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.

4 Effective Treatments for Urinary Incontinence in Men

There is no single treatment for urinary incontinence that works for all men. The treatment that your urologist recommends will depend on the type of urinary incontinence you are having and the severity of the symptoms on your life. At St Pete Urology in St Petersburg, Fl, urologists may even consider your lifestyle and your treatment preferences, beginning with the simpler treatment options before going for the complex ones.

In fact, many men usually regain urinary control after changing a few of their habits and engaging in exercises to strengthen their bladder muscles. But if the behavioral treatments fail to yield desirable results, the urologist may choose to apply a continence device or prescribe medications. In some men, surgery is the right treatment for their urinary incontinence.

If there is no cancer, infection or other underlying cause of urinary incontinence that can only be cured by surgery, the urologist will complete the treatment in stages, starting with behavioral changes and performing surgery only as a last resort. Here are the 4 treatments that are effective for urinary incontinence in men.

1. Behavioral treatments

For some men, treatment of urinary incontinence is as simple as planning for regular bathroom trips or limiting fluid intake to certain times of the day. This type of therapy for UI is called bladder training or timed voiding. So at St Pete Urology in St Petersburg, Fl, the urologist may recommend some changes in your urinary habits, diet or lifestyle to help you gain control over your bladder. As you regain control, you will be able to extend the time you take between bathroom trips. Bladder training (timed voiding) also includes Kegel exercises for strengthening pelvic muscles to enable the bladder to hold urine longer.

2. Medicines

Urologists prescribe medicines that can help to improve bladder control in men with urinary incontinence. The medicines work in different ways, with some blocking abnormal nerve signals sent at the wrong time while others slow down urine production. Still other medications help relax bladder muscles or shrink an enlarged prostate. The most common drugs used for urinary incontinence in men include:

(a) Alpha-blockers: Drugs such as Doxazosin (Cardura), Terazosin (Hytrin), Alfzosin (Uroxatral) and Tamsulosin (Flomax) are used to relieve urinary incontinence caused by bladder outlet obstruction and prostate enlargement. These drugs relax the smooth muscles of the bladder neck and prostate, encouraging the normal flow of urine and preventing abnormal contractions of the bladder, which may cause incontinence.

(b) Imipramine: The drug Tofranil, which belongs to the tricyclic antidepressants class, works by relaxing muscles and blocking nerve signals that might lead to bladder spasms. This helps to relieve urinary incontinence in men.

(c) Antispasmodics: Drugs such as tolterodine (Detrol LA), trospium chloride (Sanctura), solifenacin succinate (VESIcare), darifenacin (Enablex), oxybutynin (Ditropan XL) and Finasteride (Proscar) work by relaxing bladder muscles and relieving muscle spasms, which in turn helps to relieve urinary incontinence.

(d) 5-alpha reductase inhibitors: Drugs such as dutasteride (Avodart) and finasteride (Proscar) inhibit the production of DHT, a male hormone believed to be responsible for prostatic enlargement. When administered, the 5-alpha reductase inhibitors relieve urinary incontinence through the shrinking of an enlarged prostate.

3. Self-catheterization

Urologists at St Pete Urology in St. Petersburg may recommend self-catheterization for men having overflow incontinence due to a weak bladder or a blockage. The catheter (a thin, hollow tube) is inserted through the urethra to reach the bladder and help drain the bladder in men having urinary incontinence. In some cases, urologists may recommend self-catheterization when their evaluations have established that surgery is not ideal for their patients.

4. Surgical treatments

If you are suffering from urinary incontinence because of a nerve-damaging event, such as radical prostatectomy or spinal cord injury, then surgery is the best treatment for the condition. The surgery performed may be a urinary diversion, male sling or artificial sphincter.

(a) Urinary diversion surgery: If all the bladder function has been lost or the bladder must be removed after nerve damage, the urologist may consider an operation to create a urinary diversion. During this procedure, the surgeon will create a reservoir by removing a small piece of your small intestine and then redirecting the ureters to the reservoir. A stoma (an opening in the lower abdomen that is used to drain urine into a bag or through a catheter) also may be created by the surgeon.

(b) Male sling surgery: In the sling procedure, the surgeon boosts the support for the urethra by wrapping it with a strip of material and then attaching the ends of the strip to your pelvic bone. The sling will ensure there is constant pressure on the urethra and that the urethra does not open unless the patient consciously decides to release the urine.

(c) Artificial sphincter surgery: At other times, the urologist may decide to implant a device (artificial sphincter) that can keep the urethra closed until the patient reaches the bathroom and is ready to pass urine. This operation helps men with urinary incontinence due to weak sphincter muscles or nerve damage that has impaired the functioning of the sphincter muscle.

At St Pete Urology in St Petersburg, Fl, we know that urinary incontinence in men is an underreported and under-diagnosed problem, as many patients are too embarrassed to seek treatment. We apply a personalized, friendly, compassionate and multidisciplinary approach in the screening, diagnosis and treatment of urological problems. This approach ensures that all types of urinary incontinence are correctly diagnosed and treated promptly. If you suspect that you or your loved one is suffering from urinary incontinence, visit St Pete Urology for effective treatment. For more information on urological disorders, visit the “St Pete Urology” site.

