The dreaded bladder leak. Whether brought on by a powerful sneeze, strenuous exercise class or as part of an uncontrollable urge, urinary incontinence, also known as UI, can feel embarrassing and uncomfortable. If left unaddressed, the symptoms of UI can hinder individuals' participation in everyday activities or impact their overall quality of life.
Despite its prevalence, UI remains a health issue that individuals often prefer to keep hidden from public view. But no one should have to suffer in silence. A growing number of medical treatments are available to help those affected by UI manage and lessen their symptoms.
While the subject may be considered taboo for dinner conversation, UI is relatively commonplace. According to Johns Hopkins University, more than 25 million American adults experience UI, temporarily or as part of a chronic disease, such as diabetes.
Women are particularly susceptible to UI, regularly developing the condition during pregnancy, after childbirth or with the onset of menopause-related hormonal changes. UI's effects can range from minor inconveniences, such as slight urine losses, to disruptive, life-altering symptoms like severe, frequent wetting.
So, what should individuals do if they are dealing with or suspect they may have urinary incontinence?
For most adults, receiving a UI diagnosis is a straightforward process that entails a conversation with a urologist, a brief physical exam and urine analysis. With this information in mind, a doctor can quickly determine the patient's type of UI.
The most common category is urge incontinence, where an individual feels a strong, sudden need to urinate and cannot reach the bathroom in time. The second most frequent type of UI is stress incontinence, when pressure is put on the bladder during physical movement or activity. Then, there's mixed, or a combination of urge and stress incontinence.
Depending on the cause of a patient's UI, a urologist will likely recommend pharmacological management like anticholinergic drugs or pelvic floor physical therapy. If additional intervention is needed to control an individual's symptoms, a urologist may suggest minor outpatient procedures that take 30 minutes or less.
For stress incontinence, this could include implanting a dermal graft under the patient's urethra, a more permanent solution, or hydrogel urethral injections, which provide relief for an average of five to seven years.
If an individual is affected by urge incontinence, a urologist may decide to inject Botox into the bladder. The doctor may also consider sacral nerve stimulation, a two-step process administered by the tailbone.
Nearly all patients who receive these types of outpatient procedures will see a correction or dramatic improvement in their symptoms.
Dealing with the effects of urinary incontinence can feel isolating for patients, especially when it limits their ability to work, spend time with their loved ones or engage in social activities. However, it's important to remember that myriad treatments are available to help mitigate their symptoms.
Whether during Urology Awareness Month, celebrated each September, or as part of our daily conversations with friends, family and neighbors, we should encourage those dealing with UI to talk to their health-care providers about what step may be right for them.
John Paul Brizzolara, M.D., F.A.C.S., is a urologist with CARTI, serving patients at the not-for-profit cancer care provider's flagship campus in Little Rock and in Pine Bluff. He is certified by the American Board of Urology and a member of the American Urological Association and American College of Surgeons. For more information, visit CARTI.com.