I Had Surgery for Stress Incontinence and Now I Have Urge Incontinence! What Happened?

There are multiple types of incontinence, and I have discussed them on my SharePost blog previously. What happens when you have been diagnosed with stress incontinence and have undergone surgery and you are still wet? Stress incontinence is traditionally the type of incontinence where one loses bladder control with a cough, sneeze, laugh, or activity.

For the most part, surgical correction is the best way to treat it. I am not going to go into the details of surgeries for stress incontinence. But, I do want to discuss what happens when after surgery you end up with urge incontinence.

Urge incontinence is what is often referred to as overactive bladder (watch a video about overactive bladder). It is where the bladder muscles squeeze without a signal from the brain. It may just cause frequency of urination, but some people have leakage of urine.

So, here you are, having had surgery for your stress incontinence, and now you find that you have increased frequency of urine and even loss of urine unexpectedly, not related to activity like is was before. This is very frustrating, but it has a name - De Novo Urge incontinence. De Novo is Latin for "new." This means that you have acquired a new type of incontinence after getting a different type fixed.

I recently read a journal article that reports about 27% of people (mostly women) have urge incontinence after surgery for stress incontinence. This is a remarkably high number in my opinion, but I do find it is often true. No one knows how to predict who is at risk to have urge incontinence after surgery.

There is good news, however. Post-operative urge incontinence is easily treated with medications. There are at least five different medications on the market for overactive bladder. I truly don't believe that one works better than the other for this situation, and not every medication works well on every person, so it may take some trial and error before you find one that works well for you. Even better news, most people don't need to be on the medications forever either. Sometimes you just need to retrain your bladder for three to six months with the medications.

So why does this happen? There are many theories for this. I think it is because of the bladder's personality. Imagine that your bladder has not had to hold very much urine over the years and was able to leak whenever it felt like it. Now, after surgery, it has to do its job even better and hold more. You probably lost capacity over time, but by taking medications for a few months, you can train the bladder to hold more.

If you find that after surgery, you are having these problems, please go back and see your surgeon. There are some other situations that can cause these symptoms that are more serious, and would need to be evaluated. The important thing to remember is to not get discouraged, and there is an easy solution!

Behavioural Therapy and Male Incontinence

Urinary incontinence is a condition that affects millions of men worldwide and it is caused by a variety of reasons. One of the most prominent cause is benign prostatic hyperplasia (BPH), a natural enlargement of the prostate gland that occurs as a natural part of aging.

First of all don’t panic just because I said it is natural enlargement of the prostate and it happens as men age, this doesn’t mean that all men will have incontinence at some point in life.

Benign prostatic hyperplasia or BPH is related to age factors such as uncontrolled hormone balance and causes commonly known as “overflow incontinence“. This type of incontinence occurs when a certain individual is unable to empty their bladder completely during a deliberate urination session due to constriction or blockage of the urethra, in BPH cases the enlargement of the prostate blocks the urethra.

Since the bladder depends on a clear urethra to empty itself properly, pressure can build up inside and force urine out past the blockage without warning.

The first line of defence against BPH is behavioural therapy. Maintaining a healthy and active lifestyle will help preserve muscle tone in the pelvic area. Some say that sex is also a good way to prevent BPH as regular ejaculation helps maintain muscle tone in the pelvic and urinary sphincter area, but unfortunately there is no medical evidence to back this claim.

Not to worry if you haven’t lived a healthy life up until now, there are a number of therapies available to help you improve you condition. Bladder retraining and Biofeedback are two of them.

With bladder retraining you will learn how to strengthen the bladder muscles and adjust urinating time spans by voiding at repetitive, timed intervals. This will improve the bladder’s capacity and extend the interval between voiding.

Biofeedback is also a type of behavioural therapy, where a simple instrument detects when a chosen muscle relaxes or contracts and provides a secondary method of feedback for the patient, such as a light or sound. The added feedback allows patients to exercise and improve control of selected muscles.

