Urinary Incontinence Diagnosis and Treatment
Do you have bladder issues and are embarrassed to talk about them? Don’t worry; we can help you with these issues and more: Incontinence and other voiding dysfunctions, overactive bladder, painful bladder syndrome, urinary tract infections, pelvic prolapse, and pelvic pain. Treatment can range from therapy, medication, or surgery.
The following is a brief description of how we address the diagnosis and treatment of incontinence. However, therapy is individualized to each patient based on needs and other medical conditions that may dictate one regimen over another.
It's essential to determine the type of urinary incontinence that you have, and your symptoms often tell your doctor which type you have. That information will guide treatment decisions.
Your doctor is likely to start with a thorough history and physical exam. You may then be asked to do a simple maneuver that can demonstrate incontinence, such as coughing.
After that, your doctor will likely recommend:
Urinalysis: A sample of your urine is analyzed for signs of infection, traces of blood or other abnormalities.
Furthermore, your doctor might recommend you keep a Bladder diary. For several days you will record critical factors such as how much you drink each day, how many times you urinate, the amount of urine you produce, whether you had an urge to urinate and the number of incontinence episodes.
Post-void residual measurement: You're asked to urinate (void) into a container that measures urine output. Then your doctor checks the amount of remaining urine in your bladder using a catheter or ultrasound test. A large amount of remaining urine in your bladder may mean that you have an obstruction in your urinary tract or a problem with your bladder nerves or muscles.
If surgery is being considered as a treatment, your doctor may recommend more involved tests, such as urodynamic testing and pelvic ultrasound.
Treatment for urinary incontinence depends on the type of incontinence, its intensity, and the possible underlying cause. A combination of treatments may be needed. If an underlying condition is causing your symptoms, your doctor will first treat that condition.
The least invasive treatments are always recommended first and if these techniques fail then treatment options would move on to more involved procedures.
Behavioral techniques can include the following:
Bladder training, to delay urination after you get the urge to go. You may start by trying to hold off for 10 minutes every time you feel an urge to urinate. The goal is to lengthen the time between trips to the toilet until you're urinating only every 2.5 to 3.5 hours.
Double voiding, to help you learn to empty your bladder more thoroughly to avoid overflow incontinence. Double voiding means urinating, then waiting a few minutes and trying again.
Scheduled toilet trips, to urinate every two to four hours rather than waiting for the need to go.
Fluid and diet management, to regain control of your bladder. You may need to cut back on or avoid alcohol, caffeine or acidic foods. Reducing liquid consumption, losing weight or increasing physical activity also can ease the problem.