10 Ways to Stop Leaks in Urinary Incontinence

Urine leaks due to urinary incontinence can be stressful and embarrassing. Persistent loss of urine may make you feel wet, dirty and uncomfortable. In turn, many feel they have to restrict their social and physical activities, including shopping, exercise, dancing, or visiting friends. 

Also, many may experience low self-esteem, body negativity, low physical attractiveness, inadequacy, and reduced sexual desire, which tragically can lead to self-isolation, loneliness, and depression. Plus, accidental urine leaks can compromise daily life activities as you have to continually interrupt your life to use the bathroom. 

There are a number of effective treatments for urinary incontinence, including medications, electrical stimulation, medical devices, and surgery. But there is also a lot you can do to reduce the risk of urinary incontinence and to avoid accidental leaks. 

Here are 10 ways to stop leaks in urinary incontinence.

  1. Increase your fluid intake

Drinking enough water makes your urine less concentrated. This prevents bladder irritation and minimizes urinary urgency that is usually the immediate cause of urine leakage.

So you shouldn’t stop drinking more water when you have urinary incontinence. Instead, make sure to drink 6-8 ounce glasses of water a day. 

An easier way to know you’re drinking enough water is to monitor the color of your urine. Pale yellow urine means adequate hydration, while darker yellow suggests you should drink more.

  1. Empty your bladder regularly

Visiting the bathroom on schedule, every 2-3 hours, even when you don’t feel the urge to pass urine is effective in preventing urine leaks. The strategy keeps urine volume in the bladder low enough to stop accidental leaks.

Another strategy is to always empty your bladder before you leave your house or other venue, like a restaurant or office, even when you don’t feel the urge to go. This will reduce the chances of having an uncontrollable urge to urinate as you travel or go about your routine.

  1. Know where bathrooms are located

When in a new, unfamiliar destination, such as a museum, restaurant, shopping center or park, make sure to know the location of the bathroom. This will enable you to reach the bathroom as soon as you feel the urge to urinate and reduce the chances of accidental leaks. 

  1. Keep a bladder diary

If you want to understand the triggers and patterns behind your urinary incontinence, tracking your bathroom habits using a bladder diary is an effective method. In fact, a few days before you visit your urologist, you should start keeping a diary.

Write down what you drink, the time you drink it, the number of times you pass urine, and whether you’ve had urine-leaking episodes. Also, indicate everything that might have caused the accidental leakage, such as exercising, coughing, or a sense of urgency.

  1. Engage in Kegel exercises

Pelvic floor muscle exercises, called Kegels, help strengthen bladder-supporting muscles and in turn prevent urine leaks and urinary urgency due to overactive bladder. 

Kegels are quite easy to do. For instance, you can simply tighten or squeeze your pelvic floor muscles (muscles that you use to stop urine flow or the passing of gas) for a count of three, then relax them slowly for a count of three. Build up to doing 10-15 squeezes, 3 times a day, and see your bladder control improve within 6 weeks.

The good thing with Kegels is that you can do the exercise any time, at your desk at work or while sitting in your car. 

  1. Lose weight

Losing weight removes the extra pressure on your bladder and pelvic muscles, which can cause accidental leakage. Losing up to 20 pounds of weight over a period of say 6 months can cut bladder leaking episodes by nearly 50 percent.

  1. Cut down bladder-irritating drinks and food

Certain drinks and foods may irritate the lining of your bladder and cause an overwhelming urge to urinate, which may be followed by accidental leakage. For instance, caffeine and alcohol are top bladder irritants. And by limiting alcohol and caffeine beverages, such as tea, coffee, and cola you can prevent urine leaks.

 Also avoid bladder irritants such as apples, apple juice, artificial sweeteners, carbonated beverages, chili and spicy foods, chocolate, citrus fruit and juices, milk products, cranberries and cranberry juice, pineapple, tomatoes, sugar and honey, and vinegar. 

A good strategy is to try eliminating one or more potential irritants from your diet for 2 weeks, the reintroduce them one by one every few days to see if there is a noticeable difference in your urge to pee, how often you go, and the number of leaks you’ll experience.

  1. Quit smoking

Smoking makes you more vulnerable to urinary incontinence by damaging the small blood vessels in your body and causing tissue weakness. Also, smoking can cause coughing, which may lead to urine leakage by increasing pressure on the pelvic floor muscles. 

