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MAGAZINE / Sept-Oct 2007 / Are You A  Mindful Caregiver?

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Innovative Treatments for
Female Incontinence

By Hilary Gibson, Staff Writer  

Innovative Treatments for Female Incontinence

Stress incontinence occurs when women leak urine resulting from coughing, sneezing, laughing, exercising or intercourse. This form of incontinence affects about half of the women living with incontinence, making them afraid to engage in their normal physical activities because of increased problems during exercise. Genuine stress incontinence is the leaking of urine during increased abdominal pressure even without bladder contractions. It is the most prevalent form of urinary incontinence among women. The second most common form is detrusor instability, or urge incontinence.

Urge incontinence is associated with a heightened urgency and frequency of urination. Most of the women diagnosed with this form of urinary incontinence, feel the urge to urinate, but rarely make it into the restroom in time. Women with this type of incontinence appear to have involuntary or uncontrollable bladder contractions, even in the absence of damage to their lower pelvic nerve. There are non-surgical and surgical treatment options for all three forms of urinary incontinence.

Before you or your doctor decides the kind of incontinency you are dealing with, the doctor will have to isolate exactly which kind is being experienced: urge incontinence or stress incontinence. Most doctors feel that incontinence can be cured or controlled at least 80 percent of the time. The most important step is finding the correct treatment that will work best with a person’s lifestyle. A variety of new treatment options for women has been developed to treat urinary incontinence such as biofeedback, FemSoft Insert, Neocontrol, tension-free transvaginal tape (TVT) and medications:

  • Biofeedback or electromyography is used to collect information about the tone or condition of muscles located in the pelvic floor through the use of sensors attached to a monitor. These muscles help control urination and can be strengthened through Kegel exercises, which involve contracting the pelvic floor muscles for a few seconds and repeating the exercise several times a day. Biofeedback is a non-chemical and non-surgical treatment option for urinary incontinence.

  • The FemSoft insert is a single-use disposable product designed to prevent leakage of urine in women suffering from stress urinary incontinence,” according to Rochester Medical Corporation. The insert is a soft sleeve filled with a thin fluid that is inserted into a woman’s urethral tract. It conforms to the woman’s natural shape and prevents leakage of urine, even during increased physical activity. The FemSoft inserts are an extremely new edition to treatment options, as well as NeoControl.

  • A device known as the NeoControl is one of the latest therapies to treat urinary incontinence for women. This treatment includes fitting an office chair with magnets in its seat in order to create a pulsing magnetic field which strengthens the pelvic floor muscles. The Food and Drug Administration approved it for treatment of all forms of incontinence in women. In a study of 83 women, NeoControl has successfully reduced incidences of urinary leakage in women with stress incontinence from 3.3 to 1.7 daily according to researchers at Emory University. Another effective procedure is tension-free transvaginal tape (TVT).

  • Tension-free transvaginal tape is a surgical procedure that requires a surgeon to insert a synthetic tape between a woman’s abdominal and vaginal wall. In less than six weeks, tissue will have grown around the tape to hold it in place to support the neck of the bladder. There is a possibility with this procedure that the tape will be expelled from the body due to rejection from infection or tissue perforation. Some women prefer not to have surgery to correct their urinary incontinence and would rather take the many oral medications which are available to them today.

Other Treatments for Urinary Incontinence         

  • Behavior Therapies: For those who suffer from stress urinary incontinence, behavior therapy can be a treatment option. Techniques can teach you to control your bladder and sphincter muscles by:

  • Decreasing fluid intake

  • Prompting or scheduling voiding (used in women who can recognize some degree of bladder fullness)

  • Pelvic muscle exercises: These exercises are commonly called Kegel exercises and are used to strengthen the weak muscles surrounding the bladder.

  • Protective Undergarments: Products such as pads, undergarment liners and absorbent underwear are worn to absorb urine that has leaked from the bladder.

  • Catheter: Some women require an indwelling catheter, which is left in place 24 hours a day to continually collect urine in an external drainage bag.

  • External Devices:  Some women with urinary incontinence use a pessary device, a stiff ring that is inserted into the vagina where it presses against the wall of the vagina and the urethra. The pressure helps reposition the urethra, preventing leakage.

  • Bulking Injections: A bulk-producing agent, such as collagen, is injected to bulk up the urethral lining so the urethra can close more tightly.

  • Medication: A number of medications can help bladder control problems due to urge incontinence. However, there are presently no medicines currently available to treat stress incontinence. If your doctor determines you have mixed (stress and urge) incontinence, you may find drug therapy helpful in addressing the urge component of your incontinence.

  • Surgery: There are surgical options to treat urinary incontinence. These include:

  • Retropubic Suspensions: These surgical options treat hypermobility and often are referred to as the Burch procedure. They elevate and restore the urethra and bladder neck to a higher anatomical position. 

  • Slings: A sling procedure is used to treat both hyper-mobility and ISD. The sling serves as support for the urethra during increased abdominal pressure.

  • Bone fixated slings treat incontinence by supporting the urethra with a graft material that is secured to the pubic bone, such as the AMS In-Fast Ultra.

  • Self-fixating slings treat incontinence by supporting the urethra. The sling is secured in place by friction and natural tissue in-growth, rather than by sutures or screws.

Today, there are more treatments for urinary incontinence than ever before. They range from simple and safe, to complex and risky. The simplest and safest should always be the first to try. Often, a combination of treatments is used.

The treatment of urinary incontinence depends on the type and severity of the problem, lifestyle and of course personal preferences. Whatever the case, you should seek a professional opinion, be aware of all the options and actively participate in the decision process. The treatments range from simple and safe, to complex and risky. The simplest and safest should always be the first to try. Often, a combination of treatments is used. Just know you are not alone, and that there are many different things you can try in order to alleviate or completely do away with urinary incontinence.

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