Urge Incontinence vs Stress Incontinence
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Having a little trouble telling the difference between overactive bladder and stress incontinence, where you "go" sometimes while coughing or sneezing? It's a common confusion.
Transcript: Having a little trouble telling the difference between overactive bladder and stress incontinence, where...
Having a little trouble telling the difference between overactive bladder and stress incontinence, where you "go" sometimes while coughing or sneezing? It's a common confusion. Overactive bladder, or urge incontinence, is the sudden, frequent urge to urinate EVEN WHEN the bladder is empty or only partially full. It's due to spasms and involuntary contractions of the bladder muscles. STRESS incontinence, the ACTUAL leakage of urine, is due to a weak sphincter muscle in the bladder. This muscle can be pushed open by physical activity, such as exercise, and even coughing, sneezing or laughing. To determine which form of incontinence YOU are experiencing, ask yourself a few questions: Does my need to urinate wake me up more than once at night? Do I urinate - or try to urinate-more than 8 times a day? Do I often have urinary tract infections? Have I had a stroke or been diagnosed with a neurological condition, kidney disease, diabetes, bladder stones or tumors? And for men: Do I have an enlarged prostate? If you answered YES to a majority of these, it's possible your issues are caused by overactive bladder, or urge incontinence. If you have STRESS incontinence, you will probably answer YES to most of these questions: Have I had an injury in or near my urethra? Have I been diagnosed with chronic bronchitis or asthma, which makes me cough all the time? For women: Have I given birth vaginally? Have I experienced uterine prolapse? Have I had surgery in the pelvic area? For men: Have I had prostate surgery? Both stress incontinence and overactive bladder have various treatment options. Talk with your healthcare provider to decide what's best for your condition.More »
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Lack of bladder control, also known as urinary incontinence, can be caused by a number of elements. Watch this video to get the facts on bladder control.
Transcript: Since urinary incontinence affects 13 million American adults, it's important to clarify exactly what...
Since urinary incontinence affects 13 million American adults, it's important to clarify exactly what it is and what you can do to fix it. A normal bladder holds urine without contracting and the sphincter around the urethra prevents the constant flow of urine out of the bladder. The relaxed bladder and the tight sphincter keeps the urine inside the body until a person needs to urinate, at which time the bladder contracts while the sphincter relaxes. It doesn't work this way for someone with urinary incontinence. There are two common types of urinary incontinence: stress incontinence and urge incontinence. STRESS incontinence is what happens when the urethral sphincter is weak, so that physical exertion forces urine out of the bladder, resulting in a state of 'exert and squirt' with activities like coughing, laughing, sneezing, lifting, pushing and pulling. Stress incontinence is more common in women, age, childbirth, pelvic support and Kegel fitness can all affect the integrity of the urethral sphincter. As if a weak urethra isn't enough trouble, the bladder above the urethra can also misbehave, contracting when it shouldn't, resulting in an overactive bladder and URGE incontinence. Since adults with urge incontinence may not be able to make it to the toilet in time, it's essentially 'wetting your pants.' Overactive bladder incontinence is the result of involuntary spasms in the bladder, most of which is idiopathic, meaning that we don't know exactly what causes the condition. 1/3 of women with urinary incontinence suffer a combination of both stress and urge incontinence. It's not surprising that both stress and urge incontinence can take a huge emotional toll on sufferers! Studies show that women with incontinence have lower self-esteem, higher levels of depression, and reduced libidos. But it doesn't have to be that way! Both stress and urge incontinence may improve with Kegel exercises or pelvic floor electrical stimulation. Stress incontinence can also be treated with a minimally invasive sling procedure or injectable bulking agents placed into the urethral tissues. Urge incontinence can further be treated with overactive bladder medications, bladder retraining drills, or a pacemaker type device called Interstim. With so many treatment options, no one should suffer from urinary incontinence. If you have trouble controlling your bladder, talk to your doctor!More »
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What is the Manchester procedure? A number of women opt for this procedure. Watch this to see why.
Transcript: In a perfect world, a woman's uterus and cervix sit snugly above the vagina, supported by the uterosacral...
