Urinary Incontinence: Gotta Go, Gotta Go Right Now!

Urinary incontinence affects millions of Americans and causes havoc with their lives.  It I a source of embarrassment, shame and often depression.  Other medical consequences of incontinence include skin irritation, urinary tract infections, and pelvic pain.  This blog will discuss treatment options including medications and non-medical solutions.

Urinary incontinence means that the person suffering from it starts losing his/her control over the bladder. This leads to several kinds of problems of the urinary system including sudden urination, slow but steady leakage of urine, or dripping of urine when one undertakes a physically stressful exercise like lifting weight.  Those who have incontinence often lose urine with coughing, laughing, or sneezing.

Although this is a common medical problem, many suffers continue to suffer in silence, living a secluded and reclusive life.

While these causes cannot be controlled, it is important to take note of and control factors that can worsen the condition:

Medication

If you have a problem of urinary incontinence and the symptoms have gone from bad to worse, you need to check with your doctor about the medication or drugs you have been taking. For, chances are that some of these may be exacerbating the problem. Certain drugs to treat high blood pressure are linked to an increase in incontinence.

Alpha blockers dilate blood vessels to reduce blood pressure and they also often relax the muscles of the bladder, furthering urine flow. Some drugs to treat depression can contribute to worsening incontinence symptoms.

Anti-depressants work by relaxing the nerves of the mind and may also affect the ability of the bladder muscles to contract (side effects).

Diuretics are another set of drugs that are associated with increased

urination. In fact, these drugs are also called ‘water pills’, and are designed to flush out excess salt from your body to treat conditions like high blood pressure.

Caffeine

Caffeine is an important component of our daily lives as most of us consume it through coffee, tea and chocolates. Excessive consumption of caffeine is associated with the problem of increased urination. While mild consumption doesn’t have a negative effect, excess consumption can affect the renal system, as caffeine is a stimulant. It stimulates the cardiovascular system, increasing the heart rate as well as blood pressure. This increases the rate of blood to be filtered. It also relaxes the bladder’s detrusor muscles, causing them to feel fuller more frequently. So, limiting caffeine intake is healthy.

Type 2 diabetes

Type 2 diabetes is a major health concern of today as it affects the functioning of the entire body. It also increases the risk of urinary incontinence, as well as its severity. Efforts should be made to prevent and control diabetes by keeping your weight under control, exercising regularly and leading a healthy lifestyle.

Excessive weight also puts extra pressure on the pelvic muscles and weakens them. Therefore, it is also important to control body weight.

Solutions

Besides controlling the aforementioned factors, it is important to take medical help to treat and manage urinary incontinence.

In some patients, adopting behavioral changes may help. For example, decreasing fluid intake to average levels, urinating more frequently to decrease the amount of urine that is held in the bladder and keeping regular bowel habits (as constipation can worsen the problem) may have a positive effect.

Pelvic muscle training exercises, aka Kegel exercises, can specifically help those who suffer from incontinence. The exercises help patients exercise better control of their detrusor muscles.

Weight loss has also been shown to help decrease symptoms in overweight people.

Bottom Line:  Urinary incontinence is a common condition affecting millions of American men and women.  Help is available and no one needs to “depend on Depends”!

Leaking Urine? You Don’t Have To Depend on Depends!

Urinary incontinence is one of the most discouraging and depression conditions that affects both men and women. Incontinence can lead to a reclusive life style because of embarrassment and even be a cause of nursing home admission.

Urinary incontinence affects millions of men and women. There are numerous medical treatment options and perhaps one of the easiest solutions is dietary modification. This blog will discuss some of the dietary changes that you can implement to help control your urinary incontinence.

The solution isn’t always to limit your water intake
Remember that if you don’t drink enough water, you might get dehydrated. The problem is, when you have incontinence, drinking a lot of water could also give you problems. Even, the recommended six to eight glasses of water a day can give you problem since you have incontinence. Now, if you don’t drink as much and you will only have little water in your body, this can irritate your bladder and this could make you go often. So, the best way is to ask your doctor what would work best for you.

Cut down on alcohol
Alcohol directly affects your bladder. This is diuretic – so, that makes you go more often to the comfort room. The problem with alcohol is that, this interferes with the signaling mechanism of the brain down to your bladder. So, if you have alcohol with you, you will not be able to control your bladder fully.
However, there are some people who can still control their bladder even if they are drinking alcohol. So, if you don’t want to stop alcohol, the best bet here is to stop it first – and then, add back little by little, so you will know how much of alcohol your body can tolerate.