Causes of Urinary Incontinence in Men

Urinary incontinence in men is the unintentional or accidental loss of urine. In the United States, up to 17 percent of men may suffer from urinary incontinence, with the frequency of the condition increasing with age. Urinary incontinence is not a disease but just the symptom of an underlying condition, such as a prostate problem, injury to the urinary tract or a disease of the nerve system.

There are three major types of urinary incontinence in men:

  1. Stress incontinence: It is the leakage of urine that occurs when the pressure inside the bladder increases when doing things such as sneezing, coughing, climbing or lifting.
  2. Urge incontinence: This is the accidental loss of urine that occurs when the need to urinate is too strong and uncontrollable.
  3. Overflow incontinence: This is the unintentional loss of urine characterized by dribbling or leakage of urine in small quantities. It can happen even when you do not feel the urge to urinate.

Causes of Urinary Incontinence in Men

There is no standout factor among the causes of urinary incontinence in men. However, prostate gland problems and their treatment are often the most common causes of UI in older men. The prostate, which is normally the size of an almond, is found at the opening of the bladder. The principal role of the prostate is adding fluid to the semen during ejaculation. The problem with the prostate gland is that it tends to increase in size as a man grows older and extend to the point of impeding or slowing down the flow of urine from the bladder.

Other common causes of male urinary incontinence are muscle and nerve control problems. At the opening of the bladder is a muscle called the urinary sphincter, which controls the opening and closing of the bladder. Anything that affects the muscle or nerve function of the sphincter can result in urinary incontinence. The common underlying factors in urinary incontinence include:

  1. Benign Prostatic Hyperplasia (BPH): Most men experience prostatic enlargement after the age of 40. As the prostate grows bigger, it compresses the urethra and may impede the flow of urine, resulting in urinary incontinence.
  2. Prostate surgery: The surgical removal of the prostate gland during the treatment of prostate cancer or BPH can damage or weaken the muscles controlling urine flow, resulting in stress urinary incontinence.
  3. Urinary tract infections: The infections can cause an overactive bladder, which may be characterized by urinary incontinence
  4. Diabetes: Diabetes can cause damage to the nerves or muscles controlling how the bladder opens and closes. It also can cause frequent urination or an overactive bladder. Obesity, which is quite common in type II diabetes, can make urinary incontinence worse by exerting more pressure on the bladder.
  5. Stroke: Stroke refers to brain damage that is caused by decreased flow of blood to the brain because of a clot or a leaking blood vessel. When stroke occurs there may be loss of muscle control and decreased sensation, which may lead to urinary incontinence. Stroke also can make it difficult for a man to get up and walk to the bathroom, which also contributes to urinary incontinence.
  6. Neurological diseases: The two most common neurological diseases that may cause urinary incontinence are Parkinson’s disease and multiple sclerosis. The conditions make it difficult for nerve signals to be sent and received between the central nervous system(CNS) and the bladder, increasing the risk of urinary incontinence.
  7. Spinal injury: Nerve impulses transmitted between the brain and bladder usually come through the spine. Therefore, any severe injury to the spine can lead to urinary incontinence.
  8. Temporary causes of urinary incontinence: Temporary episodes of urinary incontinence may be caused by drinking too much alcohol or caffeine, constipation, or depression. Medications such as diuretics for treating high blood pressure, medications for depression and over-the-counter medications containing decongestants or antihistamines also can cause urinary incontinence.

When to see a doctor

If you experience urinary incontinence symptoms such as inability to control the urge to urinate, overflowing, or leaking urine under stress, then you need to talk to a urologist. At St Pete Urology, St Petersburg, Fl, we encourage men not to feel embarrassed by the symptoms of urinary incontinence and wait too long before seeing a doctor because the condition can get worse. We have established a multi-disciplinary and compassionate, patient-centric approach to treating urological disorders in order to encourage all men with the symptoms of UI to seek prompt treatment. So, if you are experiencing any UI symptoms, visit St Pete Urology as soon as you can because seeing a urologist early increases the likelihood that you will get an effective treatment that will help you find relief. For more information, visit the “St Pete Urology” site.

What is Urinary Incontinence in Men?

