What Is Pelvic Organ Prolapse?

What Is Pelvic Organ Prolapse

When Jenni was 29, she had her first child. A beautiful baby boy, she was ecstatic, and completely in love, despite the long labor she had suffered. But after several weeks, Jenni began to suspect something was wrong. She had expected to feel some discomfort after childbirth, (especially after pushing for several hours), but still, something didn’t feel right.

At her 6-week appointment, her doctor told her everything was looking good, but a few weeks later, Jenni felt a heaviness and in the shower, she felt a small bulge at the opening of her vagina while washing.

“I was horrified,” she said. “I thought something was truly wrong with me.”

Right away, Jenni called her doctor and explained her symptoms.  Her doctor calmly told her she may have a prolapse, a condition where the pelvic floor becomes too weak to hold up the surrounding organs, and caves into itself.

“It’s very common,” he told her, and after an appointment to confirm, he gave her a referral to a women’s health physical therapist.

Jenni’s story is not uncommon. Many women live with pelvic organ prolapse, which is caused by a weakening of the pelvic floor.  Some see symptoms after something like childbirth, but many women may not even realize that they are susceptible until later in life, with the symptoms appear.  

Unfortunately, many women believe this is a normal part of aging, or are too embarrassed to talk to anyone about it, including their doctor. Unlike Jenni, these women suffer in silence and live in discomfort for years, limiting their activities and even their social and personal life because of the symptoms. 

But pelvic organ prolapse is a treatable condition. Read below for answers to some of the most common questions we hear about pelvic organ prolapse. 

What is Pelvic Organ Prolapse anyway?

Before we get into the ins and outs of prolapse, let’s briefly review the pelvic floor and it’s function.  The pelvic floor muscles are a vital part of a woman’s anatomy.  This web of muscles is shaped sort of like a basket and holds up three key organs:  the bladder, rectum, and uterus.  When the tissues and the muscles become too weak, one or more of these organs can fall into the vaginal area, and may even protrude out of the vagina.  This is a pelvic organ prolapse. 

Why does pelvic organ prolapse happen?

Pelvic organ prolapse happens due to a weak pelvic floor. There can be many causes of this, including vaginal childbirth, long-term pressure on your abdomen (from a chronic cough, or straining during a bowel movement), giving birth to a large baby (over 8.5 pounds), aging, or even hormonal changes during menopause.  Sometimes symptoms show up early on, but for many, they may not realize that they have a weak pelvic floor until later in life, when symptoms start progressing. 

What are the symptoms of a pelvic organ prolapse?

The symptoms of pelvic organ prolapse may differ in both type, and severity, depending on how severe the prolapse is.  Many women with pelvic organ prolapse report feeling a general discomfort in the vaginal area.  They may feel a heaviness or pressure, or an achy feeling in the vagina, especially after standing for long periods of time, during sex, or with lots of physical activity.  Some women may also suffer from urinary incontinence. More severe sufferers may see or feel one of their pelvic organs bulging out of the vagina, or have a feeling like they are sitting on a ball 

Is pelvic organ prolapse dangerous?

Pelvic organ prolapse is not a life-threatening condition, but that doesn’t mean it shouldn’t be treated.  Pelvic organ prolapse can cause a lot of physical discomfort, and can negatively impact a person’s quality of life. There are many ways to treat pelvic organ prolapse so there’s no reason anyone should let it go untreated.

How is pelvic organ prolapse diagnosed?

A physician must diagnose pelvic organ prolapse. Because some symptoms of pelvic organ prolapse may disappear when lying down for a physical exam, your doctor may perform different tests to see if they are able to detect the prolapse. Asking you to cough, or performing a pelvic exam while standing in order to see to see the protruding organ are common techniques for detecting pelvic organ prolapse. Your doctor may use other tests too, such as an ultrasound, an MRI scan of the pelvis, or bladder health tests, if you’re experiencing incontinence.

Is pelvic organ prolapse reversible? 

There are many ways to treat pelvic organ prolapse, and in many cases, symptoms can be greatly improved, but pelvic organ prolapse will never go away on its own.

If you’ve recently had a baby and have been diagnosed with pelvic organ prolapse, there is a good chance that your symptoms may improve with time.  Hormones can play a big part of changing the pelvic floor too, so waiting for them to return to normal after baby is born, and after breastfeeding may provide some relief.  In addition, your body takes some time to recover after carrying a baby for 9 months and then giving birth, so you need to allow it time to recover. There is a good chance that with time, and the proper pelvic floor exercises, your symptoms will greatly improve. 

For women who experience pelvic organ prolapse later in life, there are ways to treat it so that your symptoms are not as severe.  But the muscles will never completely return to normal after experiencing a prolapse.

How to fix pelvic organ prolapse

There are many ways to treat pelvic organ prolapse, and choosing which one may depend on the severity of the problem, as well as what life stage you’re in.

Many people with pelvic organ prolapse can benefit from seeing a women’s health physical therapist.  These professionals are trained in dealing with pelvic floor dysfunction and can not only provide guidance on the right exercises to do, but can also guide you in learning how to do them correctly. Things like kegels are often hard to teach, but by using biofeedback machines and other helpful techniques, a PT can guide you through the exercises and ensure they are being done effectively.  Over time, these exercises can strengthen the pelvic floor, providing greater control over bladder leaks, and lessening the uncomfortable symptoms of pelvic organ prolapse. 

In addition to physical therapy, many women choose to use a pessary, a small device that is inserted into the vagina and helps hold up the pelvic organs.  This device is prescribed by a doctor and is typically fitted for each patient in the doctor’s office.  It may take several tries to find the right fit. 

If you suffer from constipation, your doctor may prescribe a special diet designed to help your bowels move more regularly, as straining on the toilet can exacerbate symptoms of a prolapse and make them worse.

Finally, if your symptoms are severe, your doctor may recommend surgery to help hold the organs in place.  Talk to your doctor about the pros and cons of surgery, and the risks associated with this type of procedure. 

(Note: It’s recommended that you wait to have surgery until you’re finished having children, as the benefits of the surgery may be undone with childbirth.) 

It can initially be scary to discover that you have pelvic organ prolapse. But so much can be done to treat the condition that you should never put off discussing the problem with your doctor.   

NAFC has many wonderful physical therapists listed in our doctor finder. If you’re experiencing symptoms of pelvic organ prolapse, visit it here to find a specialist in your area and make an appointment to discuss treatment today!

 

 

8 Most Common Questions About Fistulas - Answered!

8 Common Questions About Fistulas - Answered!

If you’ve been diagnosed with a fistula, you may have some questions about what it is, why you have it, and what can be done. Keep reading below for answers to some of the most common questions we receive about fistulas.

1. What is a fistula?

The definition of a fistula is an abnormal passageway that connects two organs or vessels that do not usually connect. The most common type of fistula is around the anus. 

2. What causes a fistula?

 Within the anus, there are glands that create fluid. Sometimes these can become blocked and infected, creating what is called an abscess. This is the most common cause of a fistula, although fistulas can sometimes be caused by other conditions as well, such as Crohn’s disease, sexually transmitted diseases, or cancer.