Go low on the “joe” (caffeine)

You can find caffeine in your soft drinks, teas, chocolate and even in decaffeinated coffees – though in small quantity. The problem with caffeine is since it tells your body to get rid of liquid; you’ll keep on coming back to the comfort room. So, avoid them if you can.

However, if you really love that coffee zest, be sure to do it in the morning. Avoid it at night, though – especially after past 7 p.m. – if you don’t want that sleep disturbed. Be sure also to limit yourself to one or two caffeinated drinks a day.

Avoid Spicy Foods
Avoid eating spicy foods like Mexican, Chinese, chili peppers, chili, and horseradish. Remember that spicy foods can irritate the lining of your bladder -just like caffeine does.

Stay away from acidic foods
Acidic foods like citrus foods and juices – as, oranges and pineapple have acids that can irritate your bladder – just like what spicy foods and caffeine can do – which can make you feel on the go – always!
Tomatoes and cranberry juice are also acidic. Yes, cranberry juice may help bladder infections – but, this doesn’t help if your bladder is overactive. So, please stay away from them if you can.

The Whiz says go easy on the fizz
The carbonated drinks may not have caffeine, but they can irritate a sensitive bladder – and when your bladders are irritated, then you have that urge to go to the rest room as always.
You have to remember that diet is not the only way to go to control your urinary incontinence. You also have to check on your weight gain, diabetes, constipation, aging – and certain cancers (well, I hope this is not the case) since these conditions may cause you your problem.

Bottom Line: Now, if even after following those diet regimen and your condition is still not improving, it is time that you should check with your doctor.

Urinary Incontinence – Don’t Depend on Depends!

Urinary incontinence affects millions of American men and women. Help is available. You don’t have to suffer in silence.

If you notice a few drops of urine dribbling out when you laugh, cough or even sneeze, you may need to consult a general practitioner as these could be symptoms of urinary incontinence, or loss of voluntary control over one’s urination. In some cases there may be a total loss of urine from the urinary bladder while in other cases there could be partial leakage too. Most commonly seen in elderly males and females, this is a condition that could cause great embarrassment and mental agony. As the person loses control over his or her urination, it drips into his inner clothes without his knowledge and this causes stains, bad smells as well as embarrassment to the person in question. This problem can prevent the person from socializing as he\she is always preoccupied with the thought that the urine might leak out and others may come to know about his or her condition. As this is a problem that often affects the elderly, it could cause severe mental agony and sometimes elderly persons may even develop depression because of it.

Causes of incontinence

Some cases of incontinence are temporary and often, these instances are caused by an external or lifestyle factor. Drinking alcohol, caffeinated beverages, or too much of any fluid can cause a temporary loss of bladder control. Some medications — such as blood pressure drugs, muscle relaxants, sedatives, and some heart medicines — may also lead to a short spell of incontinence. A urinary tract infection may also lead to instances of incontinence.

Other causes of incontinence include:
Aging: As you age, your bladder muscles becomes weaker and incontinence becomes more likely. Any issues with your blood vessels will make this situation worse.
Vaginal delivery or surgery in the pelvis: Any damage caused to your pelvic floor muscles can lead to incontinence, since these muscles support your bladder. In some cases, they can be damaged or weakened by surgery—usually during a procedure to remove the uterus—or during childbirth.
Enlarged prostate: In nearly all men, the prostate gland enlarges with age. It is common for men to experience some incontinence as a result.
Cancer and stones: Prostate cancer in men, or bladder cancer in men or women can cause incontinence. In some cases, the cancer’s treatment will cause incontinence as a side-effect. A tumor, whether malignant or benign, can also cause incontinence by blocking the usual flow of urine. Kidney or bladder stones can also have the same effect, say experts.

Evaluation of the man or woman with incontinence
The condition is determined after a person records regular urine leakages. Diagnosis of urinary incontinence may involve a physical exam, an ultrasound, urodynamic testing and tests including cystoscopy, urinalysis and a bladder stress test. Sometimes, I may ask the person to keep a bladder diary.

Prevention
Although it is not always possible to prevent UI, one can lower its risk by practicing Kegel exercises, especially during pregnancy, following a healthy high-fiber diet, maintaining a healthy weight and avoiding caffeine and acidic foods.

