Urinary incontinence treatment
Urinary incontinence is a disorder when a person cannot prevent urine leakage. It varies from minor leaks to complete uncontrolled urination. Various diseases and conditions affect the function of bladder control. Treatment of urinary incontinence mainly consists of drugs and injections, sometimes surgical, depending on the cause.
Urinary incontinence is involuntary urine discharge. It means that a patient urinates when he does not want to.
Loss of bladder control can cause problems in everyday life, such as anxiety, shame, hygiene issues, and reduced sleep quality. Urinary incontinence is more familiar among women than men. It is because they have a wider pelvis and weaker pelvic muscles.
Urologists classify several forms of the disease:
- Stress urinary incontinence is caused by exertion (coughing, sneezing, laughing, lifting heavy objects).
- Urge incontinence is a sudden, intense urge to urinate due to a urinary tract infection or neurological disorder.
- Overflow incontinence - patients do not feel when the bladder is full, they cannot control emptying, and a small amount of urine constantly drains.
- Functional urinary incontinence is associated with the fact that the patient does not have time to get to the toilet due to a physical or mental impairment. For example, it is observed in dementia, the elderly or the disabled.
Some people also suffer from mixed incontinence.
What is the cause of urinary leakage?
Urinary incontinence has different causes, depending on the type. For example, stress incontinence in women at a young age usually occurs after complicated childbirth. But often, this is a problem for older women, where the decrease in estrogen weakens the muscles. Being overweight also increases the risk of incontinence.
Urge incontinence is associated with the following:
- Infections (cystitis - inflammation of the bladder);
- Neurological diseases include multiple sclerosis, strokes, Parkinson's disease and the so-called overactive or neurogenic bladder.
- Enlarged prostate resulting in pressure on the bladder and irritation of the urethra. For example, benign prostatic hyperplasia or prostate cancer.
Overflow urinary incontinence occurs due to bladder blockage due to an enlarged prostate, bladder stones, or a tumour that presses on the bladder.
Other causes may include the following:
- Development defects of the urinary system;
- Spinal cord injury;
- Vesicointestinal fistula - opening between the bladder and intestines;
- Taking certain medications, such as diuretics, sleeping pills, muscle relaxants, and others;
- Consequences after medical manipulations or operations;
- Alcohol intake.
What are the signs of the disease?
The main symptom of urinary incontinence is unwanted leakage of urine. Other signs of incontinence include:
- Frequent and strong urge to urinate;
- The appearance of a constant smell of urine;
- Lower abdominal pain;
- Pain when urinating;
- Feeling of incomplete emptying;
- Urination during sleep.
Depending on the cause and form of incontinence, a small amount of urine (a few drops) or large portions (complete urinary incontinence) is excreted.
How is urinary incontinence diagnosed?
Urologists diagnose urinary incontinence after a thorough history and complete examination. Firstly, it is essential to determine the cause and type of incontinence. To do this, doctors prescribe laboratory tests and imaging:
- Urine and blood tests show signs of inflammation as well as kidney function.
- Ultrasound of the pelvic organs helps to identify defects in the urinary system.
- The cystogram suggests an x-ray of the bladder. The method shows developmental anomalies, fistulas and signs of inflammation.
- A cystoscopy method uses a thin tube with a camera that a doctor inserts into the bladder through the urethra.
- The urodynamic test measures pressure in the bladder and rectum to evaluate the bladder as it fills with urine and during urination.
- Stress test. Doctors ask the patient to cough and watch for urine leakage. The method determines the number of urine leaks when coughing or laughing with tension in the abdominal muscles.
Treatment of urinary incontinence
The treatment plan depends on various factors, such as the cause of the disorder, its type and severity, age, and patient preference. Urologists distinguish conservative (drug) methods and surgical intervention. Often a combination of both options is practical.
Kegel exercises strengthen the pelvic muscles and muscles that help control urination. Regular exercise gradually regains control of the bladder.
Drug therapy usually uses medication to calm and ease bladder emptying. For women with a lack of hormones, doctors prescribe ointments with estrogen.
Also, for women, there are other methods of dealing with incontinence. For example, urethral inserts and pessaries support the bladder and prevent spontaneous urination.
Sometimes, more invasive procedures are advised. For example, doctors can recommend botox (botulinum toxin) injections for an overactive bladder. In addition, urologists can insert electrodes into the vagina or rectum to stimulate and strengthen the pelvic muscles. Such a procedure is called electrical stimulation.
Surgery is an option if other treatments don't work.
- The tension-free vaginal tape (TVT) is a surgical technique for stress urinary incontinence in women. A special tape is placed under the urethra and supports the organs.
- Sling procedures. The surgeon inserts a special mesh under the urethra. It helps prevent urine leakage when the patient exerts himself (coughing, sneezing, or lifting heavy objects).
- The sacral nerve stimulator. A surgeon implants the stimulator under the skin of the buttocks. The device conducts an electrical impulse and stimulates the nerve, helping to control the bladder.
What is the treatment prognosis?
The forecast for the treatment of urinary incontinence is generally favourable. Even in cases of severe disease, doctors manage to reduce the problem significantly.
Statistics say that around 85% of patients report a cure after surgical treatment of urinary incontinence.
Is urinary incontinence treatable?
More often, yes. Urologists can treat many types of incontinence with drugs or surgery. In rare cases, when doctors cannot cure the disease completely, they significantly reduce the symptoms and give control of the bladder.
What alternative treatment for urinary incontinence?
So far, alternative methods to surgical treatment are direct drug injections.
How to find a clinic for urinary incontinence?
To start therapy faster, contact AiroMedical. A patient manager will help you choose the best clinic for urinary incontinence treatment. We cooperate with leading hospitals and doctors worldwide.
Why do patients travel abroad for urinary incontinence treatment?
Quick problem solutions and significant savings are the main factors in travelling to treat urinary incontinence abroad. In addition, specialised clinics and the latest therapy methods are the advantages.
Can I get cured of urinary incontinence?
Basically yes. You can eliminate urinary incontinence with current treatment options, the latest generation of drugs, and a combination of medical and surgical operations. The disease is difficult to treat only in a few cases, but doctors significantly improve the quality of life and reduce symptoms.
Where can I get Urinary incontinence treatment?
What are the best clinics for Urinary incontinence treatment?
Who are the best doctors for Urinary incontinence?
Prof. Dr. med. Jurgen Gschwend from University Hospital rechts der Isar Munich
Prof. Dr. Torremade Barreda Josep from Teknon Medical Centre Barcelona
Dr. Luis Garcia Aparicio from Teknon Medical Centre Barcelona
Prof. Dr. med. Martin Kriegmair from Urological Clinic Munich-Planegg
Prof. Dr. med. Laszlo Kovacs from Urological Clinic Munich-Planegg