Treatment – risk and advantages

After a doctor determines the causes and type of incontinence, he or she should recommend treatment. There are many methods used to treat incontinence – non-invasive, pharmaceutical or surgical. Each method has its strong and weak points. Effectiveness of each technique depends on the cause of condition and also on a patient’s effort. Treatment which is effective in one case, would not necessarily be good in the other, which is why it is so important to consult one’s doctor.

Non-invasive treatment
Fundamental in non-invasive treatment is physiotherapy. Exercises teach how to control bladder and muscles of urethral sphincter. They are easy and perfect in some types of incontinence. The exercises concern control of the bladder or pelvic floor muscles.

The bladder exercises are recommended especially in urge incontinence but they are also practiced in stress incontinence. In both men and women these exercises give visible improvement. Patients learn to control the bladder in many ways. Distracting attention and concentrating on other problems is one of the possibilities. Also keeping a miction diary can ease the problem.

Exercises of pelvic floor muscles (Kegel exercises) are recommended in stress incontinence. These exercises strengthen muscles of the urethra sphincter. The Kegel exercises are very effective but require a lot of time dedication. Correctness of these exercises may be checked and controlled thanks to special measuring devices called biofeedback.

Another part of the non-invasive treatment may be the electrical stimulation. Electrical devices enable strengthening muscles by causing contractions; they can also have painkilling as well as loosening effect in the case of excessive contractions of the bladder. Other kind of stimulation is given by the magnetic neurostimulation, which strengthens the bladder, sphincter and pelvic floor muscles due to stimulation of nerves – contractions caused by a magnetic field. Main advantage of this kind of treatment is that it’s non-invasive. 54 to 95 percent of exercising patients observe significant improvement in eliminating symptoms of their disease. 12 to 16 percent of the patients get cured. This kind of treatment doesn’t carry any risk. Using external magnetic neurostimulation in stress incontinence gives about 80% of noticeable improvement.

Pharmacological treatment
Some patients need pharmacological treatment. In incontinence doctors prescribe drugs disinfecting the urinary tract, relaxing bladder muscles or improving work of the urethra. The type of the drug prescribed depends on the patient’s disease. Pharmacotherapy is recommended in overactive bladder, in stress and in mixed incontinence. Each patient should be precisely informed how to use the specific drugs. In each case doctor’s supervision is necessary. As much as 77 percent of patients who need pharmacotherapy observe improvement of their condition, whereas 44 percent is effectively cured. However, pharmacological treatment may by risky as it may cause some side effects.

Surgical treatment
In some cases of incontinence a doctor can recommend surgical treatment. Surgery eliminates the cause of incontinence, but it is performed only if it’s necessary to:

• reconstruct proper anatomical conditions
• remove blockage of urine outlet
• strengthen weakened pelvic floor muscles
• increase the bladder volume

There are many surgical techniques practiced in incontinence. The surgery type depends on the type and cause of the disease. The doctor should explain the specificity of the surgery in details. About 87-92 percent of patients who need surgical treatment is cured once the surgery is done. As in each surgical activity, also in this surgery there is a risk of complications during or after the surgery.

Helpful products
To support treatment and to keep proper hygiene it is helpful to use absorbent products – bladder control pads, all-in-one diapers or anatomically shaped pads – or, in some cases, catheterisation. Catheters are used if there are problems with natural urinating. A catheter is a plastic tube inserted into the bladder through the urinary tract and it enables to channel urine to a drainage bag outside. Usually, but not always, the catheter has to be left inside the bladder. It can be also placed there for several hours just to drain the bladder. Sometimes, in men, it is necessary to use a condom catheter, which is attached outside the body and not inside. In these cases absorbent products are also used to give better protection and comfort. Bladder control pads, anatomically shaped pads or all-in-one diapers have application in all cases of incontinence. They increase comfort of patients, help to avoid embarrassing situations and give feeling of dryness.
Using catheters or absorbent products is not any kind of treatment, it is a method of increasing comfort and protection during pharmacological or surgical treatment, or if the treatment is ineffective.