3. What are symptoms of a Fistula?

Fistulas can be very embarrassing, as well as uncomfortable. Pain is a frequent symptom, as well as frequent abscesses, foul-smelling discharge, and painful bowel movements. Skin irritation can also develop due to infections and excess fluid being discharged.

4. How serious is a fistula?

Fistulas can cause a lot of discomfort, and if left untreated, may cause serious complications. Some fistulas can cause a bacteria infection, which may result in sepsis, a dangerous condition that can lead to low blood pressure, organ damage or even death. Luckily there are many treatments available for fistulas so that more serious complications don’t occur.

5. How is a fistula diagnosed?

If you are noticing any symptoms of a fistula – abdominal pain, discharge, a change in your bowel habits, severe diarrhea – talk to your doctor right away.  Diagnosing an external fistula is relatively simple since the doctor is able to see it. He or she may send any discharge that occurs to a lab for analysis, and may also perform blood tests to help confirm the diagnosis. 

If the fistula is internal, diagnosis may be harder. Your doctor may perform an endoscope to see inside, or perform ultrasounds, CTs, or X-rays to find the fistula.

6. Is a fistula a sign of cancer?

An anal fistula is a very rare sign of cancer. However, if left untreated for a long time, a fistula may lead to cancer. A fistula may also develop as a result of radiation therapy.

7. Can a fistula heal on its own?  

In some cases, fistulas may close up, but then reopen. Typically, fistulas do not heal on their own without treatment.

8. How is a fistula treated?

There are different options when treating a fistula, depending on the severity.  For small fistulas, your doctor may perform an in office procedure. A fistulotomy may be done to open and drain the fistula. Your doctor may also be able to use stitches to seal the fistula, allowing it to heal.

Larger fistulas will require surgery to close them properly.  Post surgery, you may be prescribed pain killers, antibiotics to prevent infections, and stool softeners to make bowel movements easier while healing. 

The healing process may take just a few days or weeks if the fistula was small, but larger fistulas can take a longer time to heal, and may even require additional surgeries.  Be sure to keep the area clean, especially after bowel movements. Moist pads may help this process. Taking warm baths can also be soothing and can help the treated area clean.

If you’re experiencing symptoms of a fistula, don’t wait to talk to your doctor. Seek treatment and learn the options available to you – treatment may be easier than you think, and in most every case, is better than letting it go untreated.

 

Why You Should See A Pelvic Floor Physical Therapist

October is Physical Therapy Awareness Month! NAFC has long been a proponent for physical therapy as a treatment option for things like urinary incontinence and pelvic organ prolapse. Read on to learn more about how a PT may be able to help you treat these conditions.

Read More

Ask The Expert: Will Losing Weight Fix My Incontinence?

Ask The Expert

Each month, we ask our expert panel to answer one of our reader's questions. To learn more about the NAFC Expert Panel, and how to submit your own question, see below.

Question:  I am overweight and my doctor told me that if I lose some extra pounds it would help with my bladder leakage. Is this true?

Answer: Your doctor is right. Carrying around extra weight puts extra pressure on the bladder, making incontinence more likely, especially if it’s already something you struggle with. One study that looked at weight loss intervention among incontinent women showed that women who lost weight were able to reduce the frequency of their stress urinary incontinence episodes through 12 months, and saw improved patient satisfaction with changes in incontinence through 18 months. (Click here to read the study on weight loss and incontinence.

Losing weight may not stop the leaks completely, but it can definitely help, and is probably a good idea anyway, since obesity carries all sorts of extra health risks (on top of incontinence).

If you’re overweight, small changes can make a big difference. Below are a few things you can do to get the process started.

Watch your diet and try to work in more fruits and vegetables while cutting out sugary foods. 

It may help to keep a food journal so that you see exactly what’s going into your body. Many of us eat mindlessly and sometimes as a result of our emotions. Learn to recognize your emotions when you reach for that extra cookie or bag of chips. Are you bored, sad, angry? Try dealing with it in different way – call a friend, take a walk around the block, watch a movie. You may find that the reasons you eat don’t always have to do with hunger.

See a nutritionist.

There are so many fad diets these days that it’s hard to know what you should and shouldn’t eat. A nutritionist can teach you about food and the different foods that are good for you body. They can also help devise a meal plan for you to make it easier for you to stay on track.

Start adding more exercise into your daily routine.

Not sure where to begin? Walking is a great exercise that requires no equipment. Biking is another great option that gets you outside. Most gyms have lots of great classes you can try that will help guide you through different workout routines, and some even offer personal trainers, providing you with a more custom and individual approach. If you’re just not ready to venture outside of the house yet, try a workout video, or subscribe to online video classes.

Make it a social affair and invite a friend to join you.

You’ll pass the time more quickly and also have an ally who can help motivate you to keep going.

 

Sneak in extra movements throughout your day.

Park your car a little bit further from the entry of your office/grocery store, etc. Do short bouts of weight bearing exercises like lunges, squats or pushups when you’re waiting for dinner to warm up. Take a 5-minute break every hour at work to just walk around the office. Every movement counts – your body doesn’t know if you’re in the gym or not and it doesn’t always have to be during a designated workout time. You’ll still be burning extra calories.

 

Track it.

We’re all motivated by progress so tracking your stats somewhere where you can see your improvements can help. Get a pedometer to track the steps you take and try to set a goal of reaching a certain number each day. Weigh yourself every week and mark down your progress in a journal. Stay motivated by celebrating your victories! 

Weight loss can be hard, but with some motivation and perseverance, you can do it. Keep at it and not only will your incontinence symptoms be improved, but you’ll find yourself much healthier too.

The NAFC Expert Panel is made up of some of the top medical professionals in the fields of urology, urogynecology, physical therapy, and surgery. Each month, the experts weigh in on important topics and answers to your questions.  To have one of your questions featured in our Ask an Expert series, send it to us here.

Patient Perspective: It Doesn't Matter How Old You Are - Incontinence Is Not Normal!

Patient Perspective: Incontinence Is Not Normal

At 70 years old, you’d think that I’d have come to terms with having incontinence. But time has a way of making you see that some things you thought were normal actually weren’t at all.

The leaks started in my 50’s and at the time, I chalked it up to just growing older. I started wearing absorbent pads for protection and just went on living my life. My leaks started to get worse as I got older, and in my late 60’s I finally talked to my doctor about it. He asked me during a routine check up about my bladder habits and I told him I’d been having leaks for years. I tried to brush it off like it was no big deal (it was a bit embarrassing to talk about), but he kept pressing me, asking me more details and taking notes.

Finally, he told me that he wished I had told him about the leaks sooner, since there is so much that can be done to treat bladder leaks.  He said no one should have to live with bladder control issues and that it absolutely is NOT a normal part of aging.

I felt so foolish for having believed all those years that it was just my body breaking down, getting older. Turns out that I was able to start a medication that really helped eliminate (mostly) my accidents. And there are even more treatments besides medications that I can try if I decide to.

Now that I’ve treated my incontinence, I feel freer at 70 years old than I did when I was in my late 50’s. I only wish I had opened up about it sooner to my doctor. 