Plus, cigarette smoking can triple your risk of bladder cancer, which has one of its symptoms as the need to urinate more often or an uncontrollable urge to urinate, even when the bladder is not full.

  1. Review your medications

Some medications can promote urinary incontinence. For example, diuretics increase urine production by the kidneys while muscle relaxants and sedatives relax the urethra and increase the need to pee.

When you suspect your drugs as culprits in your urinary incontinence, speak with your doctor about it. Your physician will determine if the dosage should be changed, if alternatives could be used, or if you should stop taking them.

  1. Treat constipation promptly

With constipation, your colon swells and strains due to excess abdominal muscle pressure. The continuous straining to pass stool weakens pelvic floor muscles and makes urinary incontinence worse. In turn, bladder muscles are adversely affected and the severity of urinary incontinence increases.

Eat more fiber to prevent constipation. Equally, exercise regularly and drink plenty of water. And if you have chronic constipation, speak with your doctor for recommendations on how to manage it, including taking medications or trying physical therapy.

Are you bothered by urine leaks? At St Pete Urology, we encourage you to make the above simple changes to strengthen your bladder and pelvic muscles, reduce bladder irritation, and improve your urinary incontinence symptoms.  If urine leakage persists, see your urologist to determine the underlying cause and develop a tailored treatment for you.

For more information on urinary incontinence and other urological problems, visit the site “St Pete Urology.”

How Our Urinary Systems Age With Us

Your urinary system often reflects your overall health. 

A healthy urinary system works to filter blood and to remove toxins and wastes produced in the body through urine. It also helps to maintain the balance of water, minerals and salts in your blood. Plus, it enables your body to make red cells and regulate blood pressure.

By removing wastes and toxins and regulating fluids and electrolytes, the urinary system helps the body regulate itself and work properly. That is why it’s essential to protect your urinary health as a way of improving your overall health as you age.

In fact, if you take common sense steps early in life to protect your urinary health it will significantly contribute to good overall health later in life especially after the age of 40 years. 

So how does your urinary system age with you?

  1. Kidneys

The number of cells in your kidneys decrease once you’re 40 years or older. This results in thickening of the connective tissue capsule surrounding the kidney and a reduction in the thickness of the cortical region.

The loss of cells causes loss in glomeruli function. And because the glomeruli are responsible for filtration, loss of function of the glomeruli leads to a natural yet gradual decline of kidney function. 

Between the ages of 30 and 40 years, the rate of filtration in your kidneys begins to slowly decline, the size of the kidneys begins to reduce and the arteries supplying blood to the kidneys begin to narrow.  In turn, your kidneys become more susceptible to injury and kidney disease.

  1. Bladder

The walls of your bladder and urethra are made of smooth muscles. As you grow older, the muscle tissue weakens and becomes less elastic. In turn, the capacity of your bladder reduces, resulting in difficulty to fully evacuate during urination.

Likewise, the bladder wall generally becomes stiffer as you grow older. This reduces the bladder’s ability to hold as much urine as your younger self. And as your ability to hold urine reduces, you end up urinating more often with a higher risk of urinary tract infections.

Accidental urine leakage results from muscle weakness in the bladder and is more frequent in older people, especially women. More than 50-percent of people aged 65 and older have urinary incontinence symptoms. 

By the time you are 80 years or older, bladder control may be sufficiently diminished that many find themselves waking to pass urine during the night. 

Various age-related causes of urinary incontinence include: 

  • Weak pelvic floor muscles
  • Nerve damage
  • Urinary tract infections
  • An enlarged prostate (in men)

The most common treatment options for urinary incontinence are surgery and targeted nerve stimulation. 

Another age-related urinary system condition is bladder cancer. Though the disease is not very common, the chance of having it increases with age. In fact, over 70-percent of cases of the cancer are diagnosed in people who are 65 years or older. 

Risk factors include exposure to carcinogens, tobacco smoking, and radiation. The most common symptoms are blood in urine (hematuria) and pain during urination. It is advisable to speak with a urologist if you experience these symptoms.