In a perfect world, a woman's uterus and cervix sit snugly above the vagina, supported by the uterosacral ligaments. Should childbirth or the natural aging process cause these uterosacral ligaments to weaken, the uterus and cervix may drop down into the vaginal canal. For generations, gynecologists have considered hysterectomy, the removal of the uterus and cervix, to be the best way to treat uterine prolapse. More recently, studies in Europe and North America have revived the option of uterine resuspension, aka hysteropexy, as an equivalent, if not superior, alternative to hysterectomy for uterine prolapse. Yes, I said revived. All of these new millenium uterine resuspension operations owe a debt of gratitude to the radical, 19th century prototype prolapse operation called the Manchester procedure. The Manchester procedure was first introduced in 1888, designed to restore uterine support to young, unmarried women toiling in the local sheepshearing industry. Frequent lifting of sheep tended to strain those uterosacral ligaments, causing the uterus to drop in many of these women, making marriage, conception and childbirth difficult. The Manchester procedure preserved fertility by correcting prolapse without removing the uterus and ovaries, every woman's organs of procreation. The Manchester has two steps ' First, the uterus is resuspended to the Cardinal ligaments that form the vaginal portion of the uterosacral ligaments, by wrapping one from each side in front of the cervix. Then the cervix is shortened so that it cannot be seen or felt at the vaginal opening. Cervical shortening is only necessary for women with prolapse who suffer abnormal elongation of the cervix, a condition called cervical hypertrophy. The exact prevalence of cervical hypertrophy is not known. Conservatively, probably 10-20% of prolapse patients also have a very long cervix. When necessary, cervical shortening is best done in a fashion that leaves a normal 3-4 cm cervical length. Unfortunately, it can be difficult to find a surgeon to perform this or any other uterine resuspension procedure, because most doctors today prefer hysterectomy for prolapse surgery, even though hysterectomy does nothing to improve the integrity or durability of prolapse repair. Today, the Manchester survives as a viable option for advanced elderly, sedentary women who need a quick, minimally invasive prolapse operation. If you think that uterine resuspension might be right for you, or if you're interested in alternative options to treat prolapse, check out other videos in this series.More »
Last Modified: 2012-11-09 | Tags »
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A cystocele occurs when the bladder bulges into the vagina. It can cause a number of frightening symptoms. Watch this video to better understand the symptoms, causes and treatments of a cystocele.
Transcript: At birth, a female's bladder rests in front of her vagina, and the two are separated by connective tissue...
At birth, a female's bladder rests in front of her vagina, and the two are separated by connective tissue called the vesicovaginal space. This tissue is anchored to each hip bone by tendons known as the arcus tendineus fascia pelvis. Vesicovaginal space connective tissue is NOT particularly strong. Even in a young woman who has never given birth, the tissue layer is only about as thick as five sheets of paper! When a woman gives birth, the vesicovaginal supports can weaken and stretch. Other factors that can contribute to the weakening of this supportive tissue include: being overweight or obese, engaging in recurrent heavy lifting, the normal aging process, and repeated coughing or constipation. Weakened vesicovaginal connective tissue can result in a vaginal hernia that allows the bladder to drop, a condition called cystocele. If the vesicovaginal space wears out in the center, the bladder may bulge into the vagina in what's called a CENTRAL cystocele. Meanwhile, if the tissue disconnects from either hip bone, the result is a PARAVAGINAL cystocele. But no matter the type, cystocele can cause unpleasant symptoms, like a vaginal bulge coming out between the labia, or make urinary incontinence worse, or prevent the bladder from emptying fully. Women may also experience chronic pressure in the pelvis or vagina that may be worse when coughing, bearing down, or lifting. Severe cystoceles may even emerge through the vaginal opening, causing a soft bulge that may feel like sitting on an egg. While it can be uncomfortable and embarrassing, treatment options DO exist to repair cystocele, or dropped bladder. In mild cases,a removable support device called a pessary can hold the bladder in place. More severe cystoceles may require surgery. Traditionally, this involved tucking stitches into the remnants of the supportive tissue between the bladder and the vagina during a procedure called anterior colporrhapy. This surgery has a recurrence risk as high as 30%, so many surgeons now prefer to insert a graft, which is a thin sheet of body-friendly material, as extra support between the bladder and the vagina. The trade-off for the graft's sturdier hold is a slightly higher risk of other complications including scarring of the vagina and pain during intercourse. Because each procedure has its pros and cons, talk to your doctor about the best repair option for YOU!More »
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Is hysterectomy the only treatment option for uterine prolapse? Watch this video for hysterectomy causes and uterine prolapse facts.
Transcript: Ask any 10 doctors what to do if the uterus prolapses and 9.7 of them will tell you 'Hysterectomy!' This...