Treatment of this condition
Most cases of urinary incontinence can be treated with lifestyle changes and bladder training exercises but medication and other coping strategies like use of diapers (that can absorb the excess urine) are also used if the problem is due to urgency or mixed incontinence. There are a few effective ways to put an end to your battle with incontinence, such as –

• Drink fluids in moderation
• Empty the bladder completely
• Lose weight
• Avoid drinking tea and coffee
• Stop drinking alcohol
• Treat digestive problems
• Read labels on medications
• Apart from these, there is a therapy to improve the symptoms of frequency, nocturia, urgency, and urge incontinence.
Treatment options also include anticholinergics, antispasmodic agents, and tricyclic antidepressants (Tofranil). Pharmacologic therapy for stress incontinence and an overactive bladder may be most effective when combined with a pelvic exercise regimen.

Some surgical procedures like tape or sling procedures, bladder suspension, urethral bulking agents, artificial urinary sphincter in men with incontinence after prostate surgery and other surgical procedures are available as treatment.

Bottom Line: Men and women who suffer from incontinence don’t have to suffer in silence and wear diapers. Help is available. See your doctor to discuss an evaluation and treatment options.

Treatment of Incontinence With Confidence

Incontinence is devastating problem that impacts millions of American men and women. Although diapers are acceptable in toddlers, it is not very acceptable in middle aged and older men and women. This blog will discuss the common problem of urinary incontinence and what are some of the solutions for this common urologic problem.

Do you visit the bathroom more than usual? Or worse, do you not make it on time to the bathroom because your bladder is out of control? This is nothing to be ashamed of, and can be solved if addressed properly.

Urinary incontinence is a common problem resulting in the loss of bladder control. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that is so sudden and strong you do not get to a toilet in time.

If urinary incontinence affects your daily activities, then the person must visit the doctor. The earlier rehabilitation techniques are started, the lesser the complications and the better the results.

There are different reasons for urinary incontinence but the main reason for women is pregnancy and child birth.

Pregnancy puts pressure on the bladder and the urethra and normal delivery further weakens the muscles needed for bladder control. Women who have had a C-section are less prone to face this problem but in many cases pregnancy itself can affect the muscles which causes urinary incontinence after delivering the baby.

Worldwide 25 per cent of women above 40 years and 40 per cent of women above 65 years have urinary incontinence.

A high percentage of these women are prone to urinary incontinence due to multiple pregnancies and childbirth. However, despite providing women with educational leaflets during their pregnancy and carrying other awareness activities, not everyone with the problem seeks medical assistance.

The problem is more common in women that give birth to babies that weigh 8 pounds or more and in patients that have a complicated or prolonged labor.

I recommend that all women practice pelvic exercises, which are important to tighten these muscles. Exercises such as Kegels are now getting popular and more women are aware of it.

Other reasons for incontinence include ageing and menopause, obesity, neurological causes, and diabetes. After menopause women are more prone to incontinence as there is loss of estrogen hormone which has a direct effect on the bladder and the muscles supporting it.

Treatment

One form of treatment is lifestyle modification. Certain drinks and foods act as diuretics, these include alcohol, coffee, decaffeinated tea and coffee, carbonated drinks, artificial sweeteners, foods high in spice or sugar. We ask women to reduce the intake of these foods and drinks.

Another option is to reduce the bladder irritants. These foods and fluids cause urinary frequency, urgency, and urinary incontinence. A complete list of bladder irritants is shown at the end of this blog.

Diabetic patients are asked to keep their sugar in control, and obese patients are put on a diet. Physiotherapy is another method to manage the disease. Bladder training and pelvic floor exercises such as Kegels are taught to patients to be performed at home on a daily basis.

In some causes electrical stimulation is performed, said the doctor. Gentle electrical stimulation can be effective in some types of incontinence and one may need multiple sessions over a period of few months, in addition to exercises.

Bottom Line: You don’t have to suffer incontinence in silence. Help is available. See your doctor.