  1. Urethra

After the age of 40 years, your risk of having urinary tract infections increases due to changes in the urethra. The infections may occur when bacteria invade the urethra, multiply and spread to the upper parts of the urinary system such as bladder and kidneys.

While urinary tract infections are more commonly a concern in aging women, it can also be a problem for men. More than 50-percent of women have urinary tract infections at least once in their lifetime as opposed to just 3-percent of men.

Advancing age is also a factor in UTIs as a result of general immunity weakening with age. Plus, the infections may be more frequent in older people due to urinary incontinence and retention. When not treated promptly, infections that begin in the urethra can in some cases lead to kidney infections and even sepsis.

  1. Prostate 

The prostate is not a urinary organ; it is part of the male reproductive system. However, changes in the prostate result in problems in the urinary system. This is largely due to the prostate gland gradually enlarging after the age of 40 years and leading to extra pressure applied to the bladder, blocking urine flow.

More than 30-percent of men aged 50 years or older require treatment for an enlarged prostate (BPH) while up to 90-percent of men aged 80 years have an enlarged prostate. An enlarged prostate is not cancer, but it is associated with bothersome health issues, such as urinary tract infections, kidney infections, urinary incontinence and bladder damage.

The most common symptoms of BPH are change in urination, inability to start to pee, and a weak urine stream. Speak with your urologist about BPH symptoms as soon as they start in order to get prompt, effective treatment.

Timely urological care

To prevent age-related urinary issues, consider making regular visits to your urologist. The doctor is a specialist with the skills and experience to assess your specific symptoms, ask the right questions, make the appropriate diagnosis and find the right treatment options. 

Speak with your urologist as soon as possible to get the right medications or minimally invasive treatment for relief of the symptoms. For more information on the prevention, diagnosis and treatment of urological disorders, visit the site “St Pete Urology.”

What Can Cause Incontinence

Tonight we’re going to talk about bowel and bladder control primarily. So Dr. Graves and I both actually trained together at the university of Pennsylvania in Philadelphia. And we’ve been each practicing for close to 10 years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in. So what causes incontinence of urine or stool there’s a huge host of things that something your doctor can figure out but sometimes it could be something you know is simple. If it’s mild like what you’re eating an excess amount of caffeine it can do that. Some people will be drinking an excessive amount of coffee, you know, I talk to some patients they’re drinking a pot of coffee a day. Other times it really has nothing to do with their diet, medications can do that certain diuretics can predispose to issues with urinary control. If you’re not as physically fit bedridden have other physical mobility issues sometimes that can deal with causing incontinence. And then other things can increase your risk like radiation of the pelvis before a prior injury to the spinal cord or your pelvic floor, certain pregnancy issues or childbirth like such as vaginal deliveries sometimes can have something to do with that. Complicated in terms of regards to different causes but something that is often easy to figure out when you see a physician.

How Does Bladder Bowel Control Work

Tonight we’re going to talk about bowel and bladder control primarily, so Dr. Graves and I both actually trained together at the University of Pennsylvania in Philadelphia. And we’ve been each practicing for close to ten years and we’ve had five years of urology training in residency and med school before that. And the topic tonight is something that we do have a lot of focus in and enjoy taking care of and have specialty in.

So bladder control is something we’ll discuss about the pathophysiology and how that works. So your kidneys filter your blood and make urine and then it goes into the bladder where it’s stored and then you pee that out. And you’re supposed to be able to control that and the bladder’s in muscle. And when the bladder gets full basically it’ll send a signal and you’ll get relaxation of the external sphincter, which is a sphincter control to control the urine. And then allow the sphincter to open and then the bladder squeezes down and drains the bladder. But this is a complex system and it does require basically the brain and its ability to inhibit the need to urinate and the ability to control relaxation. The sphincter and the spinal cord so it’s a pretty exquisite and very detailed system, but it’s something that different areas of that process can have an issue that could be fixed or could be the cause of the incumbents. And then the bowel control is very similar instead of a bladder you have intestines and a colon and a rectum where a stool is stored. And there is a sphincter as well that controls your ability to hold the stool in place and again that involves the brain the spinal cord and the the muscle of the rectum and the colon involved for bowel control you

How and Why Should I Do Kegels?