Don’t wait to talk about it. Don’t let the years pass you by living with incontinence. It’s just not worth it when so much can be done.

Abby M.,

Boston, MA

Patient Perspective: Having IBS Causes Me So Much Anxiety

IBS Gives Me So Much Anxiety

I am 62 years old and have been dealing with symptoms of IBS for close to 15 years.  I’ve had countless accidents in public – at events, friends houses, you name it.  The early days of having the condition were mortifying to me - I got pretty good at coming up with all sorts of excuses for why I need to leave a party or event early. But the isolation I think may be the worst. I just always felt like there was no one I could talk to about it and no one who would understand.

Luckily, my family has been supportive.  They don’t say much about it and just try to help with what they can. I know now to bring back up clothes and cleanup supplies everywhere I go.  I’ve also worked a lot with my doctor to develop an evolving treatment plan and ways to manage my IBS.

This condition has been so embarrassing for me and has caused me a great deal of stress throughout my life.  I’m constantly worried about having an accident, but that just makes me even more anxious and in turn triggers more accidents. It’s a vicious cycle that is so hard to break. 

The biggest things that have helped me are exercise, watching my diet, and taking up meditation. I find that exercising daily is a great stress reliever and also helps to get things moving, if you know what I mean.  It’s been a long road of trial and error to determine a diet that works for me, but cutting out beans, gluten, and sugary foods has seemed to really help.  Keeping a diary of what you eat and drink each day, and how it affects your bowels, can be a huge help in determining triggers and patterns. (Download our free diaries here!)

Finally, meditation has been a complete game changer. I’ve taken some classes, done a lot of self study, and have even found apps that have helped guide me through the process. Whenever I start feeling overwhelmed or anxious, even just a quick 5-minute meditation can be enough to calm my nerves, and seemingly, my bowels. I encourage everyone to give it a try – what do you have to lose?   

I think the most important thing is for people to keep some perspective on life and know that while this condition is a constant struggle, it doesn’t have to be limiting unless you allow it to be. Talk with your doctor, a nutritionist, a therapist – or all three if it helps! Find ways to manage it and cope with the stress. It really makes all the difference.  

Sherri K.,

Baton Rouge, LA

 

 

Patient Perspective: How I Allowed Incontinence Steal Parts Of My Life.

How I Allowed Incontinence To Steal Parts Of My Life.

I’m 65 years old, and for years I let my incontinence control me.

I always had a bit of an overactive bladder – I’d race to the bathroom as soon as I got home, no matter where I had been or how long I’d been out. Washing dishes after dinner had me almost hopping to the toilet, for fear I’d have a leak.

It was sort of funny at first – well, as funny as we could make it. My kids would make fun of me and we’d laugh about how silly I looked. But after a while, my body just wasn’t strong enough to hold it in and I started not making it to the bathroom in time. I brushed it off for a while – I’d had five kids after all! Wasn’t this something I should expect?

But after a while, it really started to get me down. The small leaks started turning into gushes and I wasn’t able to hide my accidents. I relied on absorbent products but so many of the ones I tried leaked that I became terrified of venturing out of the house.  

I became a hermit – making my kids come to see me at home instead of meeting them out or going to their house.  I missed events – graduations, family outings, get-togethers with friends – things I used to love to do. I was a slave to my incontinence. And I felt helpless.

I finally found help through my daughter. She saw my pain and the big changes in me over the years and finally put her foot down, demanding to take me to talk to my doctor.  It was a terrifying discussion for me – what would she say? Would it make me feel even more embarrassed?

But my doctor was very kind, and started me on a medication for OAB right away, which helped a lot. 

She also referred me to a physical therapist to help strengthen my pelvic floor.  I thought it would be extremely uncomfortable, but it’s left me feeling so much stronger and empowered, I kick myself that I didn’t start it sooner.  

I’ve regained so much control over my condition and my life now. I wish I had sought help sooner.

I’m likely an extreme case – I don’t think most people – even those with incontinence – live like I did.  But here is my challenge to anyone living with incontinence – why let it dictate your life even a little? If you’re struggling with little leaks here and there, don’t put off treatment or brush it off like it’s nothing. Packing an extra change of clothes, scouting out bathrooms, making excuses – these are changes to your life that may start off small, but can snowball into something larger if you don’t seek help and take care of it now.

Find a doctor you trust, and get treatment for your leaks. Don’t let incontinence hold you back from living your life. It’s just not worth it.

Sandra F., Minneapolis, MN

Ask The Expert: What Causes Bedwetting In Adults? (And How Can I Make It Stop?)

What Causes Bedwetting In Adults?

Question:

I’m a 40 year old man and have struggled with bedwetting on and off for several years.  It’s very embarrassing and I feel ashamed and alone. What causes bedwetting in adults, and how do I make it stop?

Expert Answer: 

Believe it or not, this is a common question we hear from adults. Bedwetting isn’t just limited to kids, and may be caused by a number of things, such as certain medications you’re taking, other medical conditions, or issues with your bladder. The good news is there are many ways to manage it.

Causes of Adult Bedwetting

There are many things that may be contributing to adult bedwetting.

Medications.

Certain medications can cause you to experience adult bedwetting. Hypnotics, some insomnia medications and certain drugs designed to treat mental or mood disorders may have the side effect of bedwetting. Talk to your doctor about what you’re taking to see if it may be contributing to nighttime wetting.

Genetics.

Believe it or not, you may be able to blame your family for your bedwetting woes.  Studies have found that when one parent has had a history of wetting the bed as a child, their son or daughter had a 40% chance of having it as well.  This likely carries into adulthood too.

Hormones

Some hormone imbalances can cause bedwetting. ADH is an anti-duretic hormone that typically signals the kidneys to produce less urine. If your levels of ADH are off, or your kidneys are not responding to the ADH signals, you may produce too much urine during your sleep, which could result in wetting the bed. 

Other Medical Conditions.

There are many other medical conditions that can contribute to adult bedwetting, such as UTIs, problems with the prostate, sleep apnea, or even diabetes. It’s very important to speak with your doctor about adult bedwetting in order to rule out any of these causes.

Stress and anxiety.

Ongoing stress or anxiety about a situation you are going through may trigger adult bedwetting, which may last long after your stressful problem is over.

Nocturia.

Nocturia is defined as needing to go to the bathroom more than once per night.  This is typically caused by the kidneys producing too much urine, and can lead to bedwetting if you’re unable to wake up at night to use the bathroom.

Overactive Bladder.

With overactive bladder, the bladder muscles become spastic causing the sudden need to go to the bathroom, and often. 70-80% of adult bedwetting patients have been found to have overactive bladder. 

Small Bladder.

Some people are simply not able to hold the amount of urine that they produce at night. This often results in bedwetting. 

How To Stop Adult Bedwetting

There are many ways to treat adult bedwetting. You’ll want to make an appointment with your doctor to determine the cause of your bedwetting, and to find a treatment that will work best with your lifestyle. 

 Protection.

