NON-SURGICAL TREATMENTS FOR INCONTINENCE
Treating incontinence can be incredibly difficult depending on the type. Generally, treatment goals are to keep urinary tract and kidney damage to a minimum or eliminate it altogether, reduce or eliminate incontinence episodes (accidents), reduce (preferably eliminate) urinary tract infections (UTI) and maintain overall health. As you saw in the “types of incontinence” section, there are a number of types of incontinence and a person can have more than one type. The information below speaks in generalities and may or may not apply to your type of incontinence or the proper treatment for it. Your first step is to talk with an Urologist for advice on where to start. The following information should NOT be used for diagnosis or treatment or in place of the advice of a qualified physician. it is for reference only to give you an idea of some of the options that may be available to treat your incontinence. This section focusses on non-surgical incontinence treatments. We have another section specifically for surgical treatments for incontinence.
Kegel Exercises: These are exercises that are used to strengthen the pelvic floor muscles in hopes of reducing or eliminating incontinence in women. Over the years, things such as childbirth, being overweight and aging can weaken these muscles and allow abdominal organs to push down on the bladder and urinary system. This site from the Mayo Clinic gives great information on these exercises and will instruct you on how to do them. The great thing about kegel exercises is that, unlike medications, surgery, etc.. there are no side effects.
Medications: There are different medications for different types of incontinence and urinary retention. The aims of these medications are to do such things as relax the bladder, shrink the prostate, and relax the urinary sphincter. Medications can have effects on other areas of the body though, causing side effects.
These medications are usually used in cases of overactive bladder (OAB), urgency, frequency and uncontrolled urination, which are all caused by spasms of the detruser (bladder) muscle. The aim is to protect the kidneys (by preventing urine from being pushed back up into them by the spasms), allow the bladder to hold more and stop involuntary leakage of urine or “bladder accidents”. These medications, while working well at relaxing the bladder, also relax other smooth muscles in the body and can cause numerous side effects including; blurred vision, inability to sweat (leading to easy overheating in hot weather), constipation, difficulty urinating, drowsiness, dizziness and dry sinus and mucus membranes which causes stuffiness and dry mouth. For some people these symptoms are mild and decrease the longer the medication is used. For others, the symptoms are too much for them and they discontinue the medications. Generically called oxybutynin, examples of brand names are Ditropan, Ditropan XL, Lyrinel XL. These medications are called “anticholinergics”. Studies show anticholinergics shouldn’t be used in people with glaucoma or gastrointestinal obstruction. You should give your Urologist a COMPLETE medical history before using these medications.
Alpha Blockers: Originally used to treat high blood pressure, these drugs are usually used to shrink the prostate by relaxing the muscles in and around it. They improve urine flow by reducing the obstruction caused by the enlarged prostate. They usually will relieve the symptoms of urgency frequency and weak urine stream. Alpha blockers must be taken regularly though, as the effects can wear off quickly, allowing the symptoms to return. Note that these medications should NOT be taken when using medications such as Viagra, as a serious drop in blood pressure can occur. Some side effects that they can cause are; dizziness, lightheadedness and fainting. They can also cause headache and stuffy or runny nose. Some of the brand names for alpha blockers are: Flomax, Hytrin, Cardura, Uroxatral and Rapaflo. Again, you should give your Urologist a COMPLETE medical history before taking these types of drugs.
There may be other medications/brands that are not listed here. Please consult your Urologist before starting or asking for ANY medication!
Biofeedback Therapy: Biofeedback therapy uses electrodes connected to a computer that allows the individual to SEE when their pelvic muscles are contracting and learn to isolate them. Usually biofeedback is used with stress, urge and mixed incontinence. Usually biofeedback is used in conjunction with pelvic floor muscle exercises and shows as much as an 87% success rate in reducing or eliminating incontinence. The individual must be able to commit to an intensive routine of therapy and stay committed to it for the best chance at success.
Intermittent Self Catheterization: Self catheterization is the insertion of a thin hollow tube, called a catheter, up the urethra into the bladder to completely drain urine out of the bladder. We will cover the types and sizes of catheters in our Types of Catheters Section. Men, women and children can use intermittent catheterization and it is a safe and easy procedure. The most important things to keep in mind are using the correct type and size of catheter and CLEANLINESS, CLEANLINESS, CLEANLINESS! While this is considered a safe procedure, any bacteria that gets on the catheter will enter the bladder, causing a urinary tract/bladder infection. Clean intermittent catheterization (CIC) is used to completely drain the bladder to prevent infection and accidents. In cases of urinary retention, CIC is used to empty the bladder to prevent over-stretching and damage to the bladder. You should consult an Urologist before using intermittent catheterization, as improper catheter type, size and technique can seriously damage the urethra and/or bladder!
Foley Catheterization: Foley catheterization is the same principle as intermittent catheterization above with one key difference: The foley catheter has a balloon that is inflated inside the bladder to keep it in place and is not removed after urine has passed. They are used when continuous urine drainage from the bladder is needed in patients who are unable to perform intermittent catheterization or patients who do not want to use diapers to keep dry. They are also commonly used after surgery to allow healing so that the surgical site is not contaminated. Again, we will cover foley catheters in our Types of Catheters Section. As noted in our other devices section, you should NOT use a foley catheter yourself unless you have been professionally trained in their use...or better yet, leave insertion up to a medical professional. Like intermittent catheters, you can cause serious damage to the bladder and/or urethra using the wrong size or type of catheter or bad technique. You can also cause serious damage if you inflate the catheters’ balloon before it is in the bladder.
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