New Options for Treatment of Urinary Incontinence
By Marja Sprock, M.D.

Leakage of urine, sounds simple, is highly annoying and often embarrassing but in reality has numerous different causes.

The incontinence your neighbor just told you about made her go to seek help, may not be at all why you are losing urine.

There are women who lose urine as soon as they get the urge to go, others do not get an urge and just leak. Some leak at night, others only when they open their own front door.

Some put on clean underwear when they leak, while others need to bring a change of clothes despite wearing diapers.

Some drink a lot of fluid, while others torture themselves by not drinking for hours at a time. Some people get up from a chair and leak; others get up from a chair and then notice the urge and cannot make it in time, while others just leak while sitting in the chair. Doing jumping jacks makes some people leak, while others leak while walking or running.

Urinary incontinence is a common problem and since it becomes more common with increasing age, we may soon be at epidemic levels. Commercials on TV address the overactive bladder, the type of incontinence where you visit bathrooms whenever you can find one, “the toilet tourist”

Numerous different medications are available and that may be your answer if you are bothered by an overactive bladder.

A good instruction in how to perform your pelvic floor exercises should be the basis though before you start taking medications.

There is a new medication on the market for overactive bladder which has a different mechanism of action. Some of you may be very pleased with the medications for overactive bladder and have noticed a significant improvement, or have no bother anymore. Others cannot tolerate the side effects of dry mouth or constipation and had to stop the medication. The new FDA approved medication called Myrbetriq®, may be helpful. It will relax the detrusor muscle of the bladder while the other medications work through stopping the bladder contractions. The new medication has more interactions with medications like Coumadin® and Digoxin®, so there is no free ride.

Botox® in the bladder can stop contractions also, but like Botox® in the face, you have to get repeat injections.

Often I get the question: “doctor if you have something left over, can you put it in my face? That would not be proper to your insurance company and in addition we have a painless FDA cleared laser for reduction of lines and wrinkles in the office: the Regenlite®.

Some people are not only bothered by an overactive contracting bladder, but in addition it does not empty completely. You guessed right: your chance of having this abnormality increases with age. It also often will give you bladder infections that keep on recurring. No medication or muscle exercise will usually improve this. Nerve stimulators, implanted pacemakers like an Interstim® are your saving grace often with this condition.

“Doctor, you inserted a sling in my neighbor and she is completely dry, could you please give me one also?” Slings are quite small pieces of material to support the urethra (tube between the bladder and vagina) and are surgically inserted. Slings are inserted for stress incontinence. Some people have stress and urge incontinence (“toilet tourist”) and are lucky; they get a sling and it takes care of the bladder over activity in about 40% of people. It cures the stress incontinence or incontinence that you get when you cough, sneeze, run or do jumping jacks with at least 85%.

If you have the feeling now that you are lost in all these different mechanisms of incontinence and have no idea why you are leaking, just that you are and nothing you have tried up till now has worked, do not get frustrated.

At Central Florida Urogynecology in Rockledge we can put it all in perspective. After we understand your problem and the severity, we may do some testing like urodynamics, where we fill your bladder with some fluid and have you cough and bear down while we have the bladder activity on a monitor. This and a very short mostly minimally uncomfortable look in the bladder will often give us a good idea how to start your treatment. Most people actually like the test where they can see the inside of their own bladder and find it quite interesting and informative.

You do not have to suffer with your incontinence.  Seek help and make it a thing of the past before the new year starts.

Call us at 321-806-3929 for an appointment or leave a note here.  We look forward to start putting an end to your incontinence.