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You don’t have to live with incontinence

By Gregg Eure, M.D.

Urinary incontinence in men and women is much worse than a nuisance. The inability to control your bladder can cause significant restrictions on your daily activities and your overall quality of life. Maybe you decline an old friend’s invitation to lunch for fear of embarrassment. Maybe you stop walking for exercise or playing golf because you don’t want to stray too far from a bathroom. In the worst cases, incontinence leads to diminished self-esteem, social isolation, depression and a general decline in your health.

With an aging population, we expect to see an increase in urinary incontinence. However, there is a broad and growing array of medicines, surgical treatments, devices and personal training available that can help you preserve or reclaim bladder control and your quality of life. The most important first step is to see a Urologist. Diagnosing the underlying cause of incontinence allows your physician to design a treatment plan just for you.

Sometimes, the reason is obvious. In men, prostate cancer surgery can result in incontinence. One of the most successful developments is a surgically implanted sling that bolsters the muscles controlling urine flow. Many men receiving these slings report they can stop wearing absorbent garments or pads.

On the opposite side of incontinence, an enlarged prostate restricts urine flow, making it difficult for men to empty their bladders. This equally troubling condition called Benign Prostatic Hyperplasia or BPH leads to frequent trips to the bathroom that can ruin sleep and limit activities. Worse, it can lead to overflow incontinence and bladder damage. BPH can be readily addressed with medication, surgery or a minimally-invasive laser procedure using the Greenlight™ High Performance System that relieves pressure on the urethra and improves urine flow. The result is less urgency and fewer trips to the bathroom.

In women, incontinence can be caused by the decline of pelvic muscles that control urine flow due to aging or childbirth. For this condition, there are also implantable slings which bolster residual muscle function. There are also specialized exercises you can do to improve urinary muscle control.

Incontinence affecting women falls into several categories. Stress incontinence leads to leakage when you cough or sneeze, exercise or rise from a sitting position, which puts pressure on the bladder. Urge incontinence, also known as overactive bladder, creates a strong, uncontrollable urge to urinate which can lead to leakage. Overflow incontinence occurs when the bladder does not empty normally. Both Urge and Overflow incontinence can cause women to urinate only a little each time, which leads to more frequent bathroom trips.
Of course, each patient is unique. A treatment plan may include a combination of medication, surgery, exercises and behavior modification.

Some people mistakenly believe that urinary incontinence is an inevitable result of aging, but believe me, it can often be controlled or cured. With so many potential solutions available, there is no reason to let incontinence ruin your life. See your doctor and get back in control!

Gregg Eure, M.D., is a board certified Urologist with Urology of Virginia, a member practice of Sentara Medical Group. He is also a Fellow of the American College of Surgeons, Research Chairman for Urology of Virginia and an assistant professor at Eastern Virginia Medical School. Dr. Eure is an investigator on many clinical trials including the treatment of BPH.

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