Kegel exercises are for strengthening pelvic floor muscles. They involve contracting and relaxing, clenching and releasing those muscles. Also called pelvic floor exercises, Kegels strengthen and coordinate the muscles that support the bladder, rectum, uterus and small intestines. The strengthening, in turn, helps to prevent the accidental passing of stool or gas, stops bladder leaks, and improves orgasm.

What are the benefits of Kegel exercises?

1. Prevent pelvic organ prolapse

Pelvic floor muscles support abdominal organs such as the stomach, bladder, intestines and uterus. With age, the weakening and slowing down of these muscles may lead to pelvic organ prolapse (POP).

A prolapse means the pelvic organs are displaced, drooping and fallen out of their normal position. In women, the pelvic organs may fall into the vagina or cause vaginal tissues to protrude from the body, particularly if the prolapse occurs after a hysterectomy.

Through regular Kegel exercises, pelvic floor muscles become stronger and more coordinated, reducing the risk of prolapse.

2. Avert incontinence

Pelvic floor exercises not only contribute to good posture and spinal stability, they also strengthen the muscular support for bladder and bowel function and help to maintain urinary and fecal continence. If you already have bowel or bladder incontinence, or drip after peeing, the exercises can help to relieve your symptoms.

3. Enhance sexual function

Kegel exercises improve sexual function. In men, they increase control over ejaculation and enhance the feeling experienced during orgasm. In women, the exercises improve flexibility and ease penetration. In addition, they provide the muscular strength to achieve orgasm while also making pregnancy and childbirth easier.

How should you do Kegel exercises?

1. Begin by identifying pelvic floor muscles

Kegel exercises do not require a lot of time, but targeting the right muscles is necessary. One of the easiest ways to identify the muscles is to stop urinating midstream by squeezing your muscles to hold the urine in. Another way of locating the muscles is to stop the passage of gas.

The muscles that help you to stop the passage of urine or gas are the ones you will need to work on. You only need to stop passing urine once or twice in order to identify the right muscles. After that, it is not advisable to perform Kegel exercises while urinating as that can lead to incomplete emptying of the bladder and increased risk of urinary tract infections.

2. Start slowly and improve with practice

Like other exercises, Kegels become easier with practice. Plan to begin slowly and build on your gains over time. For instance, you can start by squeezing your pelvic floor muscles for 3 seconds, releasing for another 3 seconds, and then repeating 10 times in a row. If you are not able to do 10 at time, begin with a lower number and increase with time.

3. Keep the focus

As you do these exercises, you will be tempted to flex the buttocks, thighs or abdomen. You may also find it difficult to increase the number of repetitions. Always target and exercise your pelvic floor muscles, pushing your body to complete at least one set of 10 Kegel exercises two to three times a day.

As you do the exercises, make sure to relax your pelvic floor muscles completely and to avoid holding your breath.

4. Perform Kegels anytime, anywhere

Kegel exercises are quite convenient. You can make them part of your routine and do them anywhere, whether brushing your teeth, driving to work, shopping for groceries or watching TV. Combining the exercise with another activity is a good way to remember your routine and see quick results.

Can Kegel exercises cause complications?

While the exercises are completely safe, you still need to do them the right way. For instance, you should not overdo Kegels as this may lead to straining when you visit the bathroom. You should also not do them as you urinate because that could increase your risk of urinary tract infections.

Kegel exercises are not for everyone. If your muscles are already tired, they will not respond if you try to contract them. Also, if your muscles are already tight, exercising them may cause more harm. Speak with your urologist to determine if you can benefit.

Are the exercises effective?

For those who do Kegel exercises regularly, the results are excellent. For example, urine leaks become less frequent within a few weeks of starting the exercises. Keep in mind that they have more impact when performed regularly over an extended period of time, such as doing them every day for at least 15 weeks. If you do not feel your symptoms are improving, you should speak with your doctor about alternative treatments.

At St Pete Urology, we offer personalized treatments for patients with urological problems. We will only recommend you do Kegel exercises after a thorough assessment of your condition. For more information on pelvic floor exercises and other treatment options for urologic disorders, visit the St Pete Urology website.

What to Expect at Your First Urology Appointment

Frequent urination, incontinence, sexual dysfunction, and other chronic issues can be embarrassing, painful, or even signs of a more serious condition. By seeing a urologist, you can ensure that these issues do not unnecessarily disrupt your life.

