Your Questions Answered
What are the different types of urinary incontinence and the causes behind it?
Many women struggle with some form of urinary incontinence at some time in their lives. The problem is often a hidden one for which many do not seek medical advice. Continence is a prerequisite for comfortable social adjustment and therefore the inability to control it leads many to suffer profound social and psychological consequences and restricted social activity. It is not uncommon for women to believe that their situation is an inevitable aftermath of pregnancy and delivery, an unavoidable part of normal aging, or simply something they can do nothing about.
There are several types of urinary incontinence and the ability to find relief for a particular problem necessitates an accurate diagnosis as each type is treated differently. GENUINE STRESS INCONTINENCE is the involuntary loss of urine which occurs without an urge to void often paired with some event such as coughing, sneezing, jumping, or change in position. By definition it occurs in the absence of detrusser (bladder muscle) contraction when the intravesical (inside the bladder) pressure exceeds the pressure in the urethra. In a typical case of URGE CONTINENCE, involuntary, sometimes substantial leakage, combined with a strong desire to urinate is the symptom most often reported. Urgency with or without leakage of urine can also be a sign of other problems such as cystitis, urethritis, tumors, or certain neurological disorders such as multiple sclerosis. MIXED INCONTINENCE is a combination of both stress and urge incontinence. The existence of both types of incontinence is not always obvious. The degree to which a woman experiences distress from a particular symptom may influence her to down play certain problems while emphasizing others
There are a number of situations which can contribute to the development of the above problems and many are common experiences to women. Pregnancy and delivery increase the risk of both types of incontinence. Obesity can also be a factor. Surgery in the pelvic region can interfere with the strength and anatomy of the organ systems which control and contain urine. As mentioned above preexisting medical conditions are another variable. The hormonal changes of aging can also contribute to a problem which might have been tolerable at an earlier time.
Because many women are embarrassed by this and hesitant to mention their problem, mainstream medicine, despite a repertoire of treatment options, has not been successful in impacting this condition for many women. In an attempt to address this deficiency we have been working hard at Harbour Women’s Health over the past few months to develop a program which is safe, usable, accessible, and most important, effective in the treatment of many forms of incontinence. Beginning with a thorough history of the problem and an exam to define the problem more completely, we will be able to work with each woman individually with sensitivity to help accomplish her goals. We are combining approaches from physical therapy, osteopathy, gynecology, western and herbal medicine, biofeedback, and midwifery to set up a program which we are excited to share with our patients. We will be helping to identify and strengthen the muscles used in controlling urine flow, realigning energy and pressure pathways, teaching bracing techniques and timed voiding strategies as well as helping to incorporate lifestyle changes which might aid in accomplishing the goal of urinary continence.
So when you feel ready to discuss this problem with someone, give us a call and set up an appointment. We are ready to help.
Jodi DeMuth, CNM, MSN
Maribeth Quinn, CNM, BSN