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URINARY INCONTINENCE - THE FACTS
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The loss of bladder control is an embarrassing and frustrating but all too common problem.
 | | That’s right, if you’ve had problems controlling “things” when you urinate, if you’ve been leaking urine whenever you sneeze or cough, or experiencing a chronic, sudden, need to urinate that makes you wonder if you’ll be able to make it to a toilet in time … you aren’t alone. Millions of men and women have the same problem. But even though it’s a common problem, urinary incontinence isn’t an unavoidable side effect of aging among men or, among women, a necessary consequence of childbirth or menopause. Urinary incontinence is one of those conditions that can be the result of a variety of issues—ranging from the temporary to the involved and long term. |
Not so long ago urinary incontinence related issues fell into an “unmentionable” area that made them difficult to discuss out in the open – especially between men and women. Fortunately, we’ve all learned that urinary incontinence is just a medical problem like any other, rather than a private cause of shame or embarrassment. These days most people who experience bladder control problems can get the help of their urologist. Over the last thirty years more and more doctors and urologic specialists have devoted themselves and their practices to the study and treatment of Female Urology / Urogynecology / Urinary Tract Infections and Incontinence.
Female Urology encompasses multiple areas of expertise:
URINARY INCONTINENCE: Especially among women, urinary incontinence is an under diagnosed, underreported and socially expensive condition. That’s right, owning to its underreported nature, the direct costs of treating urinary incontinence issues in men and women of all had reached an estimated $26.3 billion, per year, as far back as 1995. Unfortunately, despite the high occurrence of urinary incontinence issues, less than half of those of us, who experience urinary incontinence, will talk to a physician about the problem.
The Types of Urinary Incontinence Commonly Diagnosed in Women
To accurately diagnosis urinary incontinence issues, it is especially important to consider all possible causes during an initial assessment. Most cases of urinary incontinence will fall under one of the six major subtypes below:
- Stress Incontinence: Stress is the most commonly diagnosed form of urinary incontinence. It tends to occur when pressure in a bladder has been consistently greater than pressure in a urethra. That can result in a loss of urine when women cough, laugh, or sneeze. Leaks resulting from stress incontinence have also been shown to occur when women walk, run, or engage in any strenuous physical activity.
- Overactive Bladder or Urge Incontinence: Overactive Incontinence occurs when women experience a chronic, sudden, urge to urinate or leaks urine before she can make it to the bathroom.
- Mixed Incontinence: Those women who demonstrate symptoms of both stress incontinence and urge incontinence are said to have mixed incontinence.
- Overflow Incontinence: Overflow incontinence occurs when a woman’s bladder muscles aren’t active enough, have weakened or her urethra is blocked. Its main symptom is a chromic feeling that the bladder will not full empty during urination.
- Functional Incontinence: The functional incontinence label is applied to a patient with non-urinary health problems (disability, medications etc.) that keep her from making it into the bathroom in time.
UROGYNECOLOGY: The field of Urogynecology primarily covers female pelvic support problems, because the pelvic organs of women change as they age. Though such problems may first appear postpartum (after childbirth), women may also notice them as they age. These changes can cause feelings of pelvic heaviness or pressure. Many patients describe them as a feeling that … "something is falling out of their vagina."
Types of Pelvic Support Problems Commonly Diagnosed in Women
Most varieties of pelvic support problems that can cause bulging and o discomfort fall into the categories below:
- Cystocele (or a Fallen Bladder): A cystocele occurs when the wall between a woman's vagina and bladder weakens, and allows her bladder to droop into her vagina. Cystocele can result in general discomfort and cause a woman to have problems emptying her bladder. Fallen bladder may also cause two other types of problems— incomplete emptying of the bladder and unwanted urine leakage. In certain women, fallen bladder distends the opening into their urethra, resulting in urine leakage whenever she laughs, sneezes, coughs or moves in a way that places pressure on her bladder. A large cystocele can require surgery to move the bladder back into its normal position.
- Vaginal Vault Prolapse with Enterocele: Vaginal vault prolapse occurs if the upper portion of a woman’s vagina loses its normal shape and sags, bulging down into either her vaginal canal or outside of her vagina. An enterocele is a type of pelvic organ prolapse that occurs if the tissues and muscles that hold a woman’s small bowel in place are weakened or stretched. Enterocele can cause a woman’s small bowel to shift from its normal position and press into the wall of her vagina.
- Rectocele: Women, have a wall of tough, fascia (fibrous tissue) that separates their rectum from their vagina. A rectocele occurs if this fibrous tissue weakens and allows the front wall of her rectum to bulge or balloon into her vagina when strains during a bowel movement. The majority of rectoceles occur in women when an area called the recto-vaginal septum is pressed against the back wall of the vagina. Though rectocele bulges may be uncomfortable, they are rarely painful.
- Uterine Prolapse: Uterine prolapse refers to a condition wherein a woman’s uterus has slipped out of its normal position within her pelvis and into her vagina. Normally, the uterus is held in place by the ligaments and muscles that make up a woman’s pelvic floor. Uterine prolapse occurs when those pelvic floor muscles and ligaments weaken, providing insufficient support for the uterus. The uterus then slips down into the vaginal canal.
URINARY TRACT INFECTIONS: Most women suffer from a urinary tract infection (or UTI) at some point or another during their lifetimes. Certain women will experience repeat tract infections and may even have them frequently. However, urinary tract infections are rarely serious. They are easily treated with antibiotics and their symptoms can be rapidly relieved.
Read more about or Female Urinary Incontinence.
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Nabet G.Kasabian MD, FACS
103 East 80th Street (at Park Avenue)
New York, NY 10075
Tel: 212-535-0755; Fax: 212-744-4539 |
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