At St Pete Urology, we provide life-changing solutions for men and women with urinary tract problems and for men with issues affecting their reproductive organs. Our urologists diagnose and treat these conditions every day, so there is no need to be embarrassed about seeking help.

You should see a urologist if you have:

  • Blood in your urine
  • Painful urination
  • Poor bladder control
  • Urine leakage or flow issues
  • Sudden change in the color or smell of your urine
  • Pain in your groin, lower back or abdominal area
  • Hernia
  • Fallen bladder protrusion
  • Overactive bladder (OAB)
  • Low sex drive
  • Recurrent urinary tract infections
  • Hormone imbalance, such as low testosterone
  • Kidney pain or kidney stones
  • Concerns with testicles, penis or prostate
  • Cancer of the bladder, penis, testicles, prostate or kidney

What should you expect during your first visit?

Whether you are referred by another doctor or find a urologist on your own, your first visit will be similar to seeing your primary care physician. The urologist will begin by reviewing your full medical history, particularly in relation to previous urological issues. The doctor will then run diagnostic tests and use the results to determine the cause and likely treatment for your condition.

Paperwork

When you arrive for your first appointment, you should expect to fill out paperwork. Depending on the reason for your visit, you may be required to complete a questionnaire. Because the questionnaire helps to evaluate your symptoms, it is advisable to track them beforehand and arrive at your appointment with specific information. Give as much detail as possible, rate the severity of your symptoms, and make a note of their timing.

Urine Sample

You will probably be asked for a urine sample during your first visit. The urine sample is analyzed in order to give the urologist an inside look at your urinary system. It helps to go to your appointment with a full bladder by drinking 16 ounces of water an hour before the appointment. If you feel the urge to empty your bladder as soon as you arrive at the urologist’s office, inform the receptionist that you are ready to provide your urine sample before you see the doctor.

Medical History

Once you are taken into the exam room, you will be asked questions about your medical history. State your symptoms clearly. Describe when they started, their timing and their severity. Be prepared with a written list of your current medications and their actual dosages, prior imaging studies, plus any over-the-counter supplements you are taking.

Physical Exam and Diagnostic Tests

Your urologist will conduct a physical examination and run diagnostic tests to determine the cause of your problem. For men, a digital rectal exam is the standard procedure to check the prostate. Other tests, such as a urethral swab, rule out sexually transmitted diseases and blood work can check the Prostate Specific Antigen (PSA) level.

If you are a woman dealing with recurring urinary tract infections (UTI), the urologist may order a urinalysis and a pelvic exam. A blood panel can determine hormone levels in women with low sex drive, and a cough stress test may indicate the cause of urinary incontinence. Computed tomography (CT) scan, magnetic resonance imaging (MRI), ultrasound, and sonography are also frequently relied on by urologists for testing.

Making an Informed Treatment Decision

After exams and diagnostic tests, the urologist will discuss with you the findings, help you understand your condition, and recommend possible solutions. At this stage, you should ask questions to be fully informed about your treatment options and their benefits and potential risks. Possible treatment options include physical therapy, medication or surgical procedures.

At St Pete Urology, we treat a full spectrum of urological conditions to help our patients overcome medical challenges and enjoy a better quality of life. Our compassionate, patient-friendly approach ensures that patients have a great experience with us from the very first visit.

No need to feel intimated or embarrassed when seeing a urologist. We see these issues every day and we are ready to help you. For more information about the diagnosis and treatment of urological problems, visit the St Pete Urology website.

Facts About Stress Urinary Incontinence in Women

What Is Urinary Incontinence?

Many women have a silent concern due to urinary incontinence. It somehow seems taboo to talk about the problem, even with a regular doctor or gynecologist. There are approximately 25 million Americans who suffer from some type of urinary incontinence and as many as 80 percent of them are women. Pregnancy, giving birth, going through menopause and even the unique structure of the female urinary anatomy contribute to the disparity between male and female sufferers.

Urinary incontinence is defined as the unintentional loss or leakage of urine. The term “stress incontinence” means that when the body is under exertion it puts pressure on your bladder and the bladder leaks. Some triggers for stress incontinence include running, coughing, sneezing, bending or heavy lifting.

