Treatment options for incontinence depend on the type of incontinence
and the reason for urine leakage. Incontinence treatments may include
medication, behavioral modification, surgery or a combination of these.
Some incontinence medications are indicated for both men and women, and
some medications are gender oriented. There are female surgical
procedures for incontinence, and male surgeries for incontinence. Your
urologist will put together a treatment plan after evaluating the
underlying causes of your urinary incontinence.
Medications for Incontinence
Some
medications are available for both men and women to alleviate symptoms
of incontinence. Trospium (Sancture), darifenacin (Enablex) and
oxybutynin (Oxytrol Ditproan) alleviate incontinence symptoms by
relaxing the bladder muscles. Botulinum Toxin (Botox) is another
medication relaxes bladder muscles which cause the urge to urinate.
Botox is available for both men and women and is injected directly into
the bladder during an outpatient procedure.
Some menopausal women
experience incontinence as a result of decreased estrogen levels.
Although Estrogen replacement therapy has not been helpful for
alleviating urinary incontinence, topical estrogens such as Ogen,
Premarin, Estrace, and Estrig, help to strengthen the vaginal wall and
reduce leakage associated with stress incontinence. These medications
are administered topically, but they are counter-indicated in patients
who are at high risk for breast and uterine cancer, gall bladder
disease, or high blood pressure
Behavioral Modification
Behavioral modification
is usually prescribed in conjunction with medication. Your doctor may
recommend dietary modification such as eliminating excess water or
irritating foods. Bladder retraining helps you identify when
incontinence occurs, and may help you increase the time between bathroom
breaks. Your doctor may recommend daily Kegel exercises to
strengthen the sphincter muscle which controls the bladder. Both men and
women can benefit from these types of behavioral modification.
Surgery & Slings
Your
doctor may recommend surgery if medication and behavioral modification
prove ineffective on their own. Different procedures are available for
men and women.
A urologist can reposition a woman’s bladder using a number of different procedures such as retropubic suspension, pubovaginal fascial sling, suburethral sling, and tension-free vagina tape (TVT).
Some women experience a weakening of their pelvic tissue as a result of
childbirth, menopause, natural aging, obesity, or other lifestyle
issues. As a result of weakened pelvic tissue, they might suffer from
involuntary leakage when they laugh cough or sneeze. This is known as
stress incontinence, which can alleviated by a type of retropubic
suspension called the Burch colposuspension.
Male sling surgery is a procedure which repositions the bladder in men. Bulking injections into the penis may help restrict urine flow, and an artificial sphincter may help men who suffer nerve damage as a result of prostate surgery.
Talk to your doctor about the right treatment plan for your urinary incontinence.