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Urodynamics for Urinary Incontinence

Urodynamics for Urinary Incontinence Treatment

Urinary Incontinence
Urinary incontinence (UI) is a common condition that involves the involuntary loss of urine.  Although it is not usually a serious condition, UI can be embarrassing and affect a person’s daily life.  UI can affect men and women of all ages, but is more common in women, especially during and after pregnancy.  It is often caused by a urinary tract infection or weak muscles in the urinary tract.  Weak muscles may prevent you from closing off the urethra while doing certain activities and allow urine to leak.

Normal urination involves emptying the bladder when the desire to urinate occurs, at which point the bladder contracts and flows out of the body.  Once the bladder is empty, the muscles contract and urination stops.  Women with UI experience a disruption in this process that causes a loss of bladder control and results in troubling symptoms.

Symptoms of Urinary Incontinence
In addition to leaking urine, women with UI may also experience:

• Strong desire to urinate
• Pelvic pressure
• Frequent urinating
• Nocturia (need to urinate during sleeping hours)
• Painful urination
• Bed-wetting

Many women with UI often believe that their symptoms are a part of the natural aging process, or that simply wearing absorbent pads is the best treatment for their condition.  However, UI is a common condition with many treatment options to relieve symptoms and allow patients to perform their regular activities without the embarrassment and worry of urinary leakage.

Types of Urinary Incontinence
There are three main types of urinary incontinence: urge, stress and overflow.  Urge incontinence is most common and involves leakage that occurs after a sudden urge to urinate because the muscle wall of the bladder is overactive.  Stress incontinence is leakage that occurs after an activity such as coughing, laughing or sneezing places pressure on the bladder.  Overflow incontinence, considered less common than the others, occurs as the result of an inactive bladder muscle that does not completely empty the bladder after urination.

Diagnosing Urinary Incontinence
Patients exhibiting the symptoms of UI should see their doctor to determine the cause, type and severity of their condition.  If you answer yes to several of the following questions, you are likely experiencing UI:

• Do you usually have a strong sense of urgency to urinate?
• Do you sometimes not make it to the bathroom in time and leak urine as a result?
• Do you leak urine with sudden strong movements?
• Do you leak urine when you cough, sneeze, laugh, jump, run, etc.?
• Do you feel that you have completely emptied your bladder after urinating?

Dr. Quartell can diagnose urinary incontinence through a series of tests and an evaluation of the patient’s medical history.  Testing may begin with a pelvic exam to detect any physical abnormalities, and may also include blood tests, urinalysis and keeping a bladder diary.  Specialized tests such as a pad test or dye test can determine if any urine leaks during stressful situations.

Upon completion of testing, your doctor will be able to make an accurate diagnosis of UI and determine the cause of the condition in order to recommend the most appropriate treatment approach.

Treatment of Urinary Incontinence
There are many different treatment options available for urinary incontinence, depending on the severity of the condition and each patient’s desire to relieve symptoms.  Conservative treatments are often effective, and may include bladder training, avoiding alcohol and caffeine and medication to control pelvic muscle spasms.  Many doctors recommend Kegel exercises, which aim to strengthen the pelvic floor muscles and prevent urine leakage, as a home treatment especially effective for stress incontinence.

For more severe cases, a medical device or surgery may be used to relieve symptoms caused by UI.  A urethral insert or pessary may be inserted through the vagina to prevent urine leakage and may be worn everyday or when performing certain activities, depending on the type of device and the patient’s individual condition. 

Surgery often involves providing support to the bladder neck, and may be performed through the abdomen or vagina, or using minimally invasive techniques.  There are certain risks associated with surgery, including infection, bladder spasms or recurring incontinence.  Dr. Quartell will determine which treatment is best for you after a thorough evaluation of your condition.

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