January 21, 2017

Treating Urinary Incontinence and Overactive Bladder Without Surgery

Controlling When You Have to Go to the Bathroom – NATURALLY

by Dr. Scott Saunders, M.D.

Several years after her surgery, Marge began having frequent urinary tract infections. Eventually, she had a cystoscopy. The surgeon looked into the bladder and found what she had feared – mesh. The plastic mesh placed to suspend Marge’s bladder had worn through the wall of the bladder, creating inflammation and infection. She needed surgery to remove the mesh. The problem, however, was that tissue had grown around the mesh. As expected, scar tissue formed to protect the body from the foreign material. The entire mesh sling was no longer a separate piece of plastic that could be removed. It had become an integral part of the pelvic organs from the skin to the bladder, and even the uterus and ovaries.

After three surgeries she was better – for a while. But more mesh was found that had been missed. She continues to have chronic bladder problems.

adult diapers for incontinenceIt all started when Marge was having urinary incontinence and went to the doctor. They looked at the options. Medications weren’t very helpful, though they did improve the urgency to go. Finally, they settled on a surgical procedure called a sling that would pull the bladder up, so the tube (urethra) wasn’t “kinked.” This procedure has been used for years with good success, and Marge wouldn’t have to take medications. The sling seemed to be the simplest solution, but she didn’t know the potential complications.

Normal urinary function

The urinary system is a beautiful work of complex fluid mechanics and engineering. The kidney pushes urine into the bladder. Under pressure, the bladder stretches to fill like a balloon. Valves prevent urine from going back up into the kidneys. The bladder also has a sphincter to hold in the urine as it fills, preventing it from leaking urine. Normally, the bladder can hold up to 500 milliliters of fluid (about a pint).

The wall of the bladder itself is a muscle that actively contracts to push out the urine when we go to the bathroom. Sometimes it takes a few seconds to develop pressure to make the urine flow. This coordinates with the sphincter at the base holding in the urine, which needs to relax. Most of the time, the muscle in the bladder muscle wall is relaxed, allowing the bladder to fill, and the sphincter is tight, preventing leakage. These roles reverse for just a few seconds to let the urine out when we go to the bathroom.

4 Types of Urinary Incontinence

The word incontinence means the inability to hold urine. Sometimes the system doesn’t function properly and urine leaks at unexpected times.

Urinary incontinence is the forgotten stepchild of medicine. Nobody wants to talk about it. Most people who have it don’t bring it to the attention of their doctors. They just assume that they are “getting old” and wear pads, pull-ups, or diapers. Most don’t know that there are four distinct types of urinary incontinence.

  1. Stress incontinence
  2. Urge incontinence
  3. Overflow incontinence
  4. Functional incontinence

I am going to explain each type of incontinence, how you can know which type you have, and what you can do about it. I hope to spare anyone from having unnecessary surgery, and possible complications.

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