Bladder Retraining

The bladder is controlled by muscles and it can be trained. You may wish to keep a voiding diary, noting things like times of urination, duration between bathroom trips, types of food or beverages that seem to trigger urgency or frequency of bathroom trips. This journal describing your symptoms and potential causes can help if you need to visit a urologist for treatment.

As you establish baselines for your urinary problem, you can start behavior modification and training your bladder. Here’s how to do it:

  • Schedule Your Bathroom Breaks

Start by scheduling bathroom visits. Increase the time periods between those breaks by adding 15-minute increments. Visit the bathroom even if you don’t feel you need to go. You will be working toward longer and longer stretches of time between breaks.

  • Perform Kegel Exercises

When you learn to isolate the muscles that control urine flow, you can practice having more control by performing Kegel exercises while sitting, standing or during urination.

Other Tips to Prevent Overactive Bladder:

  • In addition to bladder retraining, you may want to eliminate or limit beverages that increase the need for urinating, like coffee, tea or caffeinated sodas.
  • Drink fewer fluids before bedtime.

Treating Overactive Bladder With Behavioral Modifications

You needn’t feel alone when you have urinary incontinence. Make an appointment with a urologist who is trained to deal with your condition. Your doctor may take any of the following approaches beyond what you can do on your own:

  • Recommend biofeedback,
  • Send urine or drawn blood to the lab to determine how completely you empty your bladder.
  • Prescribe medicine to address bladder function or tighten muscles.
  • Employ a medical device, such as a urethral insert or a pessary.
  • Try nerve stimulation, using a mild electric current to nerves in the bladder that help control urination.
  • Suggest surgery if indicated.

If you have stress incontinence, you may be limiting yourself from fully participating in life events. Seek treatment from experts like those at St Pete Urology, where surgeons perform hundreds of successful sling surgery procedures every year. For more information, visit the St Pete Urology website.

Treating Voiding Dysfunction in Women

Voiding dysfunction is a problem that affects women in increasing numbers, and it can be an embarrassing condition that curtails daily activities. Voiding dysfunction can take several forms, including urinary incontinence, painful urination and interstitial cystitis. Women over 40 are especially susceptible and it can be uncomfortable subject to bring up in conversations with doctors.

Preliminary Diagnosis

Although your primary care doctor can perform simple testing for a urinary tract infection, you may save time and discomfort by seeing a qualified urologist first. Some urological procedures for diagnosis include:

  1. Urinalysis
  2. Uroflow electromyogram (EMG)
  3. Abdominal X rays (KUB)
  4. Cystoscopy
  5. Uroflowmetry

Initial Care for Voiding Dysfunction

Your primary care doctor may recommend dietary changes such as reducing the amount of alcohol and caffeine you consume. Your doctor may even warn you about the use of tobacco if you are a smoker.

Kegel Exercises

Kegel exercises are often effective at improving voiding dysfunction in the form of bladder leakage in women. Kegel exercises (or Kegels) simply increase the strength of the pelvic floor, and can be done in bed or while emptying the bladder. However, there are instances when the woman’s pelvic floor is too tight and Kegels are not recommended. A urologist can diagnose and recommend the appropriate treatment for the various types of voiding dysfunction.

Additional treatments for voiding dysfunction include muscle relaxants, pelvic floor therapy, self-catheterization and insertion of a neuromodulation device.

Painful Urination and Treatment

Besides being unable to control bladder flow, painful urination is another dysfunction associated with voiding. You may be diagnosed with interstitial cystitis. Some refer to the condition as BPS (bladder pain syndrome). Interstitial cystitis is associated with bladder pain, overactive bladder, bladder distention and, at times, bladder stones.

Once your physician has isolated the source of the problem, he or she may recommend a medication that allows the bladder to relax.

Why Get Diagnosed and Treated for Voiding Dysfunction

Successful treatment of voiding dysfunction will allow you to enjoy life better, with:

  1. Fewer accidents
  2. More control over where and when you void your bladder
  3. Longer intervals between needing to urinate

For those who live in the St Petersburg, Tampa or Clearwater areas, St Pete Urology offers treatment and relief of this condition. Schedule a consultation today to learn how our experienced team offers the most advanced technology, minimally invasive surgery options and compassionate care.

