“I gotta go. I gotta go! Oops. I didn’t make it.”
It’s not funny. It’s a struggle that some 15 million American men and women struggle with everyday: Urge Incontinence – the sudden feeling of a need to urinate even if the bladder is not full. Even a rush to the nearest bathroom may not be fast enough to avoid urine leakage from their overactive bladder.
“Urge Incontinence often occurs without a triggering event, unlike Stress Continence, which occurs when a woman laughs, sneezes or jumps,” says McLeod Urologist Dr. Wallace Vaught. “However, the potential treatment options for both types of bladder incontinence are similar – ranging from absorbent products, to medications, to surgery.”
Absorbent Underwear or pads can help manage the public embarrassment of wet, stained clothing. Real treatment requires changing your life.
Lifestyle Changes. Losing weight and stopping smoking can control some of the urge incontinence. Changing diet improves the episodes by avoiding spicy foods, alcohol and caffeine. Also, patients should drink less fluid of all kinds and don’t drink close to bedtime.
Behavioral Modification. Performing Kegel exercises strengthen the pelvic floor muscles and helps a person control the urine leakage.
Medication. Medications are generally the most effective treatment for urge-type incontinence. Some drugs can help relax bladder muscles, reducing the “urge” a person feels. This category of medication – anticholinergics – can trigger potential side effects, including dry mouth, constipation, and blurred vision. A timed-release version of the medication can reduce some of the side effects.
Electrical Stimulation Therapy. A small system, similar in some ways to a heart pacemaker, is implanted in the patient’s buttocks or abdomen, using local anesthetic. Mild electric pulses are used to relax the bladder. Patients can even use a “remote control” to adjust the stimulator. This treatment is successful in about 80% of urge incontinence patients.
Botox, a drug primarily used for smoothing out lines in frowns and foreheads, was approved by the FDA in 2011 for urge incontinence. Botox causes the bladder to relax, decreasing the “urge” to urinate. Your physician will inject Botox using a minimally invasive device called a Cystoscope. Significant improvement in symptoms has been reported, but this use of Botox is so new that it’s unknown how long the benefits will last. When used for other purposes, Botox benefits last 6-8 months.
Surgical Options are generally reserved only for severe cases that have not responded to other treatment. Surgeons enlarge the bladder, adding a piece of the small intestine. Studies show the cystoplasty (SIS-tuh-plas-ee) is very effective in eliminating bladder urgency, but after surgery 10-30% of the patients must use a catheter to empty their bladder.
Final Thought. If you feel you’re suffering from urge incontinence, see your personal physician. He or she can conduct some tests right in their office to diagnose the type and severity of your problem. Potential treatments offer many options and eliminate the need for you to worry about the public embarrassment threatened by this medical issue.
Sources include: McLeod Health, National Institutes of Health, The American College of Obstetricians and Gynecologists, The Bladder & Bowel Foundation (UK), National Association for Continence, Agency for Healthcare Research & Quality, Urology Care Foundation of the American Urological Association