Help to Manage your Problem
Incontinence products are becoming increasingly sophisticated and effective. These include discreet absorbent products, such as incontinence pants or pads; urine collection bottles; catheters that are inserted into your bladder to drain urine and devices that are placed into the vagina or urethra to prevent urine leakage – particularly reassuring while you exercise.
It’s not always possible to prevent urinary incontinence, but a healthy lifestyle can reduce the chances of the condition worsening.
Firstly, try cutting down on alcohol and drinks that contain caffeine, such as tea, coffee and cola. These cause your kidneys to produce more urine and can irritate your bladder. But do drink enough fluid to keep your kidneys, bladder and urethra in good shape – that’s 1-1.5 litres (six to eight glasses) a day. Too little is as bad as too much, but to save having to get up during the night, try drinking less in the hours before bed.
If you are obese, or even just overweight, the fat inside your body could be pressing on your bladder. Losing weight has many benefits; restored continence is just one of them. A balanced diet containing lots of fruit, vegetables and fibre will also help with constipation, relieving more than pressure on your bladder.
Keeping active can help prevent a number of serious health conditions, including urinary incontinence.
Pelvic Floor/Bladder Training Exercises
At Somerset Urology our continence advisers and physiotherapists are particularly experienced at teaching pelvic floor exercises and bladder training techniques to strengthen muscles that have become weak due to damage and ageing.
Pelvic floor exercises
Pelvic floor exercises are proven to improve stress or mixed urinary incontinence in women by two-thirds, and can help men after surgery to remove the prostate gland.
Being pregnant and giving birth can weaken the muscles that control the flow of urine from your bladder. Strengthening your pelvic floor muscles during pregnancy can help prevent urinary incontinence later in life.
If you can contract your pelvic floor muscles, you will be taught certain exercises involving muscle contractions to do at least three times a day for at least three months. If the exercises work for you they can be continued indefinitely. Read More…
Electrical stimulation and Monitoring
We can monitor electronically the effectiveness of the way you exercise the pelvic floor muscles with ‘biofeedback’ – an apparatus that senses when the muscles are squeezed and feeds information to a computer screen.
If you are unable to contract your pelvic floor muscles, Somerset Urology can assist with a device that stimulates them with electrical signals.
Urge incontinence often responds well to bladder training, which requires at least six weeks and involves learning techniques to increase the length of time between feeling the need to urinate and passing urine.
Bladder training may also be combined with pelvic floor muscle training for stress or mixed urinary incontinence.
A number of medications exist to treat incontinence but are not hugely effective, and there is a risk of side effects. Studies suggest that there is no medication with a better outcome than one in ten patients treated becoming able to control their urine.
More Serious Interventions
Botox Bladder Injections
Botox can be used to help patients with difficult-to-treat urge incontinence. It works by paralysing the bladder muscle, reducing bladder contractions to a normal level. Relief normally lasts six months to a year, and repeat injections are often needed.
Sometimes the nerves regulating the bladder can become hyper-reactive, sending strong signals to empty before the bladder is full. These abnormal signals can be blocked by nerve stimulation therapies:
Percutaneous Tibial Nerve Stimulation (PTNS)
An acupuncture needle is positioned along the tibial nerve in the ankle, and mild electrical impulses are sent through it. They travel painlessly up the nerve to the sacral nerves which regulate the bladder.
PTNS sessions require weekly attendance at the clinic for 12 weeks, each session taking half an hour.
Sacral Neuromodulation Therapy (Interstim)
Sacral neuromodulation therapy applies electrical impulses directly, through wires attached to a small external generator outside the body that are threaded through openings in the pelvic bones to the sacral nerves. This procedure takes place in an operating theatre using a local anaesthetic.
If symptoms improve significantly over a fortnight using the external generator, a permanent generator can be implanted beneath the skin (under a general anaesthetic).
In extreme cases of incontinence, surgery can be performed to restore the normal position of the bladder neck and urethra. There are two main types of operations for incontinence: bladder neck suspension procedures and sling procedures.
Contact Somerset Urology to arrange an appointment to speak to one of our specialists, who will advise you on the best treatment or surgical procedure for you. Together, we can solve your problem.