Conditions and Treatment

URINARY INCONTINENCE

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Leakage of urine is called urinary incontinence. It is a common problem in women. Some women occasionally leak small amounts of urine. At other times, leakage of urine is frequent or severe. Often, women with this condition are too embarrassed to tell their health care providers about their symptoms. However, with proper diagnosis, urinary incontinence can most often be treated. There are different types of urinary incontinence.

The most common types in women include stress urinary incontinence (SUI), urge urinary incontinence (UUI), and mixed urinary incontinence (MUI) in which a patient has both SUI and UUI. Stress Urinary Incontinence (SUI) is defined as urinary leakage associated with laughing, coughing, sneezing, jumping, or physical activity. It is caused by a loss of the support underneath the urethra usually caused by childbirth, obesity, age, or other disorders of connective tissue. With increases in intra-abdominal pressure (eg, from coughing or sneezing) the muscular tube of the urethra fails to close, leading to incontinence (like stepping on a water hose in sand).

Urge Urinary Incontinence (UUI) is defined as urinary leakage associated with a feeling of urge to urinate. Many times patients leak when they are not able to reach the bathroom quickly. Overactive bladder (OAB) is a common condition affecting 1 in 6 adults. With OAB, the bladder muscle squeezes too often, causing frequent, strong sudden urges to go. As a result, patients experience urinary urgency and frequency and sometimes they can leak urine if they are not able to reach the bathroom quickly.

Overactive Bladder (OAB) with or without Urge Urinary Incontinence (UUI) is caused by involuntary bladder wall contractions that may happen randomly and at the least convenient times and locations. The first line of treatment consists of a daily medication. These medications effectively “calm” the bladder wall and decrease urinary frequency and leakage. Patients afflicted with Mixed Urinary Incontinence (MUI) have both SUI and UUI symptoms. Both conditions are treated separately as described.

Surgical correction is the only effective treatment to repair the hypermobility of the urethra and to get rid of SUI. Dr. Rebeles performs suburethral sling procedures to eliminate SUI. These procedures involve placing a permanent polypropylene mesh under the bladder neck to support it. The incision sites are very small and heal quickly. The procedure is done in an outpatient surgery center, usually takes about 15 minutes, and can be done either under general or regional anesthesia. Recovery time is short and usually patients can return to work in 1-3 days.

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