TMH Living Well: You don’t have to suffer with urinary incontinence

— Some health topics are hard to talk about — even to a doctor, it seems. Urinary incontinence is one of them, even though it is common among women in their later years. Despite feeling embarrassed, there are easy solutions for this uneasy ailment.

“Urinary incontinence and pelvic organ prolapse (POP) are what we gynecologists call the silent shames that women endure. I am amazed how many women will not seek care because they are embarrassed, or think, ‘I had kids, now I just have to live with it.’ That’s not the case. There are a lot of treatments that are simple and can bring great relief,” says Dr. Scott Ellis, OB-GYN, TMH Medical Clinic.

As women age, their bladder and pelvic muscles weaken, especially after menopause. According to the National Association for Continence (NAFC), 13 million Americans are incontinent and 85 percent are women. Also, 50 percent of women will experience some degree of pelvic organ prolapse.

The good news is that most cases of prolapse and incontinence can be cured or improved. The gynecologists at TMH offer several options, ranging from behavioral management exercises to pelvic floor rehab and surgery.

There are different types of urinary incontinence, or loss of bladder control. Urinary incontinence can be mild — as in a few, infrequent dribbles when you cough or sneeze — to more severe where you feel a sudden urge and can’t stop urine from escaping before you reach the bathroom.

Stress incontinence (brought on by a cough, sneeze or heavy lifting) is common and is caused by a weakness in the neck of the bladder. Urge incontinence is the latter. Another type of incontinence is overflow, where you can’t fully empty your bladder and only have a weak stream when you go.

Women who have experienced childbirth, had a hysterectomy, have a neurological disorder such as MS or Parkinson’s, take heart or high blood pressure medicines or have a urinary tract infection are at a higher risk for incontinence, according to the Mayo Clinic. Smoking, alcohol and caffeine agitate incontinence.

Sometimes, a few, well-placed stitches make all the difference: “With stress incontinence, we can place a sling to support the bladder so it will not leak when women cough, sneeze or laugh,” Ellis says. The simple surgery is often done in just one day, yet Dr. Ellis likes to use surgery as a last result.

TMH offers advanced laparoscopic surgeries for incontinence and prolapse and for removing diseased reproductive organs. Ellis paved the way in northwestern Colorado for total laparoscopic hysterectomies and has been performing them for many years.

“With laparoscopic surgery, incisions are smaller, less invasive and patients heal much more quickly,” says Dr. Jim Summers, OB-GYN, TMH Medical Clinic.

The hospital offers all types of surgeries for incontinence, and only needs to refer particularly complicated cases to urogynecologists in Denver.

“We have all the advanced equipment and training that we need. The only technique we don’t offer is robotic surgery, but in my mind, it is not that necessary for GYN procedures,” Ellis states.

There are several diagnostic tests doctors can perform to determine the best treatment, and there are many ways to treat incontinence besides surgery. If you are struggling with incontinence or prolapse, see your doctor. You can get back to an active life.

“I have seen hundreds of women with prolapse and incontinence issues who avoid going to the grocery store or traveling for fear of not having access to a bathroom. I know it feels embarrassing, but your doctor will act with compassion and help you,” Summers concludes.

The women’s health experts at TMH continue to improve options for women with incontinence. For example, Dr. Ellis is looking to perform more pelvic floor biofeedback at the hospital and hopes to bring a developing technique called sacral neuro-modulation for urge incontinence to TMH in the future.

“With this promising treatment we place a small, pacemaker-like device near the sacral nerve that stimulates the nerve with mild electrical pulses. This improves continence, since the nerve helps control the bladder and surrounding muscles during urination. It has been well studied and shows good results for both urinary and rectal incontinence,” concludes Ellis.

This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig – improving the quality of life for the communities we serve through patient-centered health care and service excellence.

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