Urine Incontinence — It’s Nothing to Sneeze At

One of life’s most embarrassing experiences is not being able to control your urination and soiling your clothes forcing you to leave any situation where you are engaged with others. It is one of the last medical conditions to remain in the closet as many men and women fail to seek medical attention for this common problem.
This blog will discuss the 4 types of urinary incontinence and what treatment options are available for this common problem.

Urge Incontinence occurs in women with an overactive bladder who may not be able to get to the toilet in time to prevent leakage, even though they tighten up all of their pelvic muscles, because they can’t control the bladder and keep urine in. Overactive bladder that leads to urge incontinence affects about 17 percent of women, but it increases to over 50 percent after menopause. Overactive bladder isn’t a normal part of aging.

Stress incontinence is a much more common type of incontinence. Menopause contributes to this problem, but stretching and tearing of the pelvic muscles during childbirth definitely sets the stage. The reduced muscle tone causes the urethra to sag. When pressure builds up in the abdomen from a cough, sneeze, laugh, jump or lift, internal organs put pressure on the bladder and a small amount of urine may escape.

Overflow incontinence occurs when more urine collects in the bladder than the bladder can hold and the excess urine leaks out. It can be caused by blockage of the urinary tract or nerve damage caused by conditions such as diabetes, stroke, or injury.

Functional incontinence is not really a problem with the urinary tract. It happens to people who can’t move quickly, who have eye problems or who suffer from confusion or memory loss. They simply can’t get to the bathroom in time.

Certain prescription drugs such as diuretics and some tranquilizers, and smoking and eating spicy foods or artificial sweeteners, or drinking alcohol and caffeine can irritate the bladder and worsen incontinence.

Mixed incontinence is a combination of both stress and urge incontinence.

Today, there are many more options to consider, from medications, pelvic floor physical therapy, and surgery. The first step is to have a work up to diagnose the underlying problem so that an appropriate treatment plan can be put into place. Sometimes more than one treatment is needed.
Treatment options include:
1. Bladder training — This approach teaches you to urinate only at scheduled times and waiting longer between trips to the bathroom. Start by going to the bathroom every 30 to 60 minutes while you are awake, even if you don’t have to go. After about one week, slowly increase the time interval by 30 minutes every week.

2. Kegel exercises — Dr. Arnold Kegel, a gynecologist at the University of Southern California, developed the exercises to strengthen pelvic floor muscles in 1948. Kegel exercises are often the first line of treatment for the millions of women in the U.S. suffering from unexpected bladder leakage due to coughing, sneezing, laughing or exercise. This if defined as stress incontinence but many women experience frustration because they unknowingly don’t perform the Kegels effectively, which leads to no improvement in symptoms. Most men or women need to do the exercises for 3-6 months before any changes will occur.

3. Pelvic Floor Electrical Stimulation with Biofeedback Therapy — This treatment uses computer graphs and sounds you can hear to show you which muscles you are exercising so you can perfect the exercises. Physical therapists and other professionals specially trained in problems related to women’s health teach exercises for the pelvic floor, trunk, back and extremities that can help strengthen the pelvic muscles and improve bladder control. The physical therapist may use devices that use mild, comfortable, electrical stimulation to train the bladder muscles when and how to squeeze.

4. InTone is a new FDA listed Class II Medical Device for home use that has been shown to effectively strengthen the pelvic floormuscles and helps to prevent embarrassing leakage without surgery or medication and can be done in the privacy of home. InTone is like a personal trainer for Kegel exercises.

5. Medications — Estrogen can be very helpful in improving the symptoms of some cases of incontinence. Studies have demonstrated improvement in 40- 70 percent of women. I have found that estrogen cream (one fourth to half an applicator) works better than either tablets or patches for this particular problem. Medications called smooth muscle relaxants (examples are oxybutynin and tolterodine) can also help if the problem is caused by abnormal bladder contractions.

6. Pessaries — These donut-like plastic or rubber rings are similar to a diaphragm used for birth control. They are fit into the vagina to lift and offer added support for the bladder when the pelvic muscles are weak.

7. Surgery — There are many operations that have been developed to support the bladder and improve or correct incontinence. Women don’t need to have a hysterectomy in order to control urinary incontinence. Most of these operations for incontinence can be performed as one-day surgeries.

8. Botox– If you don’t respond to oral medications, you may be a candidate for Botox injections directly into the bladder muscle. This, too, can be done as a one-day stay procedure and usually produces relief of symptoms of frequency of urination and urgency of urination with urge incontinence

Bottom Line: Women don’t have to suffer in silence. Successful treatment options are available and most women can be helped and made more comfortable and reduce their embarrassment.

ED Not Responding to Viagra? Try Gelling Out!

For patients who have failed on Viagra®, Levitra® or Cialis® and who cannot or will not self inject medicine with a needle, TriMix-GEL® has been used as an alternative to restore your sexual health.
For a patient who failed on PDE5 inhibitors and cannot use a needle to self inject his penis, TriMix-gel® has been used as an alternative.
Many ED sufferers cannot take PDE5 inhibitors for a variety of reasons. Contraindications include patients on nitrates, certain beta blockers or patients with nonarteritic anterior ischemic optic neuropthy (NAION). Still other patients cannot tolerate the side effects, which increase when dosage is increased. At the point PDE5 inhibitors are eliminated as a viable option, of the remaining options, penile injections with vasodilators prevail as the most effective non surgical alternative. There are some patients who are not receptive to this alternative because they cannot self inject the penis.
TriMix-gel® is an easy to apply gel used before sexual intercourse. Each dose contains trimix in powder form which is energized into a gel at time of use. Trimix ingredients (alprostadil, phentolamine, and papaverine) have been tested and widely prescribed for many years for improvement of sexual health.
• There are no needles, pellets, or pills
• Can be carried by the patient at room temperature
• ED-gel® Easy Applicator (pat. pending)
Typically, the trimix for injection version of the compound would have to be refrigerated and then self injected with a needle at time of use. But the compound in gel form, called TriMix-gel®, allows the patient to carry the medicine at room temperature. More importantly, an erectile dysfunction patient wil not have to use a needle to self inject his penis before sexual intercourse.
Precautions
• Tell your doctor and pharmacist if you are allergic to alprostadil/prostaglandin or any other drugs.
• Tell your doctor and pharmacist what prescription and nonprescription medications you are taking.
• Tell your doctor if you have or have ever had anemia, bleeding disorders, sickle cell disease, leukemia, cancer, kidney or liver disease.
The effects of TriMix-gel® should last no longer than one hour. We have found that this is satisfactory for most men who live in the Gulf Coast area!
Bottom Line: If you suffer from ED and the oral medications are not working, there are still options that help nearly every man so they don’t have to suffer the tragedy of the bedroom.