Ask any 10 doctors what to do if the uterus prolapses and 9.7 of them will tell you 'Hysterectomy!' This is wrong. If you have uterine prolapse you need the prolapsed fixed, not the uterus cut out. There are absolutely bona fide reasons to remove a uterus. It's a good therapy for women with non-cancerous tumors that don't respond to nonsurgical alternatives or those with constant vaginal bleeding from adenomyosis. And it's the only option in cases of cervical, uterine, or ovarian cancer. But for some bizarre reason, uterine prolapse remains engraved on the list of must-do hysterectomy rules. This is ridiculous and wrong. You don't have to take out the uterus when it falls. You can lift it up. It's a really simple concept. If you went to your doctor with a torn ligament in your knee, he's not going to remove your knee cap just because it's in the way of the ligament that needs fixing. The uterus is no different. It makes no sense to lop it off just because the ligaments that hold it in place gave way. Either way, uterus in or out, your surgeon must fix those ligaments. So here's my candid advice: If your surgeon tells you there is no way to fix your prolapse without taking the uterus out, or doesn't seem to understand that the LIGAMENTS are the problem, RUN, do not walk, to a second opinion.More »
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Urinary incontinence can take a toll on your social life as well as personal life -- especially when you wet your pants every time you sneeze or cough. Watch this video on Bladder Control to learn about treatments for this condition.
Transcript: You probably know someone with urinary incontinence. Chances are she'll never tell you-it's not exactly...
You probably know someone with urinary incontinence. Chances are she'll never tell you-it's not exactly grocery aisle conversation-but she's there. I know because it happens all the time. Women come into my office saying, 'I just want to work out in my gym without wetting my pants' Sometimes urinary incontinence is associated with pelvic organ prolapse, however, not every woman with prolapse leaks urine, and plenty of women wearing incontinence diapers have no prolapse whatsoever. But it doesn't matter why you have bladder problems or when they started. All that truly matters is that you can tell your doctor what's going on with your bladder. It's that simple. There's not a single thing appealing about wetting your pants every time you cough, sneeze or lift something heavy. This type of 'exert and squirt' incontinence is easily remedied with a minimally invasive sling procedure or urethral bulking injections that take 20 minutes and can be done at the same time as prolapse repair. If you are planning a sling or urethral injections, make sure that your doctor is POSITIVE that you're dealing with stress incontinence and not urge incontinence, or an overactive bladder. If your incontinence is due to overactive bladder, a sling or injectables can make overactive bladder worse, sending you down a long road of revision surgery, overactive bladder medications, Kegel exercise therapies and bladder retaining drills. If your incontinence is due to BOTH stress and urge incontinence, you may need both a sling for the stress incontinence, and medications, Kegels and retraining for the urge incontinence. Sometimes it's best to treat the urge incontinence before undergoing a sling procedure, and sometimes the sling should come first. Communication with your doctor is crucial, because you are the most important player in your quest for bladder control. If you understand the game plan, you're much more likely to get the results you need. The bottom line is wetting your pants not only is messy and not normal, it can drive you nuts, ruin your self esteem, your social life, your athletic performance, your professional presence and your sexuality. Don't suffer in silence. It's just not worth it.More »
Last Modified: 2013-05-09 | Tags »
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Do you feel the need to urinate frequently? You could be suffering from overactive bladder! Urinary tract infections and bladder inflammation are some common overactive bladder causes. To know more, watch this video.
Transcript: Overactive bladder is an inconvenient and UNcomfortable condition caused by a short circuit in the nerve...
Overactive bladder is an inconvenient and UNcomfortable condition caused by a short circuit in the nerve messages that are supposed to tell you when it's time to urinate. As a result, you frequently FEEL that you have to go IMMEDIATELY! Common causes of overactive bladder include: Urinary tract infections, bladder inflammation, bladder stones and tumors, an enlarged prostate, postmenopausal thinning of the tissue around the urethra, diabetic neuropathy, multiple sclerosis, Parkinson's disease, or neurological injuries. Certain medications, such as diuretics, also can cause this urinary condition. And sometimes NO CAUSE can be found. Although overactive bladder, also known as urge incontinence, may occur at any age, it is more common in postmenopausal women and the elderly. There are a variety of treatment options available for people with overactive bladder. To learn more about treating OAB, check out other videos on this site.More »
Last Modified: 2012-12-27 | Tags »
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Sometimes, treating overactive bladder is in your own hands. Learn about lifestyle treatments for OAB and how they can make a difference.
Transcript: If overactive bladder is keeping you from doing what you want, these lifestyle treatment options could...
