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Urogynecology ABC’s - Lesson One: Types of Incontinence

There are five basic types of incontinence:

Stress incontinence occurs when pelvic muscles have been damaged, causing the bladder to leak during exercise, coughing, sneezing, laughing, or any body movement which puts pressure on the bladder.
Urge incontinence, the urgent need to pass urine and the inability to get to the toilet in time, occurs when nerve passages along the pathway from the bladder to the brain are damaged, causing a sudden bladder contraction that cannot be consciously inhibited.
Overflow incontinence refers to leakage that occurs when the quantity of urine produced exceeds the bladder’s holding capacity.
Reflex incontinence, the loss of urine when the person is unaware of the need to urinate, may result from an abnormal opening between the bladder and another structure, or from a leak in the bladder, urethra, or ureter.
Incontinence from surgery follows such operations as hysterectomies, cesarean sections, prostatectomies, lower intestinal surgery, or rectal surgery.

Urogynecology ABC’s - Lesson Two

You are not alone. We can help.
Approximately 80% of those affected by urinary incontinence can be cured or improved. Despite the high success rates in treating incontinence, only one out of every twelve people affected seeks help. Many types of treatment are available for incontinent people. After a thorough evaluation, Dr. van Raalte can recommend the treatment that is appropriate for you. The three major categories of treatment are: behavioral, pharmacological, and surgical.

Behavioral Techniques include bladder retraining and pelvic floor stimulation.
Pharmacologic Therapy (medications or drugs) is another common treatment for incontinence.
Surgical Treatment may be used to treat your incontinence. Several of the more common surgeries include bladder neck suspension or sling procedures. Periurethral bulking agent injections (collagen injections around the urethra) are another out-patient treatment modality.

Urogynecology ABC's- Lesson Three

Statistics and other Fun Facts

13 million Americans are incontinent- 85% of them are women.
It is estimated that one in four women ages 30-59 have experienced an episode of urinary incontinence.
Fifty percent or more of elderly persons living at home or in long-term care facilities are incontinent.
Some foods and beverages are thought to contribute to urine leakage. Their effect on the bladder is not always understood, but you may want to see if eliminating one or all of the items listed below improves your urine control.

Common Bladder Irritants:
- Alcoholic beverages
- Carbonated Beverages (with or without caffeine)
- Milk or milk products
- Coffee or Tea (even decaffeinated)
- Medicines with caffeine
- Citrus juice and fruits
- Tomatoes/Tomato-based products
- Highly spiced foods
- Sugar and artificial sweetener
- Honey
- Chocolate
- Corn Syrup

Urogynecology ABC’s - Lesson Four

Understanding Pelvic Support Problems

The pelvic organs are held in place by three types of support:
1. Layers of connecting tissue called fascia
2. Thickening of the fascia called ligaments
3. A group of muscles that lie on either side and around the openings of the urethra, vagina, and anus

When tissues that support the urethra, bladder, uterus, cul-de-sac, and rectum become stretched, they allow the organ that they support to sag or bulge into the vagina. Based on the organ or organs involved, the main types of pelvic support problems are described as:

Cystocele: Bulging of the bladder into the vagina
Uterine Prolapse: Descent of the uterus from its normal position
Enterocele: Sagging of the small intestine against the upper part of the vagina
Rectocele: Protrusion of part of the rectum into the vagina
Vaginal Vault Prolapse: Bulging of the top of the vagina into the vagina