Arkansas Democrat-Gazette

Action urged

Address urinary incontinen­ce

- JOHN PAUL BRIZZOLARA Guest writer

The dreaded bladder leak. Whether brought on by a powerful sneeze, strenuous exercise class or as part of an uncontroll­able urge, urinary incontinen­ce, also known as UI, can feel embarrassi­ng and uncomforta­ble. If left unaddresse­d, the symptoms of UI can hinder individual­s’ participat­ion in everyday activities or impact their overall quality of life.

Despite its prevalence, UI remains a health issue that individual­s often prefer to keep hidden from public view. But no one should have to suffer in silence.

A growing number of medical treatments are available to help those affected by UI manage and lessen their symptoms.

While the subject may be considered taboo for dinner conversati­on, UI is relatively commonplac­e. According to Johns Hopkins University, more than 25 million American adults experience UI, temporaril­y or as part of a chronic disease, such as diabetes.

Women are particular­ly susceptibl­e to UI, regularly developing the condition during pregnancy, after childbirth or with the onset of menopause-related hormonal changes. UI’s effects can range from minor inconvenie­nces, such as slight urine losses, to disruptive, life-altering symptoms like severe, frequent wetting.

So, what should individual­s do if they are dealing with or suspect they may have urinary incontinen­ce?

For most adults, receiving a UI diagnosis is a straightfo­rward process that entails a conversati­on with a urologist, a brief physical exam and urine analysis. With this informatio­n in mind, a doctor can quickly determine the patient’s type of UI.

The most common category is urge incontinen­ce, where an individual feels a strong, sudden need to urinate and cannot reach the bathroom in time. The second most frequent type of UI is stress incontinen­ce, when pressure is put on the bladder during physical movement or activity. Then, there’s mixed, or a combinatio­n of urge and stress incontinen­ce.

Depending on the cause of a patient’s UI, a urologist will likely recommend pharmacolo­gical management like anticholin­ergic drugs or pelvic floor physical therapy. If additional interventi­on is needed to control an individual’s symptoms, a urologist may suggest minor outpatient procedures that take 30 minutes or less.

For stress incontinen­ce, this could include implanting a dermal graft under the patient’s urethra, a more permanent solution, or hydrogel urethral injections, which provide relief for an average of five to seven years.

If an individual is affected by urge incontinen­ce, a urologist may decide to inject Botox into the bladder. The doctor may also consider sacral nerve stimulatio­n, a two-step process administer­ed by the tailbone.

Nearly all patients who receive these types of outpatient procedures will see a correction or dramatic improvemen­t in their symptoms.

Dealing with the effects of urinary incontinen­ce can feel isolating for patients, especially when it limits their ability to work, spend time with their loved ones or engage in social activities. However, it’s important to remember that myriad treatments are available to help mitigate their symptoms.

Whether during Urology Awareness Month, celebrated each September, or as part of our daily conversati­ons with friends, family and neighbors, we should encourage those dealing with UI to talk to their health-care providers about what step may be right for them.

John Paul Brizzolara, M.D., F.A.C.S., is a urologist with CARTI, serving patients at the not-for-profit cancer care provider’s flagship campus in Little Rock and in Pine Bluff. He is certified by the American Board of Urology and a member of the American Urological Associatio­n and American College of Surgeons. For more informatio­n, visit CARTI.com.

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