List of Common Bladder Irritants*

Citrus fruit
Coffee (including decaffeinated)
Cranberries and cranberry juice
Grapes
Guava
Milk Products: milk, cheese, cottage cheese, yogurt, ice cream
Peaches
Pineapple
Plums
Strawberries
Sugar especially artificial sweeteners, saccharin, aspartame, corn sweeteners, honey, fructose, sucrose, lactose Tea
Tomatoes and tomato juice
Vitamin B complex
Vinegar
*Most people are not sensitive to ALL of these products; your goal is to find the foods that make YOUR symptoms worse

Treating urinary incontinence-Don’t Be Pampered by Pampers

Many women experience incontinence after childbirth. Fortunately, most women have a temporary problem that usually subsides with time. However, there some women that have a persistent problem that lasts for a longer period of time.

After nine months of pregnancy and a rollercoaster of experiences with a changing body, it’s easy to chalk up bladder leaks after delivery to one more outcome of childbirth. While that’s true for many women, other conditions could be responsible for urinary incontinence —the inability to control the release of urine from one’s bladder —if a woman is having difficulties controlling urination two months post pregnancy or more.

The problem is common and nothing to be embarrassed about since many new moms experience urinary incontinence after baby’s arrival.

The condition is caused by the stretching and tearing of supporting structures including ligaments, tendons, nerves and muscles, resulting in a weakened pelvic floor. The extent of the stretching or tearing varies in each person. Incontinence often resolves itself within a couple months after delivering the baby when the structures have repaired themselves naturally.

According to the National Association for Continence, approximately 25 million adult Americans experience temporary or chronic urinary incontinence. UI can strike at any age, although women over age 50 are the most likely to develop the condition. In many cases, UI is often temporary—such as during or after pregnancy for a short while — or results from an underlying medical condition.

The most common form of incontinence in women post pregnancy is stress incontinence, which consists of losing urine when pressure is exerted on the bladder by coughing, sneezing, laughing, exercising or lifting something heavy. Another common form of urinary incontinence post pregnancy is known as urge incontinence —described as an intense urge to urinate, followed by an involuntary loss of urine. Many women will experience a mixture of both forms, which medical professionals refer to as mixed incontinence.

Urinary incontinence can affect a woman in many different ways. It’s more than just an awkward issue that makes it hard to not leak urine. The impact of incontinence on a woman’s personal life can be distressing. Women often avoid going out because they are embarrassed by their frequent bathroom usage. The problem can greatly affect a woman’s sex life, especially when suffering from stress incontinence. Many patients will talk to providers about the changes in relationships that take place in their intimate lives as a result of urinary incontinence.

Women with incontinence have to rearrange their lives. They have to buy pads, which can be expensive. It can irritate their skin. They are all emotionally challenging things to deal with especially after just having a baby. It has added to the stress of having a baby in general.

There are several different ways to treat urinary incontinence.

The most important thing is to allow the muscles to repair themselves. While some cases of urinary incontinence will disappear a few weeks after a woman gives birth, women should seek medical treatment if they are still experiencing leakage after two months.

Pelvic floor exercises, commonly known as Kegal exercises, can often improve urinary incontinence. The exercises strengthen the urinary sphincter and the muscles that help control urination. A physical therapist or professional recommended by a physician can provide insight on whether a patient is properly contracting muscles to help improve the condition.

I also recommend keeping a bladder diary for those dealing with urinary incontinence, which can help normalize fluid intake. Often times women, out of wanting to remain hydrated, can drink several liters more than is necessary causing their bladders to remain over filled. A bladder diary can help to realize this problem, she says.

Another option available to treat urinary incontinence is what’s known as a vaginal pessary. The device can be put in the vagina to support the structures that help prevent urinary continence. The device can serve as a bridge to allow activities like walks and hikes while a woman rehabilitates her muscles.

It takes only one baby for the problem to occur, and the subject of urinary incontinence should not be taboo. I suggest that women ask their physicians about the problem

Bottom line: Urinary incontinence is common after childbirth. Most women will have the problem resolve without any treatment. If the problem persists after several months, then medical attention is recommended.

Gotta Go Right Now? Here’s How To Discard Your Depends For Your Next Airplane Trip

Don’t Depend on Depends

Many men and women suffer from urinary incontinence making travel difficult or nearly impossible. Here are 10 tips and tricks that you might consider before your next flight to lessen the embarrassment of urinary incontinence.