It is important to highlight the fact that with incontinence there isn’t a set treatment for all patients, each case should be accessed individually. Because what works for one patient might not work for others. So our last piece of advice is, if you are experiencing some sort incontinence episodes talk to your GP and let him suggest what is the best treatment for your type of incontinence.

Prostate Cancer and Bladder Weakness

For men prostate cancer is like breast cancer for women, many are concerned when they hear these words. Currently prostate cancer is the most common form of cancer diagnosed in men here in the UK. According to the NHS 35,000 men are diagnosed with it every year and one man dies every hour of the disease.

I must confess I was baffled when I first read these figures. To be honest I was more scared than baffled. Why? For the simple fact that it is also the second most deadliest cancer, behind only lung cancer.

In most cases cancer is a hereditary disease, but there are ways to prevent this malignant menace.

1. Healthy Diet based on anit-prostate cancer foods
2. Healthy sex life
3. Aerobic Exercises
4. Eat more Cereal high in Flax

Source: Ask Men

A common side-effect of prostate cancer is bladder weakness; currently the condition affects 3.6 million UK men, making it just as common as asthma or arthritis.

With both disease and condition closely related Tena Men made a partnership with The Prostate Cancer Charity. The partnership is aimed to support men with prostate problems, whilst highlighting possible side effects, such as bladder weakness, and encouraging them to seek help and advice.

Tena is also using the partnership to promote the re-launch of its Tena Men incontinence products range. The product range remains the same, with Level 1 and Level 2 available, but packaging has been changed to become more masculine, more discreet and more consumer-friendly.

We will be discussing Tena Men incontinence products range in more detail in future posts. For now, all of us here at Allanda we wish all our readers a Merry Christmas and a Prosperous New Year.

New Male Urinary Incontinence products

Although 1 in 10 of the male population over 65 experience urinary incontinence, until recently the taboos around male incontinence have been even greater than those surrounding the condition for women.

However, we are seeing this situation slowly changing, helped by an increasing number of products specifically designed for male use.

We’ve just added Lil for Men products to our male incontinence products range, both Lil for Men Extra and Lil for Men Super offer a large coverage area for extra security and are discreet and comfortable to wear.

These additions to our range supplement the recently relaunched Tena Men’s range which is now known as TENA Men. The packaging of these products has been changed to become more masculine, more discreet and more consumer-friendly although the product range remains the same, with Tena Men Level 1 and Tena Men Level 2 both available. The improved side elastics allow for greater comfort and ensure a better fit to the body. TENA Men incontinence pads also contain their unique Odour Control™ system that neutralises potential odours for complete confidence. The re-launch of Tena Men Level 1 sees the development of the product to become smaller and more discreet.

The Benefits Of Kegel Exercises

Kegel exercises or Pelvic Floor Exercises are exercises that increase the strength of the pelvic floor muscles and are named after Dr. Arnold Kegel. They are beneficial to women of all ages especially those preparing for birth although they can also help increase sexual enjoyment. Kegel exercises are straightforward to learn and extremely easy, you can perform them in just a few minutes while laying in bed, in the car or in fact pretty much anywhere.

There are many different causes for a damaged pelvic floor and the most common is the strain brought on from vaginal childbirth therefore, strengthening the pelvic floor muscles can ease delivery and make it safer for both mother and child.

Strong pelvic muscles also help control incontinence, many women suffer from incontinence and urinary incontinence brought on by childbirth as well as conditions known as vaginal prolapse and pelvic organ prolapse. In these conditions the uterus, bladder and guts are not properly supported and this leads on to urinary tract and bladder infections as well as incontinence.

Kegel exercises for women can also help with conditions brought on by obesity, aging and naturally feeble pelvic muscles. Many women that have had problems with sexual stimulation and climax have found a great natural cure in the Kegel exercise.

Performing Kegel exercise is fairly straightforward, the general exercise is performed by simply flexing the same muscles that are used to stop the flow of urine. It is important to note that you never want to do the exercise when urinating, this can end up in incomplete emptying of the bladder. It is generally recommended that you slowly build up the time you hold the muscles and be sure to rest the muscles for a similar amount of time and you do the exercises two or 3 times a day.

