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Talking About Urinary Incontinence: Types and Treatment
Why? For many women, incontinence is embarrassing. They do not feel comfortable talking with their physicians about their incontinence. For other women, they feel that incontinence is a normal part of the aging process and that they just have to “live with it.” “I would encourage women to talk to their physician about their incontinence because it is not something to be embarrassed about and it is not something that they have to live with,” says Damon Hoffmann, D.O., a specialist in Urology at Washington Health System. Depending on the type of incontinence, there are a variety of treatments available that can dramatically improve leakage episodes. Evaluation “A thorough history, physical examination and urodynamic testing can give a great amount of information about the type of incontinence,” Dr. Hoffmann says. “This evaluation process will identify easily treatable and reversible causes of incontinence such as urinary tract infections, medication side-effects and certain medical conditions.” “It will also differentiate the disorders of the bladder that cause long-term incontinence problems: stress incontinence, urge incontinence, mixed incontinence and overflow incontinence,” he notes. Stress Incontinence Initial treatments are aimed at increasing pelvic floor strength and minimizing stressors. “Kegel exercises and pelvic floor physical therapy can increase pelvic floor strength,” recommends Dr. Hoffmann. “Lifestyle changes such as weight loss, avoidance of caffeine, smoking cessation, and treatment of chronic constipation or cough can also significantly improve stress urinary incontinence symptoms.” “If incontinence symptoms are not sufficiently treated with pelvic floor exercise and lifestyle modification, surgical therapy, often in the form of a sling procedure, can be used with excellent results,” he says. Urge Incontinence “The lifestyle modifications and pelvic floor exercises mentioned above can also help urge incontinence symptoms. When additional therapy is necessary, medications and a nerve stimulator procedure called the Interstim procedure, are available that help control the bladder spasms and decrease leakage episodes,” notes Dr. Hoffmann. Mixed Incontinence “They often require a combination of the treatments that were described for stress and urge incontinence,” Dr. Hoffmann explains. “I often recommend treating the most bothersome symptoms first and then evaluating whether additional treatment is necessary.” Overflow Incontinence “Women with this form of leakage experience dribbling or continuous leakage. The treatment of this form of incontinence depends upon the underlying cause,” says Dr. Hoffmann. Many Treatment Options To make an appointment with the WHS Urology group, call (724) 229-2424 or visit www.whs.org/urology. ![]() |
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