1. Request an aisle seat in back of plane so you have ready access to the restroom. Reserve your seat ahead of your departure dates. Plan to go to the restroom and empty your bladder before your plane departs. Once on board the aircraft and after take off plan to use the restroom before the drink cart come down the aisle as you may be sent back to your seat before you can use the restroom.
2. Explain your medical condition to flight attendant before take-off. The flight attendant can alert you before they turn on seat belt sign making it possible for you to use the restroom. The attendant can help you get off plane for connecting flight if you are at the back the plane.
3. Be aware that you cannot use the bathroom during ascent (short) and descent (long)
4. Wear adult diaper or protective underwear for the trip. You should have a carry-on duffel bag with extra undergarments, pads, antibacterial soap, and an empty plastic bag for soiled clothing.
5. Be mindful of your fluids. It is not a good idea to dehydrate yourself for long periods before departure. To do so will lead to a concentrated urine which is irritating to the bladder and may promote bladder contractions. Drink 6 cups of fluid per day but time it appropriately to your flight departure.
6. Avoid bladder irritants (coffee, alcohol, carbonate drinks, artificial sweeteners, citrus)
7. Suppress the urge by doing Turbo Kegels, which I will describe in the next blog.
8. Voiding by the clock. Don’t wait for your bladder to become full or over distended. Urinate every 2-3 hours especially on long flights.
9. Take your medications prescribed by your doctor. I suggest that you make sure to take at least for 2 weeks before travel
10. Use a waterproof skin barrier ointment (zinc oxide) to protect skin if you do have frequent accidents

Bottom Line: If you have urinary incontinence, you may have problems with airline travel. Applying a few of these principles may just make that flight more enjoyable and less stressful.

For more information on urinary incontinence, I recommend my new book,
The Complete Guide To Women’s Pelvic Health which is available at Amazon.com

New book on women’s health

Menopause and Bladder Control

Some women begin to have problems with their bladder and experience overactive bladder (gotta go, gotta go right now) and urinary incontinence or loss of urine at inopportune times at the time or shortly after menopause.

Does Menopause Affect Bladder Control?

Yes. Some women have bladder control problems after they stop having periods (menopause or change of life). If you are going through menopause, talk to your health care team.

After your periods end, your body stops making the female hormone estrogen. Estrogen may help keep the lining of the bladder and urethra healthy. A lack of estrogen could contribute to weakness of the bladder control muscles.

Pressure from coughing, sneezing or lifting can push urine through the weakened muscle. This kind of leakage is called stress incontinence.

Although there is no evidence that taking estrogen improves bladder control in women who have gone through menopause, small does may help thicken the bladder lining and decrease the incontinence.  Your doctor can suggest many other possible treatments to improve bladder control.

What Else Causes Bladder Control Problems in Older Women?

Sometimes bladder control problems are caused by other medical conditions. These problems include:

Infections

Nerve damage from diabetes or stroke

Heart problems

Medicines

Feeling depressed

Difficulty walking or moving

A very common kind of bladder control problem for older women is urge incontinence. This means the bladder muscles squeeze at the wrong time and cause leaks.

If you have this problem, your doctor can prescribe medication that can certainly alleviate that problem.

What Treatments Can Help You Regain Bladder Control?

Your doctor may recommend limiting foods or fluids, such as caffeine, which are bladder irritants and increase the desire to go the rest room.

There are also pelvic exercises that can strengthen the muscles in the urethra and the vagina.   Life’s events like childbirth and being overweight, can weaken the pelvic muscles.

Pelvic floor muscles are just like other muscles. Exercise can make them stronger. Women with bladder control problems can regain control through pelvic muscle exercises, also called Kegel exercises.

Exercising your pelvic floor muscles for just five minutes, three times a day can make a big difference to your bladder control. Exercise strengthens muscles that hold the bladder and many other organs in place.

Two pelvic muscles do most of the work. The biggest one stretches like a hammock. The other is shaped like a triangle. Both muscles prevent leaking of urine and stool.

Pelvic exercises begin with contracting the two major muscles that stretch across your pelvic floor. There are three methods to check for the correct muscles.

1.     Try to stop the flow of urine when you are sitting on the toilet. If you can do it, you are using the right muscles

2.     Imagine that you are trying to stop passing gas. Squeeze those same muscles you would use.

3.     Lie down and put your index finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscle.

Do your pelvic exercises at least three times a day. You can exercise while lying on the floor, sitting at a desk or standing in the kitchen.

Be patient. Don’t give up. It’s just five minutes, three times a day. You may not feel your bladder control improve until after three to six weeks. Still, most women do notice an improvement after a few weeks.