If overactive bladder is keeping you from doing what you want, these lifestyle treatment options could help. They can reduce the when and how often you have the urge to go, and get you back to an active life. Control you intake of liquids. Some doctors recommend spacing out 10, five-ounce drinks throughout the day. That way your bladder isn't overtaxed, but you can still stay hydrated. Also, set a cut off time for drinking any liquids. Two hours before bed seems to work well for most people. Avoid any drinks - or foods-- that could irritate your bladder. They include spicy dishes, citrus fruits and juices, and caffeine. Retrain your bladder muscles. This involves strengthening the pelvic muscles so you can gain more control over how you hold and release urine. Retraining is done by: Scheduling bathroom breaks. Visit the bathroom every hour or hour and a half to empty your bladder. In-between these breaks, you work on holding in the urine. You should also learn to do Kegel exercises, in which you 'pull in' using the muscles you use to urinate, as if you're trying to stop urine midstream. If you're Kegeling correctly, you'll feel the pull in your urethra and anus, NOT in your butt or abs.And then there's double voiding. After you urinate, DON'T GET UP. Wait a few minutes and try again so that your bladder becomes COMPLETELY empty. Feel free to try these lifestyle treatments before considering medical and surgical options; and continue them throughout your therapy, whatever it ultimately involves. To learn about other OAB treatment options, check out more videos on this site.More »
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If your OAB condition doesn't respond to lifestyle changes, you may need medical and surgical treatment for OAB. Learn your options here.
Transcript: If you have overactive bladder, the first treatment options usually involve lifestyle changes such as...
If you have overactive bladder, the first treatment options usually involve lifestyle changes such as a change of diet, or bladder retraining and Kegel exercises, which strengthen pelvic muscles. But sometimes that isn't enough to stop the constant urge to urinate, and your doctor will recommend medications or even outpatient procedures and surgery. Several oral medications for overactive bladder aim to stop the hyperactive muscle contractions that cause the sensation that you have to GO NOW. Ironically, they often trigger dry mouth, making you need to drink more fluids, which can aggravate OAB symptoms. A newer solution is an extended release skin patch. It stops muscle contractions without causing dry mouth. Tricyclic antidepressants are sometimes prescribed to treat urge incontinence since they can make the bladder muscle RELAX, while causing the smooth muscles at the bladder neck to contract. These too come with side effects, including dry mouth, fatigue, insomnia and nausea. And then there's a kind of Botox, which is injected into tissues to paralyze bladder muscles. The effect lasts for about 6 months. While it has NOT been approved by the Food and Drug Administration for treating OAB, some experts think it's the answer. However, Botox could worsen bladder problems in older adults. In place of medication, sacral nerve stimulation may be used to control OAB. It entails placing a thin wire near the sacral nerves, which carry signals to urinate between the spinal cord and bladder muscles. Once the wire is placed, electrical impulses are sent through it to the bladder, almost acting as a pacemaker. If successful at reducing symptoms, the wire is permanently connected to a small battery device that's placed under the skin. Surgery is typically the LAST option, used only when symptoms are severe and if other treatments have failed. There are two choices. Augmentation cystoplasty, which enlarges the bladder using portions of the bowel. And bladder removal, in which an opening is created and a bag to collect urine OUTSIDE the body is attached. While these surgical options are effective for some, they are very invasive, can cause blood clots, bowel obstruction and infections. Augmentation cystoplasty is also linked to a slightly increased risk of developing bowel tumors. To learn about lifestyle treatment options for OAB, check out more videos on this site.More »
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Coping with an overactive bladder calls for a combination of good medicine, smart self-care and a reasonable sense of humor. Here's a few tips on getting started.
Transcript: Coping with an overactive bladder calls for a combination of good medicine, smart self-care and a reasonable...
Coping with an overactive bladder calls for a combination of good medicine, smart self-care and a reasonable sense of humor. But no one's saying it's easy. First you need to commit yourself to doing what it takes to return to a fully engaged lifestyle - no shying away from doing what you love. Solutions to OAB take a commitment - but there are tangible rewards. You'll have fewer episodes of urgency and feel more comfortable in any situation. Then, see a doctor who can help you create an effective management plan. Practicing bladder retraining, doing Kegel exercises, monitoring your fluid intake, and avoiding stress can all help. But you need to do that EVERY day. If you need more help, there are medications to control bladder contractions. You need to take them as prescribed even if the side effects, such as dry mouth or constipation, become bothersome. Talk to your doctor about how to ease those side effects and get your best results. And finally you need to confide in family and friends - even coworkers-- about your condition, so they can help you be comfortable in social situations. Remember, the more they know and understand, the more they can help. If you feel embarrassed or awkward telling them, ask another family member to help you bring it up. And take advantage of support groups, such as the National Association for Continence (NAFC). You can connect with others who are going through what you are going through, and share concerns and personal experiences, get advice and self-care tips. They also have online resources and information. Sometimes, people with OAB benefit from one-on-one talk therapy to help them find ways to deal with their feelings of social anxiety and depression that can result from living with overactive bladder. Don't hesitate to try it, if you feel OAB is more than you can deal with on your own. These strategies can help you control your urge to urinate and make you more confident and comfortable in your day-to-day life. For more information on overactive bladder, check out other videos on this site.More »
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To determine if you have overactive bladder, your doctor needs to know your symptoms. The more detailed, the better the diagnosis.