NHS approves new pelvic muscles’ toner

Pelvic floor exercises are widely known as one of the most effective treatment for urinary stress incontinence but a lack of orientation from GP’s and the NHS itself has devalued this practice. Nevertheless, things are about to change thanks to brand new device called the Pelvic Toner.

It’s been 60 years since Arnold Kegel developed its worldwide famous exercise programme, also known as Pelvic Floor Exercises, to strengthen pelvic floor muscles and reduce the episodes of stress incontinence in women. But as afore mentioned scarcity of resources and information led women to loose faith in this practice.

The main reason was that they were simply handed a sheet of paper with instructions to use unsupervised. With PelvicToner things are about to change, following an extremely successful clinical trial and a robust cost-benefit evaluation, GP’s can now offer a more effective and faster treatment option to the millions women of all ages that present with the distressing symptoms of Stress Urinary Incontinence.

Published in the British Journal of Urology International the study reported an exceptional level of satisfaction with over 80% of PelvicToner users reporting significant improvement within a couple of weeks. Based on that the NHS has decided that the PelvicToner™ will be available on prescription with effect from January 2011. The PelvicToner will be the only product available under the brand new Drug Tariff category of Pelvic Toning Devices.

Research leader and author of the British Journal of Urology International article, Professor Marcus Drake of the Bristol Urology Institute, stated:

“Continence service provision is patchy and this sort of product empowers women, gives them better privacy and the prospect of not wasting their time. In our study the PelvicToner aided women to identify their pelvic floor confidently. It increases patient choice and may promote subsequent compliance and sustained efficacy.”

Clinical trials also confirmed that the PelvicToner is much more effective than expensive electrical stimulation devices and weighted vaginal cones reason why it has been recognised by the NHS and a special new category of ‘Pelvic Toning Devices’ has been created on the Drug Tariff IXA.

When Your Incontinence Is a Symptom of Something Else

I always find it interesting that while I am taking care of a patient for something, often another family member will say to me, "You know, I should come see you." Many times it is for incontinence, and it is something they have been dealing with for years.

Many people, women in particular, have ignored their symptoms of incontinence and overactive bladder because they felt it was all a part of aging. Many women will tell me that their mother and grandmother had incontinence and just dealt with it, so they felt they had to deal with it as well. As I have stressed time and time again, incontinence is not normal and should be evaluated first to help you get better, and second, to make sure it is not a sign of something worse.

The most serious and worrisome diagnosis in someone with urgency and frequency of urination would be cancer in the bladder. When a patient comes into my office with these symptoms, cancer is the first thing I work them up for. Incontinence for the most part is not that common, but the irritative voiding symptoms are often a first sign of a low grade cancer.

Bladder cancer is a very interesting cancer. Found at a low grade or stage is remarkably treatable by minimally invasive means. Found at later stages makes it a very challenging disease to cure. This is why all urologists are vigilant about evaluating and finding bladder cancer early. If you have signs and symptoms consistent with overactive bladder like frequently urinating and have a sudden urge to go which is hard to control, make sure you get some simple tests done instead of just allowing your physician to place you on medications.

Another situation which can cause you to have overactive bladder and some incontinence is kidney stones. Whenever I tell people this, they often report that they have no pain and wouldn't they have pain if they had a kidney stone? Not necessarily.

If you have a small stone stuck in the tube that travels from the kidney to the bladder, called the ureter, it may only cause some bladder symptoms and not necessarily pain. Recently, I found two young women who had these bladder symptoms for over a year and it was discovered that they each a kidney stone very low down irritating the bladder.

There are other causes for urgency and frequency as well, like a urinary tract infection. This too can cause incontinence. Most of the time, the testing for the above mentioned situations are easy, and I think it is worth the extra time it may take to make sure you don't have something more serious. If you are not seeking medical attention for your bladder symptoms because you don't think it is a big deal, think again. Even if you choose not to have any treatment for your incontinence, please see a doctor and make sure that is all it is!