This causes urine to leak out of the bladder involuntarily. It can be caused by a variety of factors, such as nerve damage, bladder obstruction, or weakened bladder muscles. Women with overflow incontinence may experience frequent urination, difficulty starting urination, weak urine flow, and a feeling of incomplete emptying of the bladder.

Functional Incontinence:  This type of incontinence is not caused by a problem with the bladder or urethra, but rather by a physical or mental impairment that makes it difficult for a person to get to the bathroom in time. This can include conditions such as arthritis, Parkinson’s disease, or dementia.

HOW IS URINARY INCONTINENCE TREATED?

Treatment of urinary incontinence depends on the type of incontinence and the severity of symptoms.

Conservative options:

There are several conservative options to help cure the condition. If a patient is getting up multiple times in the night to urinate, it is advised to reduce their fluid intake, especially before going to bed. Decreasing consumption or avoiding caffeinated and alcoholic drinks can help. Urinary urgency, frequency, and urge incontinence symptoms can be further aided by pelvic floor therapy, Electromagnetic stimulation (V-Tone), overactive bladder medications, newer technologies such as vaginal radio-frequency (Morpheus 8V).

Minimally invasive options:

There are several minimally invasive options available to help patients with urine leakage. All these options are done in an outpatient setting, and the patient goes home the same day.

Periurethral bulking:

This outpatient procedure significantly helps patients with leakage of urine with coughing, sneezing, and laughing. During this procedure, a bulking agent is injected in the middle part of the urethra. This helps form cushions, which give support to the urethra and prevent urine leakage. Read More

Sling procedure:

This procedure is helpful for patients who experience urine leakage when coughing, sneezing, etc. In this procedure, a piece of small plastic mesh called a sling is put as a support beneath the middle portion of the urethra, to prevent urine leakage.

 

 

Botox injections in the bladder:

Patients suffering from symptoms of urinary frequency, urgency, and urge incontinence, are properly selected for this procedure, which can prove to be extremely useful. The botox injections are injected into the bladder muscle under local anaesthesia. Through this process, the need to take medications for an overactive bladder may be controlled. This treatment effect lasts for 3–9 months and can lead to a significant improvement in the patient’s lifestyle.

Sacral Neuromodulation:

This is a minimally invasive procedure in which a thin lead wire is placed close to the sacral nerves. This procedure can be very effective for patients with urinary frequency, urgency, leakage of urine, difficulty emptying the bladder, and even in some cases of faecal incontinence.

Percutaneous Tibial Nerve Stimulation:

If a patient experiences symptoms of urinary frequency and urgency, this procedure is recommended. Through this simple acupuncture-like procedure, a thin needle is placed above the ankle to allow for nerve stimulation in an office setting. This is a fairly relaxed procedure in which the patient comfortably sits in the office for 30 minutes. During this time, the nerve supplying the bladder is gently stimulated to aid their condition. It can be done in a weekly fashion for 12 weeks and then repeated every month for 2 years.

 

Novel treatment options:

  • VTone:
    VTone is a gentle, FDA cleared technology designed to provide intravaginal electrical muscle stimulation (EMS) and neuromuscular re-education to rehabilitate weak pelvic floor muscles and address stress, urge, and mixed urinary incontinence.
  • FORMA V:
    FormaV is a safe and effective treatment option that requires no downtime and is typically performed on an outpatient basis. During the FormaV treatment, a small handheld device is used to deliver controlled radiofrequency energy to the vaginal tissues. The energy heats the tissues, stimulating collagen production and encouraging the growth of new, healthy tissue. This results in tighter, stronger vaginal muscles that can better support the bladder and urethra.
  • Morpheus 8V:
    Morpheus8V is a minimally invasive treatment that uses radiofrequency technology to address a variety of aesthetic and medical concerns, including urinary incontinence. The treatment works by stimulating collagen production and tightening the tissues in the vaginal area, which can help support the bladder and urethra and reduce the symptoms of urinary incontinence.