Transcript: If you're plagued by the frequent urge to urinate, even when there's very little liquid in your bladder,...
If you're plagued by the frequent urge to urinate, even when there's very little liquid in your bladder, don't keep it to yourself. A few visits with a urologist will let you know just what's going on and what can be done about it. To determine if you have overactive bladder, which is caused by involuntary contractions of the bladder muscles, or some other urinary tract condition, let you doctor know: How often and when you urinate. If urinating causes you any pain or discomfort. Whether you ever experience any leakage. And if you're taking any medications or supplements. A physical exam focusing on the abdomen and lower back, and possibly an ultrasound may be used to help isolate the issue. Based on the information your doctor gathers, she may take a urine sample to test for: bacteria, indicating a urinary tract infection, blood or protein, indicating a kidney problem, and an elevated glucose level, indicating diabetes. If you DON'T have any of THOSE problems, then it may be time for a series of tests to pinpoint if you have OAB or some other form of incontinence. A bladder stress test will see if you can retain urine when your bladder is full. You may also need a post-void residual volume reading, in which a catheter is inserted through the urethra AFTER urinating to see if your bladder is emptying completely. Or you may have cystoscopy, in which a flexible tube equipped with a light and camera is inserted through the urethra to get a view of the inside of the bladder. For severe cases of overactive bladder, you may go through urodynamic testing. This is a series of tests gauging the amount of urine the bladder can hold and how well it can hold it. Based on your pattern of urination and the condition of your bladder, the doctor will determine if you have OAB or not. If you usually urinate more than 8 times a day, often feel you MUST GO NOW even when you DON'T have a full bladder, and get up several times at night to urinate, OAB may be likely. Fortunately treatment can do a lot to ease your symptoms. To find out about your OAB treatment options, check out other videos on this site.More »
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The main symptom of overactive bladder in women is the constant urge to urinate. Check out the video to learn more.
Transcript: "Gotta go; Gotta go!" You may have seen commercials of women franticly running to the bathroom because...
"Gotta go; Gotta go!" You may have seen commercials of women franticly running to the bathroom because they have the overwhelming urge to, well, GO. That's overactive bladder, or OAB, looks like, and it's twice as common in women as in men. If you urinate more than eight times a day, or if you frequently wake up in the middle of the night to urinate you may have OAB. About 10-15 percent of women in the United States have to contend with the condition. Overactive bladder is most common in older women because of menopause and a general deterioration of muscle tone that often happens with aging. Menopause causes estrogen levels to drop; this leads to thinning of the tissue in the urethra walls and weakens the bladder. Other causes of overactive bladder include problems affecting the nervous system, urinary tract infections, strokes, and bladder stones or bladder tumors. To control overactive bladder you can try pelvic floor exercises, bladder training and limiting your fluid intake. If those techniques don't help, you can ask your doctor about medications that may ease your symptoms.More »
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Now that you’ve made an appointment with your doctor to figure out why you're experiencing overactive bladder, there are a few things you’ll want to make sure you discuss.
Transcript: Now that you've made an appointment with your doctor to figure out how to stop that constant feeling...
Now that you've made an appointment with your doctor to figure out how to stop that constant feeling that you have to urinate, there are a few things you'll want to make sure you discuss. First, make sure to explain: how strong your urge to urinate is, how often you feel this urge, if you feel it after eating certain foods or doing certain activities and the number of late-night trips you take to the bathroom. Also mention any other changes in your health, even if you don't think they're tied to your urinary issue. And tell your doctor about any medications you take, as well as any vitamins or supplements. They could be the cause. In addition, here are some questions you'll want to ASK your doctor: What are my treatment choices, and what's right for me? Are there generic medications I can take? How long will it take before I see positive results from my treatment? What kind of side effects do the medications cause? Are there any lifestyle or self-care treatments I can do for myself, such as diet changes or Kegel exercises? And ... Should I avoid any activities? Don't hesitate to mention the emotional problems that OAB can cause - such as embarrassment, social withdrawal, and depression. You doctor can offer suggestions to ease your distress. And make sure to ask for any brochures or printed material that you can take home, as well as what websites are most helpful. Your doctor may suggest: NIDDK dot gov or Medscape dot com. For more information on overactive bladder, check out other videos on this site.More »
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