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How to treat urinary incontinence

Urinary incontinence can make you feel alone or embarrassed, but you don’t have to suffer in silence. With multiple treatments available, your doctor can help find a solution that fits you.

“Urinary incontinence is actually very common,” says Joye Lowman, M.D., a urogynecologist at Piedmont. 

She encourages patients to be upfront about their issues. Although most incontinence problems aren’t physically dangerous, they can be disruptive to women’s lifestyles and schedules.

“Incontinence doesn’t kill you, but it can steal your quality of life,” Dr. Lowman says. Many noninvasive therapies are available, she adds, so it’s worth discussing options with a physician.

What causes urinary incontinence?

There are several types of urinary incontinence, and multiple causes are behind them.

Dr. Lowman says that age, some surgeries, and smoking history can boost your risk. Exposure to bladder irritants (like coffee, tea, alcohol or anything acidic) may also cause problems.

A woman’s gynecological history plays a role, too. Large fibroids can lead to incontinence issues, and so can pregnancy and vaginal delivery. Childbirth can cause injuries that lead to pelvic floor issues including stress incontinence, which is when laughing, coughing or sneezing causes urine leakage.

Although most types of urinary incontinence, particularly stress and overactive bladder, are not severe or life-threatening, Dr. Lowman says it’s still important to see a physician.

“Most urogynecology patients have suffered with these conditions for years before they actually seek definitive therapy,” she says.

Urinary incontinence treatment options

If your issue is mild, you may be able to find relief from at-home exercises and lifestyle changes. Kegel exercises can be beneficial, and quitting alcohol and coffee (which irritate the bladder) may also help.

“If medicine or behavioral changes fail, there are excellent procedures that can help,” Dr. Lowman says.

She recommends physical therapy for some women, and she also prescribes medications including Botox.

Although it’s best known as a cosmetic treatment, Botox is also highly effective for urinary incontinence patients, Dr. Lowman says. 

“Efficacy is over 80 percent,” she says.

Botox patients do need repeated therapy for best results, but injections may only be necessary once every few months. And, people who stop the treatment usually find their incontinence symptoms do not return to the same degree.

“It’s important for patients to be armed with knowledge,” Dr. Lowman says.

Fighting the stigma of incontinence

Many of the patients Dr. Lowman sees have struggled with incontinence for a long time. She points out that although women’s issues like breast cancer and menopause are openly discussed, urinary health often has a stigma around it.

“We don’t talk about, and don’t hear patients talking to one another, about incontinence,” she says.

As a result, women tend to assume they’re the only ones suffering, which couldn’t be further from the truth.

Dr. Lowman encourages anyone dealing with incontinence to be upfront with their physician.

“The important thing to know is there are many excellent options for therapy, both surgical and non-surgical,” she says. “It’s important for patients to discuss their symptoms with their doctor so that they can get the relief they deserve.”  

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