Non-surgical therapy for urological incontinence
Your therapy will depend on the intensity of your symptoms and the type of urine incontinence you have.
If urine incontinence is the result of an underlying ailment, you may also receive therapy for the underlying illness.
Initially, non-pharmaceutical and non-surgical therapies are attempted. These consist of:
- lifestyle alterations
- training of pelvic floor muscles (Kegel exercises)
- bladder training
Adaptations in way of life
Regardless of the type of urine incontinence you experience, a doctor may recommend that you adopt easy lifestyle adjustments to alleviate your symptoms. For instance, the physician may suggest:
- decreasing your caffeine intake, which is found in tea, coffee, and cola, as caffeine can increase the quantity of pee your body produces.
- adjusting your daily fluid intake, since drinking too much or too little might aggravate incontinence
- weight loss for those who are overweight or obese – Use the healthy weight calculator to determine if your weight is appropriate for your height. Incontinence Treatment Nottingham
Conditioning of the pelvic floor muscles
Your pelvic floor muscles encompass the bladder and urethra (the tube that takes urine from the bladder out of the body) and control the flow of urine when you urinate.
Weak or injured pelvic floor muscles can result in urine incontinence; hence, strengthening these muscles is frequently advised.
A general practitioner may recommend you to a specialist for pelvic floor muscle therapy.The specialist will determine if and to what extent you can squeeze (contract) your pelvic floor muscles.Your program should consist of at least eight muscular contractions at least three times each day and last at least three months. If the exercises are still beneficial after this period, you may continue practicing them.
Research indicates that pelvic floor muscle exercise is beneficial for all individuals with urine incontinence.
The inability to engage the muscles of the pelvis may warrant the use of electrical stimulation.
A tiny probe will be introduced into the vagina or anus (if you have a penis). The probe conducts an electrical current, which strengthens your pelvic floor muscles as you exercise them.
If you are unable to perform core stability contractions without electrical stimulation, you may find it difficult or uncomfortable, but it may be useful.
Biofeedback is a method for monitoring the effectiveness of pelvic floor workouts by providing feedback in real-time. There are various distinct biofeedback methods:
- A tiny probe might be placed into the vagina, or the anus (if you have a penis), which detects when the muscles are compressed and transmits the data to a computer screen.
- Electrodes might be inserted into the skin of the abdomen (abdomen) or around the anus; they detect muscle contractions and transmit the data to a computer screen.
There is no evidence to show that biofeedback provides a major benefit to those undergoing pelvic floor muscle training for urine incontinence, however, the feedback may inspire some individuals to perform their exercises.
The usage of vaginal cones can aid with pelvic floor muscle training. These little weights are implanted vaginally.
Using your pelvic floor muscles, you maintain the weights’ position. When you are able, you advance to the following vaginal cone, which is heavier.
Some women find it difficult or unpleasant to use vaginal cones, yet they may be helpful for stress or mixed urine incontinence. https://bristol.lipo-sculpt.co.uk/incontinence-treatment/
If you have been diagnosed with urge incontinence, bladder training may be one of the first therapies you get.
If you have mixed urine incontinence, you can also combine bladder training and pelvic floor muscle training.
It entails learning strategies to lengthen the duration between the sensation of having to pee and the actual urination. Typically, the course will run for at least six weeks.
Even though incontinence products are not a therapy for urine incontinence, you may find them beneficial for managing your disease while you wait to be evaluated or for your medication to take effect.
Among incontinence products are:
- absorbent items, such as trousers and diapers
- portable urinals
- the use of a catheter
- devices that are inserted into the vagina or urethral to stop urinary leakage, such as during exercise
Medications for stress urinary incontinence
If lifestyle adjustments and exercises do not dramatically alleviate stress incontinence, surgery is typically advised as the next step.
However, if you are unfit for surgery or wish to avoid an operation, the antidepressant duloxetine may be beneficial. This can assist in increasing the muscular tone of the urethra, hence aiding in its closure.
After 2 to 4 weeks of taking duloxetine twice daily, you will be evaluated to see if the medication is useful or producing negative effects. Possible duloxetine adverse effects include:
- sore throat
- severe exhaustion (fatigue)
Do not abruptly discontinue duloxetine, as this can potentially result in severe side effects. A physician will gradually lower your dosage.
However, duloxetine is not appropriate for everyone; thus, your doctor will review any other medical issues you have to determine if you may take it.
Medications to treat urge incontinence
If bladder training is ineffective in treating urge incontinence, a doctor may prescribe an antimuscarinic.
Antimuscarinics may also be administered if you suffer from urinary retention disease, which is characterized by a regular having to urinate, either with or without urinary incontinence. These are the most frequent antimuscarinic medications used to treat urge incontinence:
Oxybutynin is also available as a patch that is applied to the skin twice a week. Typically, they are taken as tablets that are swallowed twice or three times daily.
Typically, you will begin treatment with a low dose to minimize any negative effects. The dose of the medication can be raised until it becomes effective. Possible antimuscarinic adverse effects include:
- sore throat
- impaired eyesight
- severe exhaustion (fatigue)
In rare instances, antimuscarinics can cause angle closure glaucoma, which is an increase in intraocular pressure (glaucoma).
After 4 weeks, you will be evaluated to determine if the medication is successful, and then every 6 to 12 months to determine if it remains effective.
To identify whether antimuscarinic is suitable for you, a physician will review any other medical issues you have.
If antimuscarinics are unsuitable for you, have not benefited your urge incontinence, or have undesirable side effects, mirabegron may be suggested as an alternative.
Mirabegron relaxes the bladder muscle, which assists the bladder by filling and storing urine. It often comes in the form of a daily pill or capsule. Possible mirabegron adverse effects include:
- urinary tract disease (UTIs)
- an irregular or rapid heartbeat
- abruptly observable heartbeats (palpitations)
- a rash
The doctor will discuss any additional medical issues you have to evaluate if mirabegron is appropriate for you.
Medicine for nocturia
A low-dose form of the medication desmopressin may be used to treat nocturia, which is the frequent urge to pee throughout the night, by assisting the kidneys in producing less urine.
A loop diuretic given in the late afternoon may also keep you from waking up in the middle of the night to urinate.
The use of diuretic medication increases pee production and output. By eliminating extra fluid from the body in the afternoon, night-time symptoms may be alleviated.
Loop diuretics are not approved for the treatment of nocturia. This indicates that the product may not have undergone clinical testing to determine its efficacy and safety in treating nocturia.
However, a general practitioner or specialist may recommend an unlicensed medication if they believe it would be successful and the advantages of therapy exceed the risks.
If a general practitioner is considering prescribing an unlicensed loop diuretic, they should inform the patient of the risks and advantages involved.