It pretty much goes without saying that if you’re experiencing bedwetting you’ll want to get some protection. But did you know that not all adult absorbents are equal? You can look for products that are extra absorbent or specify nighttime use. Fit is also a very important part of preventing leaks so don’t be hesitant to try out a few products until you find one that’s comfortable and works. Lastly, for extra protection, try a waterproof mattress pad. It may seem like a hassle, but you’ll thank yourself later if you do end up leaking.

Bladder retraining.

The bladder is a muscle, and just like any muscle, it can be trained over time.  Bladder retraining may help you condition yourself to go longer in between bathroom breaks and you can even try using an alarm to wake you up at certain times of the night to use the toilet.  Over time, you may be able to reduce the number of times you have to get up.

Limit fluids before bed.

Don’t let yourself get dehydrated, but try cutting liquids off an hour or so before bedtime. This is especially true for things like alcohol or caffeine, which can irritate the bladder.

Try a bed-wetting alarm.

There are lots of different types of bed-wetting alarms on the market. These work by waking you when the alarm detects the slightest bit of wetness so that you can make it to the bathroom and avoid an accident. 

Medications

There are some medications that can help treat bladder leaks and may help with bedwetting. Click here to learn more about medications that can be used for adult bedwetting.

Surgical treatment options.

If all else fails, surgery may be an option for treating adult bedwetting. Sacral nerve stimulation, clam cystoplasty and detrusor myctomy are all surgical procedures that may treat adult bedwetting.  Be sure to talk with your doctor about the benefits and risks associated with each one.

We know that as an adult, bedwetting can be a very sensitive topic and can cause deep embarrassment.  But know that you’re not alone – millions suffer from adult bedwetting and there are treatments that can help. 

Talking to others may help calm some of the emotional aspects of adult bedwetting. Join the NAFC message boards to hear stories from others, share your own, or ask for advice.  Our message boards are anonymous and provide a great source of community for those living with incontinence and adult bedwetting.

Do you have any tips that have helped you manage adult bedwetting?  Share them in the comments below!

Urinary Incontinence After Prostate Surgery: Everything You Need To Know

Incontinence After Prostate Surgery

Undergoing a prostatectomy (removal of the prostate due to cancer) can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.

But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.  

What causes incontinence after prostate surgery?

Urinary incontinence is a potential side effect of prostate removal surgery. The prostate surrounds the bladder. Removing it, or using radiation to treat it, can sometimes cause damage to the nerves and muscles of the bladder, urethra, and or sphincter, which controls the passage of urine from the bladder. This can result in urinary incontinence.

Is Incontinence Normal After Prostate Surgery?

Approximately 6-8 percent of men who have had surgery to remove their prostate will develop urinary incontinence. (Cleveland Clinic) The good news is that most men will eventually regain bladder control with time.

How bad is incontinence after prostate surgery?

The degree of incontinence varies from person to person and can be anywhere from full on incontinence, to light dribbles. And, the amount you leak right after surgery will likely lessen as you continue with your recovery and any additional bladder or pelvic floor treatments you may be doing.  

How long will I have incontinence after prostate surgery?

Most men who experience a loss of bladder control have symptoms for 6 months to 1 year post prostate surgery. However, a small percentage of men may continue to experience problems past the one year mark.

Does incontinence go away on its own after prostate surgery?

For most men, urinary incontinence will go away within about 1 year. Performing pelvic floor exercises, also known as kegels, which help strengthen the muscles that are located in the base of the pelvis between the pubic bone may help to speed the recovery process along.

Does incontinence happen if I treat prostate cancer with radiation?

Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.

How can I improve incontinence after prostate surgery?

Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery.  Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively.  To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions (sitting, standing, lying down, etc.). For a complete guide on performing a men’s kegel, click here.)

Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

What treatments are available to me if my incontinence doesn’t go away after a year?

While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.

Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.

With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.

An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.

As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor. 

Incontinence after prostate surgery forums.

Going through prostate cancer and having your prostate removed can be a physically and emotionally trying time in life. Many men are unprepared for the extent to which they may experience bladder leaks after prostate removal and it can be disheartening to have undergone surgery only to experience a loss of bladder control for a period afterward.

Fortunately, this is usually resolved within a year. During that time though, you may find that you need someone to talk to about your experience. Finding a forum or message board filled with people who can relate can help ease some of the tensions that you may be going through. 

The NAFC message boards are a great way to connect with others who may also be experiencing incontinence, due to prostate surgery or other conditions.  They’re free to join and the forum is anonymous so you can speak freely without the worry of feeling embarrassed or ashamed. NAFC is proud of this amazing group of individuals who visit the forums and courageously share their stories, offer support, and provide inspiration to each other. We encourage you to check it out!

What To Do About An Enlarged Prostate?

What To Do About An Enlarged Prostate

Enlarged prostates are common as you age. Men aged 60 and older have a 50/50 chance of having an enlarged prostate and those who are 85 have a 90% chance. Those may be scary stats, but what exactly does having an enlarged prostate mean? Is it something to worry about? And if so, what are the treatment options? Keep reading to learn more about this very common condition and what it may mean for you.

Anatomy Review – function of the prostate

The main function of the prostate glad is to serve as a reproductive organ. It is responsible for producing prostate fluid, which is one of the main components of semen. The prostate gland muscles also help to transport semen into the urethra during ejaculation.  

The prostate gland sits just below the bladder, where the bladder and urethra (the tube that inside the penis that carries urine and semen out of the body) connect. In early life, it’s about the size and shape of a chestnut, and grows to different sizes throughout a man’s life. 

What causes the prostate to get enlarged?

As men age, the prostate gland grows. It’s estimated than as many as 17 million men have an enlarged prostate, or symptoms of Benign Prostate Hyperplasia (BPH). While it’s unclear why the prostate begins to grow, its thought that an excess of certain hormones may be to blame.

Symptoms of an enlarged prostate include the following:

  • A weak or interrupted urinary stream

  • The sudden urgency to urinate

  • Frequent urination

  • An inability to empty the bladder during urination

  • Trouble initiating urine flow, even when you feel like your bladder is full.

Should I worry? 

Even if your prostate becomes enlarged, it may never become an issue for you. The problems start when the prostate begins to constrict or block the urethra. This can compromise the bladder’s ability to effectively empty, causing chronic retention of urine. And, because the bladder still continues to send signals that it needs to empty, urgency and frequency can occur (this is also known as overactive bladder).  If left for too long, the bladder may become distended, making it even harder for it to empty completely. 

For these reasons, it’s important to see your doctor right away if you start experiencing any of the symptoms listed above. Additionally, the symptoms of an enlarged prostate can also mimic those of other conditions, such as bladder cancer or overactive bladder. Your doctor will be able to help diagnose your condition to determine an appropriate treatment.

What’s the treatment for an enlarged prostate?

There are many treatment options for enlarged prostate, depending on your symptoms.

Active surveillance, or “watchful waiting” is a term used to describe the act of monitoring your condition regularly for any changes. This approach is often used for men whose symptoms are mild and not too bothersome. 

There are several medications that are approved for BPH, but most of them fall into two categories: Alpha blockers and inhibitors. Both are effective at treating BPH and sometimes are even prescribed in combination with each other.  

