Bladder Control Management

Is a weak bladder ruining your active lifestyle? Don't let urinary leakage stop you! 

More than 13 million people in the United States share your problems with bladder control. Though they are most common in women, especially moms and older women, men can also experience signs of incontinence.

Many people have trouble reaching the bathroom in time or experience leaking when you laugh, sneeze, or lift something heavy. There may be a medical solution for you.

Dr. Laub has the expertise and advanced technology to quickly diagnose the cause of your bladder incontinence. There are surgical and non-surgical solutions to benefit most patients with their bladder leakage.

Non-Surgical Incontinence/urinary control treatments may include:

• Pelvic muscle exercises
• Biofeedback therapy
• Injection therapy
• New, more effective medications
• Behavior modification
• Botox for overactive bladder

Surgical Treatments include:

• Hammock or sling underneath the bladder to help suspend the bladder and stop the leakage (Outpatient).
• Bladder surgery to place the bladder back to its normal position.
• Prolapse surgery to place the bladder and other organs in their correct position in the vagina.
• Most procedures are done in an outpatient setting and patients are home within several hours of the procedure; many are back on their feet in no time!

Facts and physiology behind incontinence:

Women experience incontinence twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference. But both women and men can become incontinent from neurologic injury, birth defects, strokes, multiple sclerosis, and physical problems associated with aging.

Older women, more often than younger women, experience incontinence. But incontinence is not inevitable with age. Incontinence is treatable and often curable at all ages. If you experience incontinence, you may feel embarrassed. It may help you to remember that loss of bladder control can be treated. You will need to overcome your embarrassment and see a doctor to learn if you need treatment for an underlying medical condition.

Incontinence in women usually occurs because of problems with muscles that help to hold or release urine. The body stores urine-water and wastes removed by the kidneys-in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

During urination, muscles in the wall of the bladder contract, forcing urine out of the bladder and into the urethra. At the same time, sphincter muscles surrounding the urethra relax, letting urine pass out of the body (see figure 1). Incontinence will occur if your bladder muscles suddenly contract or muscles surrounding the urethra suddenly relax.

The Types of Urinary Incontinence

• Stress: Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).
• Urge: Functional Leakage of large amounts of urine at unexpected times, including during sleep.
• Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
• Overflow: Unexpected leakage of small amounts of urine because of a full bladder
• Mixed: Usually the occurrence of stress and urge incontinence together.
• Transient: Usually the occurrence of stress and urge incontinence together.
• Leakage that occurs temporarily because of a condition that will pass (infection, medication).

How is incontinence evaluated?

The first step toward relief is to see a doctor who is well acquainted with incontinence to learn what type you have. Dr. Laub has extensive experience in this area to quickly diagnose and correct the problem. To diagnose the problem, you will first be asked about symptoms and medical history. Your pattern of voiding and urine leakage may suggest the type of incontinence. Other obvious factors that can help define the problem include straining and discomfort, use of drugs, recent surgery, and illness. If your medical history does not define the problem, it will at least suggest which tests are needed.

You will need a physical exam to evaluate for other medical conditions causing incontinence, such as the nerves that affect the urinary tract, stool impaction, and poor reflexes or sensations, which may be evidence of a nerve-related cause.

Often, Dr. Laub will measure your bladder capacity and residual urine for evidence of poorly functioning bladder muscles. To do this, you will drink plenty of fluids and urinate into a measuring pan, after which the doctor will measure any urine remaining in the bladder. He may also recommend:

• Stress test - You relax, and then cough vigorously as the doctor watches for loss of urine.
• Urinalysis - Urine is tested for evidence of infection, urinary stones, or other contributing causes.
• Blood tests - Blood is taken, sent to a laboratory, and examined for substances related to causes of incontinence.
• Ultrasound - Sound waves are used to "see" the kidneys, ureters and bladder.
• Cystoscopy - A thin tube with a tiny camera is inserted in the urethra and used to see the inside of the urethra and bladder.
• Urodynamics - Various techniques measure pressure in the bladder and the flow of urine.

Dr. Laub may ask you to keep a diary for a day or more, up to a week, to record when you void. This diary should note the times you urinate, the amount of urine you produce, and how often you are drinking. To measure your urine, you can use a special pan that fits over the toilet rim.

Contact Dr. Laub’s office for more information about bladder control management.