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Incontinence: You Are Not Alone

Incontinence Is Widespread
More than 10 million Americans suffer from urinary incontinence, and half of all women experience incontinence at some point in their lives. Urinary incontinence is the involuntary loss of urine, ranging from an occasional few drops
to a complete or continuous loss of urine.

Causes
Urinary incontinence can occur at any age and can be caused by many physical conditions. Among them are:

• Vaginal infection
• Weak muscles
• Some types of surgery
• Effects of medicine
• Urinary tract infection
• Constipation
• Childbirth
• Menopause

Types of Incontinence

Stress Incontinence: Leaking when the abdomen is strained during activities such as coughing, laughing, sneezing, or even walking.

Urge Incontinence: Uncontrolled contractions of the bladder that cause a complete loss of urine.

Overflow Incontinence: bladder overflows from fullness, usually caused by a weak bladder or blocked urethra.

Kegel Exercises
Putting Some Muscle Into It
These exercises are used to strengthen the pelvic muscles. They were developed by Dr. Arnold Kegel as a way to teach these muscles how to contract and relax under your command
to control the opening and closing of the bladder. When there is urine leakage, the muscles are weak. By doing these exercises consistently, a woman can build up her strength and endurance
and likely increase bladder control.

Locating the Muscles
1) As you begin urinating, try to stop or slow the urine without tensing the muscles in your legs, buttocks, or abdomen. It’s important not to use these other muscles if you want to find the
correct muscles to exercise for bladder control.
2) When you are able to stop or slow the urine, you are using the correct muscles. Feel the sensation of the muscles pulling upward and inward.
3) Squeeze in the rectal area to tighten the anus as if trying not to pass gas. You will be using the correct muscles.

Exercising
1) Once you’ve located the correct muscles, exercise them three or four times a day: morning, midday and
evening.
2) Squeeze your muscles to the slow count of four. Then relax them to the slow count of four.
This is considered one set.
3) Complete 10 sets during each daily session.

Helpful Hints
If your pelvic muscles are very weak, you should begin by contracting the muscles for only three to five seconds. Your goal is to hold each contraction for 10 seconds, to relax for 10 seconds, and to complete 25 to 30 sets.

Do the best you can, and continue faithfully. In a few weeks, you should be able to increase the amount of time you can hold each contraction and the number of exercise sets you can do. In the beginning, check yourself frequently by looking in the mirror or by placing a hand on your abdomen or buttocks to be sure you aren’t using the wrong muscles. If there is movement in any of these muscles, continue to experiment until you have isolated just the muscles of the pelvic floor.

If you maintain a regime, your bladder control should begin to improve in three to four weeks. By keeping a record of urine leakage each day, you should begin to notice fewer marks in the bladder leakage column.

What Are My Treatment Options?
The successful treatment of incontinence begins with an accurate diagnosis and your input. At Old Pueblo Urology we take the time to discuss your choices as well as the risks and
benefits of each option.

Medication can be prescribed for some incontinence conditions to relax the bladder or tighten the sphincter muscles. Injections of protein bulking agents can be applied in the urethra to strengthen the area. These compress the urethra and increase resistance to urine flow.

Surgery may be required to restore the support of the pelvic floor muscles or to reconstruct and compress the sphincter. Surgical procedures aim to support the bladder neck in the correct position so it can function properly. An incision is made in the abdomen or vagina, and stitches are inserted into the muscle and connective tissue surrounding the bladder neck. This forms a sling that restores it back to the correct position. A short hospital stay is needed for surgery, and some soreness is usual after the procedure. Recovery takes four to six weeks.

Preparing for your visit to the Urologist
You will need to bring with you:
• A list of all medications you are taking.
• The dates and outcomes of any bladder-related tests or surgical procedures.
• A bladder diary recording your liquid intake, bathroom visits, and leakage over a five-day period.

Additional testing you may expect:
• Urinalysis
• Cystoscopy
• Ultrasound

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