Non-invasive treatment options include things like laser therapy, which decreases the size of the prostate by removing some of the tissue, or laser vaporization, which enlarges the prostate obstruction and opens the urethra.  Transurethral microwave therapy or transurethral needle ablation are other non-invasive treatment options that destroy excess prostate tissue that is causing blockage.

Finally, surgery is also commonly used to help relieve symptoms of an enlarged prostate. The most common form of surgery is transurethral resection of the prostate, or TURP. This surgery requires no incisions, relying instead on a surgical instrument inserted through the tip of your penis and the urethra. Using this tool, the doctor is able to trim excess prostate tissue that may be preventing the flow of urine. 

Other less common surgeries are also used to both trim excess tissue from the prostate, or to decrease pressure on the urethra in order to make urinating easier. You can read more about additional surgical options here.

Atlantic Therapeutics Debuts the First FDA-Cleared, Wearable and Non-Invasive Solution for Stress Urinary Incontinence

INNOVO For Stress Urinary Incontinence

 1-IN-3 WOMEN IN AMERICA CAN NOW PROUDLY DECLARE “I JUST FREE’D MYSELF WITH INNOVO THANKS TO REVOLUTIONARY NEW DEVICE TO TREAT ROOT CAUSE OF BLADDER WEAKNESS

Pleasanton, CA (JUNE 5, 2019)“OMG. I just free’d myself!” Today, 20 million women in America will rewrite that whispered, uncomfortable admission of bladder weakness[1] into a declarative, celebratory shout thanks to INNOVO®. As the first-in-class wearable, non-invasive solution for Stress Urinary Incontinence (SUI), INNOVO has the potential to positively impact the lives of one in three women.[2] These women will now be able to laugh louder, exercise harder and even sneeze with ease.

The INNOVO thigh-length, elasticized therapeutic shorts are outfitted with eight electrodes sewn in a crisscross formation across the pelvic region. When activated via its attached hand-held controller, INNOVO delivers a series of pelvic stimulations equivalent to Kegel exercises for strengthening the pelvic floor.

“INNOVO can help women declare freedom from incontinence and independence from pads,” said Dr. Nita Landry, board-certified OB/GYN and co-host of the Emmy® Award-winning television show “The Doctors.”  “These innovative, therapeutic shorts with targeted muscle stimulations empower women to treat the source for a long-term solution, rather than rely on a short-term pad to manage the problem.”

According to the Urology Care Foundation, one in three women suffer from SUI at some point in their life. Of those women, 23 percent report it negatively impacts their sex lives and 31 percent dress differently because of their symptoms.[3] Of the 33 percent of women who experience SUI after childbirth, 65 percent are still affected over the next dozen years.[3] 

What is INNOVO?

INNOVO is the first transcutaneous muscle electrical stimulator cleared by the FDA.2 Utilizing its innovative Multipath™ technology, INNOVO sends targeted and pain-free muscle stimulations through a pair of shorts, via neuromuscular electrical stimulation, to safely and effectively strengthen the muscles in the pelvic floor.  In a study, 80 percent of INNOVO users saw significant improvements after four weeks and 87 percent were defined as ‘dry’ or ‘near dry’ at the end of three months.

“I’ve seen first-hand the everyday shame and pain patients endure with Stress Urinary Incontinence,” said Dr. Ruth Maher, co-inventor of INNOVO, Professor, Department of Physical Therapy Philadelphia College of Osteopathic Medicine – Georgia. “With more than 2.5 million, safe and successful therapy sessions in Europe, I’m proud and happy to finally bring this prescribed treatment to women in America.”

INNOVO can be used in the privacy and comfort of one’s home while either standing, reclining or lying down. The recommended treatment is 30-minutes a day, five days a week, for three months. After the three-month period, it is recommended that INNOVO be used once a week for 30-minutes. In each 30-minute session, INNOVO delivers 180 perfect pelvic floor stimulations (or Kegels).

Turning Stress Urinary Incontinence into I’m Confident

SUI is the term used when leaks accidentally occur after pressure on the bladder from coughing, sneezing, laughing, or exercising. These simple movements put pressure on the bladder and, should the pelvic floor muscles be unable to tighten enough, will cause an involuntary leak. It can happen at any age, however, is most common during pregnancy, post-childbirth [i] and during stages of menopause.

 

The Prescription for a Pad-free Future

INNOVO is available only by a doctor’s prescription for a US retail price of $449.95. Women interested in treating their SUI should visit myinnovo.com for more information. While not covered by insurance, the price is almost a third less than the average $700 per year typically spent on incontinence pads each year.

 

About INNOVO

INNOVO is a first-in-class, wearable and truly non-invasive solution that treats the root cause of SUI or bladder weakness safely.1 Utilizing its innovative technology, INNOVO sends targeted and pain-free muscle stimulations through a pair of shorts, via neuromuscular electrical stimulation (NMES), to safely and effectively strengthen the muscles in the pelvic floor. 

 

About Atlantic Therapeutics 

Atlantic Therapeutics develops professional and consumer medical devices, related software, apps and connected health technologies to treat all types of incontinence, sexual health dysfunctions, and other associated disorders by strengthening muscles and modulating nerves of the pelvic floor. INNOVO from Atlantic Therapeutics is an FDA cleared, externally applied, patented CE device that delivers a safe, clinically effective and comfortable therapy to treat reversible clinical conditions associated with pelvic floor weakness in the comfort of the user’s own home. Learn more at www.myinnovo.com.

 

# # #


References:

[1] Epidemiology Of Mixed, Stress, and Urgency Urinary Incontinence in Middle-aged/older Women: the Importance Of Incontinence History. Yuko Komesu-Ronald Schrader-Loren Ketai-Rebecca Rogers-Gena Dunivan - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957945/

[2] R. Dmochowski – Novel external electrical muscle stimulation device for the treatment of female stress urinary incontinence: randomized controlled noninferiority trial versus intravaginal electrical stimulation. ICS Conference 2018

[3] Urology Care Foundation. What is Stress Urinary Incontinence (SUI)?. https://www.urologyhealth.org/urologic-conditions/stress-urinary-incontinence-(sui). Accessed February 2019.

 

pee when you...laugh, sneeze, cough, workout, have sex….? You’re not alone. Learn about a new option to treat Stress Urinary Incontinence.

Stress Urinary Incontinence Treatment

Stress Urinary Incontinence, the type of incontinence that happens when you exert any type of pressure on your bladder or pelvic floor, happens to millions of American women. The pesky leaks can show up unexpectedly, whether you’re laughing at your best friends joke, or doing a jumping jack in your Tuesday morning workout class.

Peeing your pants something that almost no one wants to admit to. But unfortunately it happens a to a lot of us. And, even worse, many women choose to do nothing about it, chalking it up to a normal part of getting older. 

So let’s set the record straight – bladder leakage is not a right of passage as we age, nor is it something that you should live with. It’s a medical condition that deserves to be treated, because while it might be common, wetting yourself regularly is not normal. 