Other treatments include inserting a device, a pessary, directly into the vagina to lift the urethra and the base of the bladder to its proper position behind the pubic bone.  And finally, if the conservative methods of medication, exercises, and dietary modification don’t work, then you should talk to your doctor about one of the surgical procedures that can lift the bladder into the proper position to prevent leakage

Bottom Line: No one needs to suffer the embarrassment of urinary incontinence.  Help is available for all those women who have bladder control problems

Urinary Incontinence-What It Is and What Can Be Done

What is urinary incontinence?

Urinary incontinence is the uncontrollable and involuntary loss of urine that affects more than 10 million Americans. Incontinence can be very embarrassing as it can interfere with a normal, full life. Fortunately, today something can be done about it and in most instances it can be cured completely.

What are the types of incontinence?

There are three common categories of urinary incontinence. These are stress incontinence, overflow incontinence, and urge incontinence. Although all people with incontinence experience a loss of bladder control, each type of incontinence has its own pattern of signs and symptoms. People with stress incontinence leak urine when they cough, sneeze, or laugh. They may be dry at night but leak upon getting up from the bed in the morning. People with urge incontinence wet themselves if they don’t get to the bathroom immediately. They get up frequently during the night to urinate. They go to the bathroom constantly. They may wet the bed at night. People with overflow incontinence take a long time to urinate and have a weak, dribbling stream with no force. They dribble small amounts of urine throughout the day and night.

What causes incontinence?

Stress incontinence is due to the loss of the support from the pelvic floor muscles. Commonly the pelvic organs bladder and uterus slip down into the vagina (vaginal prolapse). Overflow incontinence is to either a narrowing of the tube (the urethra) that allows the urine to exit from the body or inability of the bladder muscle to contract and expel the urine from the bladder. Urge incontinence can be a result of bladder irritability such as a urinary tract infection or to neurologic problems in the brain or spinal cord.

How is the diagnosis of urinary incontinence made?

An accurate diagnosis is the essential first step in the treatment of incontinence. The evaluation consists of a medical history followed by a thorough physical exam that includes a pelvic exam and a rectal exam. Certain diagnostic tests such as a urinalysis, urine culture, cystometrogram (bladder pressure test) and cystoscopy (inspection of the bladder with a small lighted tube) are usually required to complete the diagnostic evaluation.

What is the treatment for urinary incontinence?

The treatment for stress incontinence depends on the degree of anatomical abnormality. In mild cases pelvic exercises and/or medication may be all that’s needed. However, in more severe cases surgery is the best treatment. The treatment for overflow incontinence may be alleviated with medication or intermittent self-catheterization to drain out the urine. Surgery may be required when the cause is a narrowed urethra or a nerve problem. The treatment of urge incontinence consists of antibiotic medication to treat the infection or medication to relax the irritated bladder.

Summary

Urinary incontinence shouldn’t take over your life. It is almost always treatable, and often completely curable. Working as a team, we can put you back in control of your bladder and your life. That means you’ll be free-free to get a night of uninterrupted sleep, to travel comfortably, to be as active as you want to be. Instead of worrying about embarrassing accidents, you’ll be able to do the things you most enjoy.

Urinary Incontinence-Tests You May Need To Do

The purpose of the evaluation is to identify the cause of the incontinence, to determine the damage to the bladder and kidneys, and to select the appropriate treatment for the specific cause of the leakage. All of the tests can be performed in the office or as an outpatient at the hospital. All of the tests are associated with minimal discomfort. You can resume normal activity immediately following the procedures. The evaluation of urinary incontinence can include any of the following tests or procedures:

Cystoscopy – A local anesthetic is inserted into the urethra (the tube that drains the urine from the bladder). A small telescope is inserted in the urethra to examine the inside of the bladder. In women, a pelvic examination is performed at the end of the procedure. The examination takes approximately 5 minutes. After the procedure there may be a small amount of bleeding or mild burning with urination.

Flow Rate – This is a procedure to measure the efficiency of the bladder and the muscles or sphincters that hold the urine in the body. You will be asked to drink several glasses of water, When you feel that you have to urinate, you will be asked to urinate over a toilet that contains a recording device. The device will measure the volume of urine and the time it takes to empty your bladder.