What is Urinary Incontinence in MenAccidental or unintentional leakage of urine is called urinary incontinence (UI). While urinary incontinence in men is not a disease, it is usually a symptom of an underlying urinary tract problem, such as overactive bladder muscles, damaged or weak bladder muscles, nerve damage, and certain prostate conditions. In men, urinary incontinence can occur at any age, with young boys being slower than girls in developing bladder control and being more likely than girls to experience bedwetting (nocturnal enuresis). However, due to anatomical differences, adult men are less likely to experience urinary incontinence than adult women. In adult men, the prevalence of urinary incontinence increases with age, though UI is not an inevitable part of aging in men.Reasons for the occurrence of urinary incontinence in men

Urinary incontinence can happen when:

  1. The bladder muscles squeeze at the wrong time or if they squeeze too hard.
  2. The muscles around the urethra are either weak or damaged, allowing urine leakage even when you do not have a problem with your bladder squeezing at the wrong times.
  3. You frequently experience incomplete emptying of the bladder when you void, increasing the volume of urine in the bladder significantly and resulting in loss of urine when the bladder gets too full.
  4. There is a blockage of the urethra which causes urine build-up in the bladder and results in eventual leakage.

Types of urinary incontinence in men

Urinary incontinence can be either a short-term problem or a long-term issue. Short-term urinary incontinence in men is usually caused by an underlying health problem or an ongoing treatment while long-term (chronic) incontinence may be caused by a wide range of physiological problems. The types of urinary incontinence in men include:

  1. Stress incontinence: Leakage of urine when a man sneezes, coughs, laughs, lifts something, changes position, or performs an activity that strains or puts stress on his bladder.
  2. Urge incontinence: It is an urge to urinate that is usually so strong that a man can’t make it to the toilet in time. This type of urinary incontinence can happen when the bladder squeezes at the wrong time, resulting in loss of urine even when the bladder has only a small quantity of urine. Overactive bladder is a common example of urinary incontinence, though not all men with overactive bladder will experience leakage of urine.
  3. Overflow incontinence: Occurs when a man has the urge to urinate but can only release a small amount of urine at a time. Since the bladder does not empty fully as it should, the urine remaining in the bladder leaks at a later time.
  4. Functional incontinence: Occurs when a man cannot make it to the bathroom in time either because he is not able to walk on his own or because something prevents him from reaching the bathroom promptly.
  5. Total incontinence: When a man’s sphincter muscles can no longer work, urine will always leak and the man will have no control on when to urinate. This is called total incontinence.

Causes of urinary incontinence in men

Different types of urine incontinence have different causes.

  1. Stress incontinence: Can occur after the prostate gland is removed or when there is damage to the nerves or the sphincter, which reduces the support afforded to the lower part of the bladder.
  2. Urge incontinence: Occurs when bladder muscles squeeze extremely hard and make it difficult for the sphincter to hold back urine. As a result of hard squeezing, a man will experience a very strong urge to urinate.
  3. Overflow incontinence: Can occur when something blocks the urethra, resulting in the build-up of urine in the bladder. Overflow incontinence may be caused by enlarged prostate, prostate cancer, a narrow urethra, or weakened bladder muscles.

In men, urinary incontinence is usually related to prostate problems and various treatments. Nevertheless, excessive drinking of alcohol may make incontinence worse while over-the-counter or prescription drugs such as antidepressants, sedatives, diuretics, narcotics and sedatives can affect the type of symptoms experienced.

Diagnosis and treatment

The diagnosis of urinary incontinence involves a medical history and a physical examination, but also may include keeping a bladder diary. Your urologist will examine you physically and ask some questions about your past health and current symptoms before ordering any tests. Usually these steps will enable your urologist to determine the cause of your urinary incontinence. But at other times, particularly when your symptoms have more than one cause or have an unclear cause, the urologist may include urodynamic testing and an ultrasound in order to come up with a more accurate diagnosis.

The treatment offered will depend on the type of incontinence and how the condition is affecting your life. Generally, urologists treat urinary incontinence in men using medicines, behavioral treatments (such as Kegel exercises and bladder training), surgery, or a blend of two or more of these therapies. A few men may require surgery to regain their bladder control, but most men do not. Apart from the treatments offered by the urologist, there are a few things that men can do at home to help them regain control over their bladders. Such actions include:

  1. Cutting back on caffeine-containing drinks, such as tea and coffee. Alcohol should be reduced to not more than 1 drink per day while fizzy drinks such as soda pop also should be reduced.
  2. Eating foods highly rich in fiber to prevent constipation.
  3. Keeping a healthy weight.
  4. Stopping cigarette smoking. Talk to your urologist about stop-smoking medicines and programs.
  5. Practicing double voiding whenever you urinate. This means trying to lose as much urine as you can, relaxing for a short while, then going again.
  6. Visiting the bathroom many times per day. It is important to wear clothes that you can remove with ease and make your route to the bathroom as clear and quick as possible.
  7. Engaging in simple pelvic-floor exercises, such as Kegels.
  8. Using a diary to monitor your urinary symptoms and any leakage of urine. This will help you and your urologist choose the best treatment for you.

Are you experiencing symptoms of urinary incontinence? Do not feel embarrassed to inform your urologist about them. Most men with urinary incontinence can be helped or effectively cured. At St Pete Urology located in St Petersburg, Fl., we fix all urinary incontinence issues affecting men. We have done this for many decades and have some of the best technologies and techniques to help men regain control over their bladders. For more information, visit the “St Pete Urology” site.