There are many things that can contribute to SUI. Anytime the pelvic floor is weakened or compromised it can cause the muscles to be a bit lax, making it harder for you to hold in urine.  A common cause is, of course, childbirth – especially if you delivered vaginally.  The mere act of carrying a baby around for nine months and then delivering it can make your muscles weak and even cause some nerve or tissue damage that make you more prone to leaks.

But other things can cause damage too – being overweight puts extra pressure on the pelvic floor, causing it to weaken.  As does having a chronic cough (commonly seen in long-time smokers). And any other type of surgery that may have touched the pelvic floor may make you more susceptible.

Our pelvic floor does also naturally weaken a bit as we age. Most people don’t pay much attention to their pelvic floors, which can cause problems later in life.

The pelvic floor is a muscle, and like any other muscle in the body, it needs to be strengthened in order for it to do its job. If you’ve had damage to the pelvic floor at some point in your life, like during childbirth, you may have already put it in a state of weakness, even if you didn’t immediately have any problems like incontinence.

But without treating it, gravity can continue to weaken the pelvic floor and can lead to things like incontinence, or other types of pelvic floor disorders.

All that being said, it’s important to note that while incontinence may happen more often when we’re older, it can strike anyone at any age. New moms may be just as susceptible to experiencing bladder leaks as someone who gave birth 30 years ago. 

The good news is there are many options to treat it. One of the newest options is a product called INNOVO.

INNOVO

INNOVO: A new product for Stress Urinary Incontinence 

New to the scene is a product from Atlantic Therapeutics called INNOVO.  INNOVO is the first wearable, active and truly non-invasive solution to treat stress urinary incontinence. INNOVO is cleared by the FDA, and provides women a safe, clinically effective solution that treats the root cause, not just the symptoms of bladder weakness.

How it works.

INNOVO’s Multipath technology delivers 180 gentle pulses, strengthening the pelvic floor during each 30-minute session.

The device is cleverly hidden in a pair of easy-to-slip on shorts that deliver 180 pulses to stimulate muscle contraction. INNOVO shorts are comfortable and are made of breathable, skin-friendly material, which come in a range of sizes.

INNOVO is highly effective. It’s been proven to clinically treat SUI when used for 30 minutes a day, five days a week for 12 weeks. In fact, 80% of users found that INNOVO significantly improved their quality of life. After just 4 weeks, 80% of INNOVO users saw significant improvement and after 12 weeks of use, 87% of reported being dry or nearly dry.

The best part? You’re able to use INNOVO in the comfort of your own home.

INNOVO is now available! Talk to your doctor or PT about this innovative new product and learn how you can start using it to address Stress Urinary Incontinence.

Learn more about INNOVO here.


SIGN UP TO RECEIVE THE SUI TREATMENT TRACKER!

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Patient Perspective: My Husband Doesn't Understand My Incontinence

Patient Perspective: My Husband Doesn’t Understand My Incontinence

Are you like me? Do you live with someone who is unable to deal with your incontinence? I am sad to say that I do, and while it hasn’t always been easy, I’m starting to find ways to help my husband accept my problem. 

We’ve always been a carefree couple. Even in our early days we’d drop everything at a moments notice if a cheap flight to an exotic destination came along. We’d host impromptu parties with friends, go on vacations with other couples, and push ourselves to try new things like running marathons or participating in intense group workouts or races. 

And while we are still very much in love, and still like to be adventurous, in recent years, I’ve held back, because I suffer from incontinence.

I started noticing leaks when I was in my early 40’s. At first they were small, and didn’t happen very often. I brushed them off and still tried to do all the things we always had, without feeling the need to share this new development with my husband.

But after a while, the small leaks turned to bigger ones, and they were happening more and more frequently. I found that I couldn’t go out of the house without packing a spare change of clothes. I no longer wanted to just hop on a 5-hour flight to somewhere exotic where I wasn’t sure I’d be able to find a bathroom, or worse, have an accident on the plane.  

I had to tell my husband what was happening, and while he was supportive, he didn’t understand why I couldn’t “just hold it”.  He started to grow resentful as I declined more and more invitations, and we soon began to have fights about it, often leaving me feeling ashamed and embarrassed because of my condition.

I decided that I needed to take matters into my own hands and help my husband understand. We started doing research together online and learned more about my condition, what causes it, and ways to better manage it.  And, I’ve talked with my doctor about ways to treat my incontinence so that I can do more of the things I love. 

It hasn’t been easy, and my husband still sometimes gets frustrated at my hesitation to do some of the things we used to, but educating ourselves, together, was one of the best things we could have done to get back on track. It’s helped us both learn that this is not my fault, and that there are ways to overcome it. And, despite his frustration, I’m glad my husband is pushing me to get treatment instead of hiding behind my condition. I’m confident that with my doctor’s help, I’ll soon be able to get back to many of the things that we used to enjoy, and can’t wait to feel like my old self again. 

Sylvie R., Rockport, Massachusetts

Treatments For Neurogenic Bladder

Treatment Options For Neurogenic Bladder

Having a neurological condition, such as Multiple Sclerosis or Parkinson’s disease can be overwhelming, both physically and emotionally.  But one thing many people may not realize is how it will affect their bladder. Luckily, there are treatments available that can help to minimize symptoms of neurogenic bladder and allow you to live without the fear of an accident. Today, we’re going to discuss what neurogenic bladder is, and 2 ways you can treat it.  

What Is Neurogenic Bladder? 

Neurogenic bladder affects many Americans and occurs when there is a problem with the way your brain communicates with your bladder. People who have a neurogenic bladder usually experience a bladder that is either overactive (spastic) or underactive (flaccid).

 

What are the symptoms of a neurogenic bladder?

There are many symptoms of a neurogenic bladder. These include: 

  • Incontinence

  • Urinary Tract Infections (UTIs)

  • Frequent urination

  • An urgent need to use the empty the bladder immediately

  • Painful urination

  • The inability to completely empty the bladder

  • A weak urine stream

  • Nocturia, the need to empty the bladder more than once per night

 

What treatment options exist for Neurogenic Bladder?

Luckily, there are many treatment options for Neurogenic Bladder.

Behavioral modifications.

Certain foods and drinks are known bladder irritants and may contribute to an overactive bladder. Try keeping a bladder diary to identify any triggers that may be causing your bladder problems and then work to avoid them. Additionally, maintaining a healthy weight through diet and exercise can help ease pressure placed on the bladder and also strengthen the pelvic floor muscles used to control bladder function. 

Self Catheterization.

Many people with neurogenic bladders use a catheter to control their bladder. A catheter is a thin tube that is inserted into the urethra and then into the bladder to allow urine to drain from the bladder.  While using a catheter may sound a little intimidating at first, most people are able to master the process quickly and it can provide a great deal of freedom for those struggling with bladder control.

Pharmaceutical Options.

There are a number of pharmaceutical options available – both prescription and over the counter. Always talk with your doctor before trying something new.   

Botox Injections.

It’s not just for wrinkles!  Botox is also approved for overactive bladder (spastic bladders). Your doctor will inject botox into the bladder muscle, where it helps to block the nerve signals that trigger OAB, or spastic bladder.  Many people find this reduces leaks and the number of times you need to urinate each day. It also helps with that urgent feeling of needing to empty the bladder. 

