Treatment for Patients with Bladder Incontinence

The Mayo Clinic sees over 10,000 people a year for urinary (bladder) incontinence. They run tests to confirm that a patient has it, to diagnose it and then to offer treatment options for the condition. Treatment can range from a simple urinalysis to a procedure that allows the doctor to see right into the bladder (a cystoscopy). Eighty percent of the people treated for bladder incontinence either improve significantly or are cured altogether.

Bladder Incontinence Defined

• In simple terms, bladder incontinence is when a person is unable to control their urine output. That might consist of leaking a little throughout the day (overflow incontinence), or it might involve completely urinating on yourself and your clothing because you can't wait or make it to the bathroom first (urge incontinence). Some people with this condition experience a slight leak only when they laugh or cough (stress incontinence).

Diagnosis Testing

• Generally, a complete medical evaluation is conducted, and one or more tests are performed to confirm the condition---and to determine which of the various types (overflow, urge or stress) you have. The tests used for such diagnosis include: studies on your urine flow and pressure, stress tests, a urinalysis or examination of the inside of the bladder with a special scope tool, which is the procedure known as a cystoscopy.

Treatment Options

• The severity and type of the problem, along with data about the individual's overall health and conditions, lifestyle and medication use, will all have an impact on the treatment option recommended. There are currently six treatment options used by the Mayo Clinic in treating bladder incontinence, which fall into three categories: noninvasive, minimally invasive and invasive. The six treatment options are: behavior and diet modification, medication prescription and use, bulking agent insertion, botulinum toxin (BOTOX) injection, device implementation and surgery.

Noninvasive Treatments

• Behavior modification of an individual's liquid diet intake and schedule (no liquids before bedtime, for example) is one noninvasive treatment option. Performing pelvic muscle exercises to strengthen the sphincter muscle, biofeedback, electrostimulation of the pelvis muscles and certain medications round out other options in this category.

Minimally Invasive Treatments

• Bulking agents, botulinum injections and bladder devices fall under this category of bladder incontinence treatment. Bulking agents (like collagen) are used to help the sphincter muscles stay closed in order to prevent leakage from the bladder. These agents are injected into the actual urethra. Botulinium injections block the release of certain chemicals in the bladder, which in turn prevent spasms from occurring in the bladder muscles.

  And one of five different medical devices (pessary, bladder neck support device, urethral insert, urine seal and artificial urinary sphincter) can be implemented as a treatment option too. Devices elevate or close the weakened bladder neck (or the entire bladder) and serve as a pad, plug or valve to prevent unexpected or unwanted bladder release.

Invasive Treatments

• Surgery falls under this treatment category option. Sometimes surgery is done to eliminate a blockage in the bladder or to improve or change the muscle tissues within it. It is also used to increase the bulk of the bladder as well as to resolve weakened muscles in the pelvic area.