Female Urinary Incontinence: Compassionate Treatment and Best Results
At some time during her life, almost every woman will experience losing bladder control. This is related to stress incontinence, most often associated with physical activity that allows displacement of the bladder and urethra and the control mechanisms associated with them. This displacement results in the inefficient function of both the bladder and the shutoff mechanism known as the sphincter.
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Urinary Incontinence in Women: Changes in Aging
The birth canal is a marvelous organ system which, unfortunately, creates a weakness in the center portion of the pelvic floor. Change occurring over a lifetime results in stretched pelvic muscles, frequently related to pregnancy and the trauma of delivery. Once the pelvic muscles become stretched, the pelvic organs can actually move, often displacing the bladder, causing malfunction. Stress urinary incontinence is due most frequently to this pelvic floor weakening; leakage is frequently noted as a result of laughing, sneezing or coughing. An overactive bladder condition (OAB) manifests in the need to urinate even when the patient thinks her bladder is empty. OAB frequently results with aging, as bladder muscles weaken, and sometimes as a result of infection or inflammation of the bladder or urethra. It can also result from problems with the nervous system. As pelvic floor weakness occurs over time, the muscles surrounding the vaginal wall and pelvic floor stretch, and the bladder and/or the urethra balloon or herniate through the weakened muscle. This can occur specifically in the area of the birth canal, creating an out-pouching of the vagina known as a cystocele or urethrocele. This out-pouching can make it very difficult to empty the bladder; it can stretch the urethra in such a way that the muscles that normally hold urine in can’t work as effectively. A woman with this condition will feel a bulge in the vagina, particularly when coughing or during physical stress. With the onset of menopause, estrogen levels decrease and the lining of the vagina and the urethra thin out. This also adds to the problem of leakage, because what holds the urine in place is the sealing together of the lining surfaces of the urethra in the area of the shutoff valve or the sphincter.
Female Urinary Incontinence: Treatment
Treatment for these conditions can include pelvic floor exercises, known as Kegel exercises, or surgical treatment to strengthen the pelvic floor and hold the organ systems in place. Surgically, this can be accomplished with a sling mechanism placed with a minimally-invasive surgical procedure that provides more support for the urethra. If there is a cystocele—the previously-noted hernia or bulging of the bladder—a variety of techniques can be applied to repair this condition. Graft materials can be placed with minimally-invasive needle techniques to provide anterior pelvic wall support. In some cases, posterior vaginal wall weakness results in bulging of the rectum—this condition pushes the posterior wall of the vagina forward and down. Surgical anatomic techniques can reinforce this area or, in cases of severe relaxation, minimally-invasive needle techniques can place graft material to support the posterior aspect of the pelvic floor. In the most severe cases of pelvic floor weakness, a significant prolapse or falling out of the dome of the vagina occurs—this severe pelvic floor defect may affect the uterus, the bladder and the rectum. Once again, anterior and posterior graft procedures performed with minimally-invasive needle implant techniques, can correct this defect.
The Good News
In the past, these operations were more invasive. Frequently, patients needed to be hospitalized for many days or even longer. Today, most of these procedures can be done as an outpatient in an Ambulatory Surgery Center. The patient can return to normal level of physical activity within days, or at the most, a very few weeks. At Riverside Urology, we are very interested in your overall well-being. We have a long history of successfully treating urinary incontinence in women, particularly when associated with pelvic floor weakness. We recognize the importance of improving this condition and treating the incontinence that may be affecting your lifestyle. Please contact us through this website—we will respond promptly.