Cystometrogram (CMG) – This is a procedure in which a small catheter (a plaster or rubber tube smaller than a pencil) is inserted into the bladder. The catheter is used to deliver sterile water or gas (carbon dioxide) into the bladder. You will be asked to describe the first sensation to urine and the strong urge to urinate. This procedure takes approximately 10-15 minutes. After the cystometrogram the catheter is removed and you will be asked to cough, strain and then urinate. This test is performed to determine the extent of leakage. You can expect some burning or passage of air with urination,

Voiding Diary – This is a record of the amount and time of day that urination takes place and when leakage occurs, (The amount of urination should be recorded in ounces.)

Voiding Cystourethrogram (VCUG) – This is an X-ray procedure in which a catheter is inserted in the bladder and the bladder filled with iodine. The catheter is removed and X-rays are taken while voiding.

Intravenous Pyelogram – This is an X-ray procedure that requires an injection of iodine into a vein and pictures are taken of the kidney at various time intervals. This determines the anatomy and the presence of damage to the kidneys. There is occasional nausea, bad taste in the mouth, or lightheartedness with the procedure. You will be asked to take laxatives before the procedure. (Please notify me or the radiologist if you are allergic to iodine or seafood.)

Not all of these diagnostic tests are required for each patient.

Kegel Exercises Are For Men, Too

Kegel exercises have been helpful for women with urinary incontinence and have been used for years with favorable success.  Recently, these same exercises have been useful for men suffering from erectile dysfunction, urinary incontinence, and premature ejaculation.

Kegel exercises focus on the muscles of the pelvic floor, which supports the bladder, the prostate gland and the bowel and is made up of layers of muscle that stretch from the tailbone at the back to the pubic bone in front.  Exercising these muscles will increase the support of the prostate gland, the bladder, and improve the blood supply to the penis, and increase the tone of the urinary sphincter or the muscle that surround the urethra and helps control urination.

By regularly performing Kegel exercises men report improvement in their erections and even in the quality of their orgasms.  Perhaps the most dramatic finding was the improvement resulting from pelvic floor exercises compared to the use of Viagra – the results were the same.

Approximately 10% of men will have some mild urinary incontinence after surgical removal of their prostate gland for prostate cancer.  This is usually temporary and subsides after several months.  The period of incontinence can be significantly shortened if the men practice Kegel exercises before the surgery and immediately after the surgery.

Pelvic floor rehabilitation is also effective for premature ejaculation, the condition when ejaculation occurs within seconds after vaginal penetration.  This is a condition that is very common and is a source of anxiety and disappointment for the man who has the problem and also for his partner.  Men who do Kegel exercises can expect a 50% improvement in time from vaginal penetration to ejaculation.

How to find and use the muscles of the pelvic floor

The muscles in the pelvis support the bladder, prostate gland, the urinary sphincter which is responsible for control of urination.  As men age, or after surgery, especially for prostate gland surgery, these muscles become weakened and men will have problems controlling urination and\or erectile dysfunction.  This group of muscles can be strengthened by performing Kegel exercises.

In men, this exercise lifts up the testicles, also strengthening the cremaster muscle, as well as the anal sphincter, as the anus is the main area contracted when a Kegel is done.

How to find the pelvic floor muscles

To find your pelvic floor muscles, you should sit or lie comfortably with the muscles of your thighs, bottom and stomach relaxed.  You should then tighten the ring of muscle around your anus without squeezing your bottom. To feel these muscles, try to stop your flow of urine mid-stream, and then restart it.  Although the exercises have to be learned (possibly over a matter of days), with practice they can be carried out while watching TV or while waiting for the light to turn from red to green.

Getting started.

First, go to the bathroom and empty your bladder.  Next tighten the pelvic floor muscles as if you were preventing gas from escaping from your rectum and hold for a count of 10.  Then relax the pelvic muscles completely for a count of 10.  Repeat this cycle 9 more times.  Do this same exercise 3 times a day (morning, afternoon, and night).

You can also identify the pelvic muscles when you are urinating over a toilet by starting and stopping the flow of urine.  You can do the same exercise when you are not urinating.

You can do these exercises at any time and any place. Most people prefer to do the exercises while lying down or sitting in a chair. After 4 – 6 weeks, most people notice some improvement. It may take as long as 3 months to see a major change.

Bottom Line:  Erectile dysfunction, premature ejaculation, and dribbling after urination are all amenable to strengthening the pelvic floor muscles.  This can be accomplished by performing Kegel exercises.  Remember a Kegel 3 times a day, keeps the doctor away!