Understanding incontinence


RAPID CITY, S.D. — Incontinence is an extremely common condition experienced by women of all ages which often impacts their comfort in everyday activities. From riding a bike to playing with children, the threat of incontinence often stops women from doing things they enjoy.

According to Dr. Heather Moline, a gynecologist at Rapid City Medical Center, many women think that occasional incontinence is normal, but she urges them to seek help from their doctor. “Incontinence is not something you have to live with,” Dr. Moline says. “There are many minimally invasive or free interventions that can make a significant impact on your incontinence.” Finding the right treatment depends on what kind of incontinence a woman has.

One type is called stress incontinence caused by a sneeze, cough, or physical activity like lifting a heavy object or doing a jumping jack. The first step toward fixing stress incontinence is strengthening the pelvic floor and muscles around the bladder through pelvic physical therapy. This helps to “retrain” the bladder and regain control. When physical therapy alone is not enough, stress incontinence can also be treated surgically with a bladder sling. Newer treatment options include laser devices like the MonaLisa Touch and Votiva, which help increase blood flow to muscle tissue, healing and strengthening the muscles.

The second type of incontinence is urge incontinence, where a woman feels a very sudden, strong urge to urinate which leaves very little time before the bladder begins to empty. Urge incontinence is commonly treated with a combination of medication and pelvic physical therapy. Some women can experience a mix of both stress and urge incontinence. With these patients, Dr. Moline says that pelvic physical therapy is often the first step, with other treatments added on a case-by-case basis.

Additional lifestyle changes can help women counteract incontinence. Limiting caffeine and alcohol consumption can help, as these can worsen incontinence. Changes in diet and exercise can also help, though exercise may be difficult for some. Certain exercises like squats or jumping jacks will often irritate the bladder and cause leaking, but Dr. Moline encourages women to find exercises that their body is comfortable with. “Women who lose 5-15 pounds notice they have a significant improvement in their incontinence just from the weight loss alone because it lessens the pressure on the bladder,” Dr. Moline says.

For elderly patients, incontinence can be one of the only signs of a urinary tract infection (UTI). “One of the things I like to remind elderly patients is that they don’t have the same signs or symptoms of UTIs they may have had in their youth,” Dr. Moline says. Many elderly patients will have an asymptomatic UTI with complaints of incontinence as the only indication that something is wrong. If left untreated, a UTI can develop into a much more serious infection called urosepsis.

Regardless of age or circumstance, Dr. Moline encourages people experiencing incontinence to seek help in alleviating your symptoms.

“Women of all ages think that a certain amount of incontinence is normal,” Dr. Moline says. “The truth is more complicated. Some incontinence can happen to anyone, men or women, but a persistent, daily problem isn’t normal and there are things that can be done to make it better. A lot of people think that nothing can be done to alleviate symptoms and that it is a normal after-effect of having children. There are a lot of interventions we can do to make it better.”

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