Saturday, September 14, 2013

Is Incontinence Permanent?

In America, 25 million adults suffer from some degree of incontinence, so you might be asking: “Is incontinence permanent?” Incontinence can be uncomfortable, embarrassing, or down right inconvenient. However depending on the the circumstance, but for most, the answer is “no”. Incontinence does not have to be permanent. 

Often diet, medication, and lifestyle impact incontinence, and sometimes making changes can correct temporary incontinence. For example, alcohol and caffeine are bladder stimulants and diuretics, which can lead to the frequent urge to urinate. Certain medications, such as cold medicines, heart medicines, blood pressure drugs, muscle relaxants, and other can lead to temporary incontinence. Urinary tract infections and constipation can also interfere with normal bladder and bowel control. 

Often men who have had prostate surgery will experience temporary incontinence as a result of weakened muscles.Of course, persistent incontinence may be caused by things that are not quite as easily remedied. Pregnancy, aging, menopause, hysterectomy, enlarged prostate, prostate cancer, bladder cancer, bladder stones, neurological disorders, obstructions, and damage to the pelvic floor muscles can all lead to a more permanent form of incontinence.

Pregnancy and childbirth, for example, can lead to hormonal changes, enlarged uterus, stress and weakness on the muscles that control the bladder, can lead to a weakened pelvic floor and often stress incontinence. This may not be totally corrected, but Kegel exercises can help strengthen the pelvic muscles and improve the condition. 

Aging can lead to an increase in overactive bladder symptoms, and weakening of the muscles that control the bowel and bladder. Menopause, a natural part of aging, can also lead to incontinence as a result of hormonal changes.

The only way to know if your incontinence is permanent is to have a medical evaluation with an urological exam and diagnostic work-up. This should be followed up with an individualized treatment plan.

Your physician will likely ask about your symptoms, medications, diet, habits, frequency of urination, how often you leak, what kind of protection you use, what precipitates leaking (sneezing, coughing, running, jumping, etc.), if it is accompanied by constipation. They may ask you to keep a voiding diary.

Treatment Options

A treatment plan will be created with your doctor that may include medications such as alpha blockers, anticholinergies, topical estrogen, imipramine, or duloxetine. In addition treatment will often include stimulating the sacral nerve, treating the prostate, kegel exercises, a male sling, using a bulking agent injected into the urethra, artificial sphincters, urethral plugs.  Lifestyle changes will also be encouraged including fluid and diet management, bladder retraining, and more. 

I encourage you to comment below with a question or a treatment option that you've heard works best.

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