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Incontinence (Stress, Urge, Fecal, & Overflow)

Whether you’re living with stress incontinence, overflow incontinence, urge incontinence or fecal incontinence, Advanced Urology is here for you. While seeking treatment isn’t always an easy first step, rest assured that our urologists will make you feel as comfortable as possible and handle your case discreetly. Call 678-344-8900 for a private consultation today. Read on to learn the symptoms, causes and treatments for all types of incontinence.



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Stress Incontinence Overview and Causes

Stress incontinence in males and females occurs when physical activities exert pressure (stress) on the bladder causing the involuntary loss of urine. Stress incontinence is not connected to psychological stress. Normally, when such stress is applied to the bladder, the various muscles involved in retaining or expelling urine withstand the pressure to keep the urine in the bladder. However, because of factors like childbirth, surgery and injury, these muscles become weakened and unable to withstand certain levels of pressure. This results in stress incontinence following childbirth as well as when a person sneezes, laughs hard or lifts a heavy weight.

Stress Incontinence Symptoms

Stress incontinence may be present if you leak urine when you undertake any strenuous activity. In some cases, the activities may be as mild as sneezing or experiencing stress incontinence first trimester while in others, leakage will occur when extreme pressure is applied like when lifting heavy weights at the gym. In general, stress incontinence symptoms are easy to identify and do not require a trained eye. Nevertheless, further testing may be required to determine the level of incontinence and how weakened the urinary muscles are.

Stress Incontinence Diagnosis and Treatment

Diagnosis involves going over your medical history including childbirth, undergoing a physical exam, urinalysis, neurological testing and a bladder stress test. These will be used to determine the level of stress incontinence you have. After diagnosis, treatments your doctor may suggest include behavioral therapies like foods to avoid and Kegel exercises, or medications, and devices like a vaginal pessary. If your symptoms are extreme, surgery may be recommended, which may involve a retropubic colposuspension or a sling procedure to support the urethra.

Urge Incontinence Overview and Causes

The cause of urge incontinence is an overactive bladder. However, it should not be confused with Overactive Bladder Syndrome (OBS), a different condition with the same cause but different symptoms. With urge incontinence, the bladder experiences frequent and abnormal contractions. The origin or cause of these contractions is not known.

Urge Incontinence Symptoms

If you have urge incontinence, you will experience a sudden urge to urinate that may not give you time to get to a toilet. In addition, when this urge comes, you may experience some leakage before you get to the restroom. These incontinence symptoms are most prevalent in older adults and in women who have given birth via C-section. Other risk factors like obesity, nerve damage, prostate cancer, bladder cancer or UTIs also increase the chance of getting these symptoms. If you recognize these symptoms, do not be embarrassed. Speak with your doctor about management and treatment options.

Urge Incontinence Diagnosis and Treatment

If you feel you may have urge incontinence, your urologist will order tests to determine the extent of the condition. These tests may include a urinalysis to rule out infections, cystoscopy, bladder biopsy among others. If conclusive, your doctor will suggest one or more of the following treatments: behavioral therapy including Kegel exercises, biofeedback, and a bathroom schedule and medical incontinence treatments including taking drugs like Darifenacin (Enablex) and Mirabegron (Myrbetriq) or surgical treatments targeting the bladder.

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Fecal Incontinence Overview and Causes

Fecal incontinence is characterized by an inability to hold or prevent the passage of fecal matter from the rectum. This inability is usually involuntary and can happen at any time. Incontinence of feces causes include diarrhea, constipation, surgery, rectal prolapse or damage to the nerves and/or muscles in the rectal area. Women who have given birth are especially susceptible to fecal incontinence as the muscles around the anus tend to be weakened during childbirth. Dementia, age and physical disability are other risk factors associated with bowel incontinence etiology.

Fecal Incontinence Symptoms

Fecal incontinence symptoms may occur periodically, like when a bout of diarrhea strikes or may be chronic. When the symptoms are chronic, they can be a source of acute stress and shame for the person. Fecal incontinence may occur when the person has a sudden urge they cannot resist (urge incontinence) or occur without the knowledge of the person (passive incontinence). In all cases, the person will pass a small amount of stool involuntarily and at inappropriate times. Other symptoms that may accompany fecal incontinence are bowel incontinence back pain, bowel incontinence bleeding, bowel incontinence blood spotting, flatulence, diarrhea and constipation.

Fecal Incontinence Diagnosis and Treatment

Diagnosis involves keeping a journal and noting down the number of occurrences. Your doctor will also perform a physical exam that may include a digital rectal exam. Once diagnosed, they may suggest several remedies you can try before pursuing more aggressive treatments. The first line of treatment involves preventative measures like managing constipation, treating diarrhea and using stool softeners to prevent straining. If this does not work, you may need further treatment that may involve bowel training, sacral nerve stimulation or surgery.

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Overflow Incontinence Overview and Causes

Overflow incontinence can be caused by one or a combination of factors that impact the bladder and related muscles. When a person has overflow incontinence, their bladder muscles are usually too weak to hold the urine in, resulting in the sudden release of urine when the bladder becomes full. This will often happen even when the person does not feel the urge to pee. The weakening of bladder control muscles can be caused by conditions like multiple sclerosis or diabetes that affect nerves, urinary tract blockage, a compromised detrusor muscle (controls expulsion of urine) or certain medications.

Overflow Incontinence Symptoms

When a person has overflow incontinence, they may experience symptoms that include a sudden and involuntary release of urine, bladder fullness even after urinating, urine leakage while sleeping, a urine stream that starts and stops and difficulty starting to urinate even when the bladder is full. A person with these symptoms may experience overflow incontinence at night or during the day. If you have these symptoms, it is worth the risk to speak with your doctor, despite the embarrassing nature of the subject. Overflow incontinence after childbirth and overflow incontinence pregnancy if left untreated, can be a source of embarrassment and can negatively impact your quality of life.

Overflow Incontinence Diagnosis and Treatment

Diagnosis often involves keeping a journal and testing the various structures of the urinary tract. Treatment follows two somewhat distinct paths when dealing with overflow incontinence in females and in males. In females, catheterization may be a solution where a thin tube (catheter) is introduced into the urethra to drain urine. This can be done either through intermittent self-catheterization or the installation of an indwelling Foley catheter. In males, treatment involves surgery (if an enlarged prostate is involved), catheterization or incontinence medication to reduce the size of the prostate.