What is the best treatment for urinary incontinence?

The sling procedure is the best, safest and most effective surgical operation for treating urinary stress incontinence. During the procedure, the urologist creates a sling using an artificial mesh, animal tissue or human tissue and places it under the urethra to support the urethra and bladder neck and to prevent unintentional urine loss.

What is stress incontinence?

Unintentional urine leakage (loss) occurs when you engage in physical activities or movements, such as running, sneezing, heavy-lifting, coughing or any action that puts stress (pressure) on your bladder. The condition is triggered by the weakening of pelvic floor muscles (the muscles supporting your bladder) and urinary sphincter muscles (muscles that control the release of urine).

Normally, as the bladder fills with urine and expands, the valve-like muscles in the urethra remain closed to prevent leakage of urine until you have reached the bathroom. However, if those muscles weaken and are not able to withstand pressure, then anything that exerts pressure on your pelvic and abdominal muscles can cause unintentional loss of urine.

Your sphincter and pelvic floor muscles may weaken because of:

  1. Type of childbirth/delivery.
  2. Previous pelvic or abdominal muscle surgery.
  3. Obesity/increased body weight.
  4. Smoking, which may trigger frequent coughing.
  5. Prolonged involvement in high-impact activities, such as running and jumping for several years.
  6. Age — the muscles weaken with increasing age.

You have stress urinary incontinence if you frequently leak urine when you:

  1. Sneeze
  2. Cough
  3. Stand up
  4. Laugh
  5. Have sex
  6. Get out of your car
  7. Exercise
  8. Lift something heavy

While stress incontinence does not imply that you will lose urine every time you do these things, you will most likely experience frequent leakage of urine when you engage in pressure-increasing activities.

Why should you undergo the sling procedure for stress urinary incontinence?

Having stress incontinence can be really awkward and embarrassing. In fact, with frequent leakage of urine, you may begin isolating yourself and limiting your social and work life. For instance, you may find it difficult to engage in exercise and in different leisure activities for fear of urine leakage. But with treatment, you can manage the incontinence and improve your overall quality of life and well-being. The sling procedure is ideal for you if you’ve tried other measures and still find urine leakage disruptive to your life.

How does the sling procedure work?

The sling procedure is aimed at closing your urethra and the neck of your bladder. For the procedure, your surgeon uses strips of synthetic mesh, animal tissue, donor tissue or your own tissue to develop a sling (hammock) that is inserted under your urethra or bladder neck. Once the sling is placed, it supports the urethra and ensures it remains closed — particularly when you are engaged in pressure-increasing activities such as coughing, laughing, sneezing or exercise — preventing the leakage of urine.

How is the sling procedure performed?

Before the procedure begins, you are placed under either general or spinal anesthesia. With general anesthesia, you will remain asleep throughout the procedure and will feel no pain. With spinal anesthesia, you are completely awake except that the area of your body from the waist down is numb and you don’t feel pain as the procedure is performed. Following application of anesthesia, the urologist places a tube (catheter) into your bladder to drain any urine already inside it.

The surgeon then proceeds to place the sling in any of the following ways:

1. Retropubic Method (Tension-Free Vaginal Tape/TVT Method): The surgeon makes a tiny incision inside your vagina, just under the urethra. Two other cuts are then made above your pubic bone — large enough to allow needles through. The surgeon uses a needle to place the sling beneath the urethra and behind the pubic bone. Using stitches or skin glue that is easily absorbed by the body, the surgeon closes off the cuts.

2. Single-Incision Mini Method: The surgeon makes a single tiny incision in the vagina, then passes the sling through it. No stitches are used to attach the sling, but over time the scar tissue grows and forms around it, keeping it in place.

3. Transobturator Method: The surgeon makes a tiny cut inside the vagina, just under the urethra. Two more cuts are made, one on each side of the labia (folds of skin on either side of the vagina). Using the incisions, the surgeon inserts the sling under the urethra.

At St Pete Urology, we perform hundreds of sling surgery procedures every year with remarkable results for our patients. The sling procedure is an outpatient operation that takes about one hour to complete and the patient is free to go home the same day. After the procedure, we arrange for follow-up sessions with our patients in the doctor’s office to assess the efficacy of the procedure and help with any complications that may arise. So if you are feeling embarrassed by stress urinary incontinence or have tried other measures without success, check with us to find out if the sling procedure can help you overcome the condition. For more information, visit the “St Pete Urology” site.

