The inability to control bladder function (urinary incontinence) or rectal function (fecal incontinence) can affect people of all ages. Although incontinence is a medical problem, it can affect emotional, psychological and social well-being also. Many people are afraid to participate in routine, daily activities because they are afraid of having an accident. Contrary to popular belief though, incontinence is not a normal part of aging or an inevitable consequence of bearing children. The majority of incontinence problems can be successfully treated.
Urinary incontinence, involuntary loss of urine, affects more than 12 million Americans. Women are affected twice as often as men, and at least one of every four women suffers from some degree of incontinence. Types and causes of urinary incontinence include:
- Stress incontinence Urine loss that occurs when there is stress to the bladder such as laughing, coughing or sneezing. This is the most common type of urinary loss in women and is usually caused by a "dropped" bladder.
- Urge incontinence Urine loss caused by involuntary contractions of the bladder. This is the most common type of urinary loss in menopausal women and in patients who have a neurologic problem.
- Mixed incontinence This condition occurs when both stress and urge incontinence occur together.
- Overflow incontinence A loss of urine which occurs because the bladder is distended.
- Environmental (functional) incontinence This condition occurs when a physical or mental condition prevents normal bladder function and results in involuntary loss of urine.
Fecal incontinence is estimated to affect one percent or more of all Americans and 10 percent or more of senior citizens. Like urinary incontinence, women are affected more often than men. Fecal incontinence may be the result of damage to the anal sphincter muscle or damage to the nerves which control the anal sphincter and pelvic floor muscles.
Causes of fecal incontinence:
- Childbirth injuries
- Spinal cord injuries
- Colorectal tumors
- Neurologic diseases
- Irritable bowel syndrome
- Previous rectal surgery
Highly Skilled Physicians
Physicians with special training in treating incontinence at the center include:
- Colorectal surgeon - specializes in problems of the colon, rectum and anus, with special emphasis on motility disorders including constipation, diarrhea and incontinence
- Urogynecologist - specializes in problems of the reproductive system and lower urinary tract in women
- Urologist - specializes in problems of the urinary tract in women and the urinary tract and reproductive system in men
- Adult gastroenterologist - specializes in problems related to the gastrointestinal tract with special emphasis on motility disorders, including constipation, diarrhea and incontinence
- Pediatric gastroenterologist - specializes in problems related to the gastrointestinal tract of children, with special emphasis on motility disorders including constipation, diarrhea and incontinence
Tests to Evaluate Urinary Incontinence
Urinary incontinence can be determined using a number of different methods:
- Urinalysis and culture
- Catheterization for residual volume
- Stress testing
- Urodynamic testing
- Urethral pressure profilometry
- Pressure/voiding studies
- EMG studies of muscle function
- Bladder x-ray studies
Tests to Evaluate Fecal Incontinence
Fecal incontinence can be determined using a number of different tests and methods:
- Barum x-ray studies including defecogram
- Manometric studies of sphincter function
- EMG studies of muscle function
- Ultrasound of sphincter muscles
There are so many types and causes of incontinence, it is critical that patients undergo a thorough evaluation to determine the best possible treatment plan.
There are special exercises and training programs designed to improve bladder and bowel control that involve behavior and diet modifications. Biofeedback techniques can also help improve control of the bladder, bowel and pelvic floor muscles. In addition, pelvic floor stimulation involves painless electrical stimulation of the pelvic floor muscles to increase strength and enhance bladder and bowel control. Several different medications and surgical techniques can also be highly successful in treating certain types of incontinence.
The Comprehensive Continence Center is located on the first floor of Lutheran General Hospital and is open Monday through Friday, with early morning hours available.
Call us at 847.723.8014 for more information or to make an appointment.