Surgery

If all else fails, there are different surgeries available to treat neurogenic bladder.  Bladder augmentation is a surgical procedure to make the bladder larger. This helps reduce the pressure in the bladder, and reduce leaks.

If you’re living with Neurogenic Bladder, talk with your doctor about treatment options. Need help finding a qualified specialist? Try our Doctor Finder!

 

What Is A Pessary And Do I Need One?

What Is A Pessary And Do I Need One?

If you have incontinence, or a pelvic organ prolapse, you’ve likely heard the term “pessary” tossed around at some point.  Pelvic organ prolapse is a condition in which your pelvic floor becomes weak or compromised – sometimes due to age, sometimes due to trauma (like childbirth), causing one or more of your pelvic organs to collapse into the vagina. Pelvic organ prolapse can be mild, or severe, and symptoms can vary greatly depending on the severity. Some women may not even realize they have a prolapse until later in life.  Symptoms can include pressure or a feeling of heaviness in the vagina, incontinence, or even pain.

While some women can see big improvements in their condition with physical therapy, the condition cannot truly be “fixed” without surgery.  But, it is possible to manage pelvic organ prolapse by using a pessary. 

A pessary is a medical device, typically made out of silicone that is placed in the vagina and is used to support the pelvic floor, and the bladder, uterus and rectum.  Pessaries are not a one-size-fits all type of device. Everyone is different so your doctor will usually fit you for one that works for you. This may take a few tries, so don’t get discouraged if the first one you try doesn’t feel quite right.  Just be open with your doctor and work with them until you get the right fit.

Once you’ve found the right fit, your doctor will train you on how to insert and remove the device.  You’ll also learn how to care for your pessary, which will require weekly or biweekly cleansing.   

Pessaries can be a great solution for women with pelvic organ prolapse, or bladder incontinence, who don’t want to consider surgery (or are not quite ready for surgery yet).  It works by “holding up” the organs that may have collapsed into the vagina, relieving many of the side effects of a prolapse, such as the feeling of pressure or heaviness in the vagina, or incontinence.   

If you think you may be a good candidate for a pessary, talk to your doctor. They can review the pros and cons and help get you fitted for one.  It’s a great option for those experiencing symptoms of pelvic organ prolapse, and can provide great relief without undergoing surgery.

 

Your Guide To Treating Incontinence

Your Guide To Treating Incontinence

For many of us, January is a time for setting resolutions – A blank slate where we can rewrite a new reality for ourselves. For those with incontinence, knowing where to start treatment can be one of the biggest challenges.  Luckily, we’re here to help.

Treatment for incontinence has come a long way in recent years.

Here’s a breakdown of steps you can take right now, as well as some more advanced options to look at for the future.

1. Manage incontinence with adult absorbent products.

Managing your incontinence is much different than treating your incontinence, but it is the logical first step. After all, you need to find some way to stay dry until you can properly address the issue. For most people, management will consist of a few things – finding a good absorbent product that works, and watching your food and drink intake to see if there are certain triggers that may make your incontinence worse. Management is a first step, but definitely not the last - while both of these can do wonders in helping you control the symptoms of incontinence, they’re not really addressing the true problem.

2. Behavioral Therapy

Along with diet and exercise, there are several other things you may want to try when treating incontinence. Bladder and bowel retraining – which literally involves training your muscles to hold urine or bowel movements for longer more controlled periods of time – are a good step to try and improvements can often be seen in several weeks.  In addition, many people see vast improvements from physical therapy. A qualified physical therapist (usually specialized in treating the pelvic floor) can give you an examination, pinpoint areas of weakness or tension, and provide a customized treatment plan designed to address your muscle strength or weakness. (Need help finding a PT? Check our Specialist Locator.)

3. Medications.

If behavioral modifications don’t yield the results your looking for, medications may be your next option. Most medications for bladder control work by relaxing the bladder muscles and preventing the spasms that sometimes accompany overactive bladder and incontinence. These work differently for everyone, and can sometimes produce unwanted side effects though, so talk to your doctor about your options before settling on one.

4. Advanced Therapy Options

If medications don’t work for you, or you don’t like the side effects that they present, there are still other options. InterStim and Botox injections are two of the more advanced, yet very effective procedures available.   InterStim, also known as sacral neuromodulation, works by stimulating the nerves that control your bladder, bowel and rectum, and the muscles related to urinary and anal functions (the sacral nerves). InterStim stimulates these nerves with a mild current, which helps your bladder/bowel/rectum work as they should.  Botox, treats overactive bladder symptoms by calming the nerves that trigger the overactive bladder muscle. Both procedures are fairly simple and take about an hour to complete.

5. Surgery.

For some, surgery may be an option. There are several types of surgeries that address stress urinary incontinence.  These procedures are intended to help correct a weakened pelvic floor, where the bladder neck and urethra have dropped. The most popular procedure is to use a sling, which serves as a “hammock” to support the urethra. Surgical slings may be used in both men and women who experience stress incontinence, and also women who have experienced pelvic organ prolapse. There are many types of sling procedures so be sure to talk to your doctor about your options and research what is right for you.

The most important thing to remember when exploring incontinence treatment is that you have options. Talk to your doctor about your wishes and work together to find a treatment that works for you.

What Causes Incontinence In Women?

What Causes Incontinence In Women_.jpg

Incontinence is a condition that affects over 25 million men and women in America. It can really happen to anyone, and can be caused by many different things. But it is much more common in women – nearly twice as common actually – and unfortunately has become something that many people (even potentially your doctor) brush off as being a normal part of aging. This couldn’t be further from the truth.

Why Is Incontinence More Prevalent In Women?

Incontinence can have many root causes.  Being overweight, problems with the prostate in men, and even conditions that cause damage to the nerves, such as multiple sclerosis, Parkinson’s disease, or even diabetes can all lead to incontinence.  But it’s no secret that women suffer from incontinence more than men. This is in part due to the fact that things like pregnancy, childbirth, and menopause are unique to women and create extra pressure and complications that can cause incontinence. 

The pressure of carrying a baby for 9 months and the trauma of childbirth to the pelvic floor can weaken the pelvic floor, making it difficult to stay continent.  Additionally the hormonal changes that occur during menopause cause a change in continence.  A decrease in estrogen can cause the vaginal tissues to become less elastic and dry and can lead to incontinence and urinary tract infections.

What Types Of Incontinence Are There 

Did you know that there are actually different types of Incontinence? Depending on what you have, there may be different options available to you.

Urge Incontinence

Urge incontinence is the frequent and urgent need to use the bathroom, accompanied by bladder leakage.  You may have a sudden feeling that you have to go to the bathroom right now, or it may be triggered by familiar things, such as arriving home, washing the dishes, etc. This type of condition may also exist without bladder leakage, and is then referred to as Overactive Bladder. 