Bladder Control Problems in Women

While there are many types of bladder problems in women, including an overactive bladder and urinary incontinence, one of the most common problems related to the bladder is urinary tract infection (UTI).

Urinary tract infection occurs when a bacteria gets into the urethra and then moves into and multiplies in the bladder. The bacteria may even spread to other parts of the body from the bladder, resulting in complications such as blood poisoning and kidney failure.

Causes of urinary tract infections in women

The urethra is located close to the anus, making it easier for bacteria found in the large intestine (such as E. coli) to move from the anus into the urethra. Once inside the urethra, bacteria can move into the bladder and begin to multiply, resulting in inflammation of the bladder. If the infection is not treated, the bacterial infection may spread into the kidney or the blood.

Women have a higher risk of bladder infection than men because their urethra is shorter, allowing bacteria to gain quick access to the bladder. Bacteria also may be introduced into a woman’s urinary tract during sexual intercourse. Other factors that make women more susceptible to UTIs include diabetes, older age, surgery, catheterization, menopause, immobility and improper hygiene.

Symptoms of urinary tract infection in women

Women with UTIs may have the following symptoms:

  1. Cloudy, bloody, dark or strange-smelling urine.
  2. A burning sensation or feeling when urinating.
  3. An intense or frequent urge to urinate, although very little urine comes out when they do.
  4. Cramping, pressure or pain in the lower abdomen or back.
  5. Feeling shaky or tired.
  6. Low-grade fever or chills (indicating that the infection has reached the kidneys).

Seeking for medical help

Even though most urinary tract infections do resolve on their own, it is important that women seek medical help when having symptoms that are very uncomfortable or when their symptoms last for more than 5 days. Similarly, UTIs may require medical help when there is a sudden worsening of fever or of symptoms. Likewise, women who are diabetic or who are pregnant should seek medical help.

During a visit to a urologist or doctor, a urine test may be ordered to check for offending bacteria before antibiotics are given. In some instances, specialized laboratory testing may be necessary and an intravenous urogram (IVU) may be done to evaluate the urinary tract. Another diagnostic option is cystoscopy, a procedure in which a thin flexible tube is used to look into the bladder.

Treatment of UTIs in women

Generally, most cases of urinary tract infections are easy to treat as long as the diagnosis and treatment begins early. Therefore, it is important to visit a urologist as soon as your UTI symptoms worsen or last longer than expected. Treatment is usually done using antibiotics for about 5 days. However, more complicated cases of UTIs, such as those occurring during pregnancy, may call for administration of antibiotics for a longer duration. Even if you get better soon after starting to take antibiotics, make sure to continue the treatment so that all bacteria are killed and to prevent a recurrence of the infection.

The doctor also will recommend that you drink plenty of water to prevent dehydration and to relieve symptoms. Paracetamol may be prescribed for relieving UTI pain and discomfort, while methenamine hippurate (which is effective in stopping bacterial growth in the urinary tract) may be used as an alternative treatment in women who cannot use antibiotics. More severe cases of UTIs may require hospital admission, where antibiotics are administered through intravenous (IV) drips.

Prevention of urinary tract infections

Because women are at higher risk of getting UTIs than men, they should always take the necessary steps to prevent the infections. Ways of preventing UTIs include:

  1. Urinating soon after sexual activity.
  2. Drinking copious amounts of fluids.
  3. Practicing proper hygiene.
  4. Avoiding fragrant feminine products (not douching).
  5. Wearing cotton underwear.
  6. Avoiding tight-fitting-pants.
  7. Taking showers instead of baths.
  8. Avoiding bladder-irritating fluids such as alcohol and caffeine.

At St Pete Urology in St Petersburg, Fl., we have treated bladder and urinary tract problems in women for decades. Through our skilled, experienced and professional board-certified urologists, we give the most accurate diagnosis and administer the most effective treatments. If you have a bladder problem or have symptoms of UTIs, come see us for quick relief. For more information on the diagnosis, treatment and help with bladder problems, visit the “St Pete Urology” site.