Stress Urinary Incontinence

Stress urinary incontinence happens when pressure is placed on the bladder and causes bladder leakage. This type of leakage might happen when you’re working out, or even when you sneeze or laugh. Unlike Urge incontinence, stress urinary incontinence is not typically accompanied by the sensation of a sudden urge to urinate. Rather, stress urinary incontinence is caused by a weakened pelvic floor, and/or a weak sphincter muscle.  Stress urinary incontinence often occurs in women (although men can have it too), and typically as a result of pregnancy and childbirth. It’s a condition that can get worse as you get older, since we lose pelvic muscle tone as we age. Luckily, there are many treatment options available, and behavioral modifications, such as learning how to create a healthy pelvic floor, can do wonders for this type of incontinence.

Mixed Incontinence

As the name implies, many women can suffer from both Stress Urinary Incontinence, and Urge Incontinence, although one is typically more severe than others. Treatment options for mixed incontinence are typically the same as the treatments you would use for stress urinary incontinence, or urge incontinence.

What Are My Options?

Luckily, there are many treatment options available for the various types of incontinence women tend to have.  Below are just a few treatment options available.

Behavioral Modifications.

Often, simple changes to our lifestyle, including changes to our diet and exercise regimen, can ease a lot of the symptoms of incontinence in women.  Learning the foods and drinks that irritate the bladder, and knowing how to strengthen the core and pelvic floor muscles can do a great deal to help reduce or even eliminate symptoms.

 Absorbents

Absorbent products come in all shapes and sizes and are a great option for those who need some extra protection. Read our guide to finding the right absorbent product for you.

 Medications

There are many types of medications available that can sooth an irritable bladder. These medications typically work by relaxing the muscles around the bladder, or stopping the signal to your bladder that you need to go right now!

Procedures

If medications and behavioral modification don’t work for you, there are several options that you may want to try before you think about surgery. Many women have seen success with botox injections into their bladder (it’s not just for wrinkles!), and different forms of neuromodulation, small pulses that stimulate the nerves involved in controlling the bladder.  Learn more about these options here.

Surgery

Finally surgery can be a good option for those who have tried other treatments without success. There are several types of surgical procedures, including urinary diversion, sling procedures, and augmentation cystoplasty, that can help with incontinence in women.

It’s important to note that no treatment is 100% effective all the type. Talk with your doctor about what you can expect with each treatment, as well as the pros and cons associated with them.

Urinary incontinence can have a big impact on a woman’s life and it’s important to get it treated.  Too many women live with symptoms of urinary incontinence, thinking it’s just a normal part of aging. But there are many treatments available and it can make life so much more enjoyable when you’re not looking for a bathroom or worried about having an accident. 

If you live with urinary incontinence, make an appointment with your doctor to talk about treatment options.  

Advanced Therapies For Overactive Bladder

Advanced Therapies For Overactive Bladder (OAB)

All month long we’ve been talking about ways to treat Overactive Bladder – that urgent need to go to the bathroom many times per day (and sometimes night!).  If you have OAB, you may have tried switching up your diet, adding in pelvic floor exercises, or even trying different types of medications to treat your symptoms. But if those didn’t work (they don’t for everyone) or if the side effects made them difficult to continue, you may want to try some advanced therapies.

What are advanced therapies for OAB?

Percutaneous Tibial Nerve Stimulation

This treatment stimulates the nerve responsible for bladder and pelvic floor function by placing an acupuncture-like needle in the skin near your ankle. During treatment, a device sends mini electrical pulses to the tibial nerve, which changes the activity of the bladder. This is a gradual procedure and must be performed weekly for 12 weeks, and then occasionally as determined by a doctor.  

Sacral neuromodulation

Sacral neuromodulation (SNM) is a procedure that is performed in your doctor’s office and modulates the nerve activity between the brain and the bladder through electric stimulation of the sacral nerve. The sacral nerve delivers signals between the brain and the bladder.  SNM helps to control these signals, so that the bladder functions normally. 

SNM involves 2 phases – an evaluation phase and an implantation phase.  During the evaluation phase, which lasts around 2 weeks and is designed to see if SNM will be a beneficial option to you, a thin, temporary wire is inserted in your lower back, near the sacral nerves, which control the bladder.  A device is connected to the wire, which delivers electric stimulation to the sacral nerves.

Once your doctor has determined that SNM will be effective for you, the wire used during the evaluation period will be removed and a more permanent device, similar to a pacemaker is implanted just under the skin, usually in the buttocks.  Your doctor will monitor you over time, but in most cases, it has shown to be effective in patients for as many as five years.

Both of these options are effective ways to treat Overactive Bladder, if behavioral therapies or medications are not an option for you. 

To learn more about advanced therapies to treat Overactive Bladder, watch our 4th video below from our new series on Managing Overactive Bladder.  Then talk to your doctor to see if an advanced treatment is right for you.

Surgery For Overactive Bladder

Surgical Options For Overactive Bladder

Overactive Bladder at its best (is there really such a thing?) can be annoying. The constant running to the bathroom can be frustrating to say the least. But at its worst, OAB can be debilitating. Those with severe OAB make multiple trips to the bathroom a day and even night, and many times may have embarrassing accidents too.  It can cause anxiety in social situations, limit interaction with friends and family, and can even negatively affect a person’s work. If you think you’ve tried everything and it hasn’t worked for you, surgery may be an option.

Surgery is typically a last resort for most people and should be considered only after more conservative options, such as behavioral modifications, medication or even advanced therapies like Sacral Neuromodulation have failed.  The surgeries listed below are often done on women who no longer wish to have children, as childbirth can often remove many of the benefits of surgery.   

What types of surgeries are available?

Augmentation Cystoplasty

This procedure increases the size of the bladder, enabling the bladder to store more urine. A small amount of tissue is typically taken from the intestine and added to the wall of the bladder to make it bigger. In some cases, a catheter may be needed after this surgery has been performed.

Urinary Diversion

This procedure takes the tubes that lead from the kidneys to the bladder, and reroutes them through the abdominal wall to the outside of the body. Urine is then collected in an ostomy bag – a specially designed bag to be worn on the abdomen. While this option does require maintenance (emptying the bag, keeping the area clean and safe from infection) it does allow an active life post surgery. 

Sling Procedure

Vaginal sling procedures are surgeries that help control stress urinary incontinence, which happens when you leak urine upon coughing, laughing, sneezing, lifting or exercising. The basic concept of a sling is to place a strong piece of material beneath the urethra as a supporting “hammock”. During the procedure, physicians use a sling placed around the urethra to lift it, or the bladder, back into a normal position.

There are many different types of sling procedures, as well as a number of different sling materials available, so talk to your doctor about your options, as well as the pros and cons for each one.

Is surgery for me?

The decision to have surgery can be difficult, as there are pros and cons with each procedure. But, if your OAB symptoms are severe, and you have tried all other options, surgery may be right for you. Be sure to talk with your doctor about all of your options, including what the procedure is like, the materials used, the pros and cons of different surgical options, and the recovery times for each.  It’s also important to talk with your doctor about what you can expect after surgery, as not everyone is completely cured from incontinence after these procedures.  A frank discussion with your doctor, and your own research on surgical options can help you decide if this is a path you would like to consider.

 Learn more about surgery options for OAB in our 6th and final video of our series on managing Overactive Bladder.