Urinary incontinence is defined as the failure to prevent urine from leaking out of the urethra (the tube carrying urine from the bladder out of the body). There are three general types of urinary incontinence:
- Stress incontinence: may be exacerbated or brought on by sneezing, coughing, laughing, or exercise
- Overflow incontinence: bladder is unable to properly empty, causing dribbling and urine leakage
- Urge incontinence: describes the sudden, uncontrollable urge to urinate
Pregnancy, childbirth, and the anatomical structure of the female urinary tract account for why women are two times more likely than men to experience incontinence. This condition becomes increasingly common with age, and can develop as a result of a prolapsed bladder (cystocele) or a prolapsed uterus.
Incontinence can be an unsettling and potentially embarrassing condition, but there is no need to suffer in silence! At the pristine Women’s Medical Center, PC facility, located in Mt. Pleasant, Michigan, our team of board certified Obstetricians/Gynecologists understand the unique health concerns of our patients, and offer compassionate, discreet care and customized treatment plans that are tailored to address your specific gynecological and/or urological concerns. After performing the appropriate diagnostic tests to ascertain the root cause of your incontinence, your Women’s Medical Center treatment provider will provide clear recommendations as to the optimal course of treatment, taking into consideration your medical history, general health, personal preferences, severity of current symptoms, and plans to become pregnant in the future.
CYSTOCELE (BLADDER PROLAPSE, ANTERIOR PROLAPSE)
A cystocele, which is also referred to as a prolapsed bladder or anterior prolapse, develops when the supportive tissue situated between a woman’s vaginal wall and bladder weakens and stretches, causing the bladder to bulge downward and press against or move the wall of the vagina. Bladder prolapse is often caused by a straining of the muscles responsible for supporting the pelvic organs, as can occur during vaginal childbirth or chronic constipation.
Cystocele symptoms typically include:
- Difficulty urinating or involuntary release of urine (incontinence)
- Feeling of pressure or fullness in the vagina and pelvic region
- Discomfort when bearing down, coughing, or lifting
- Pain during sexual intercourse
- Chronic bladder infections
- A bulge of tissue which may feel as though you are sitting on an egg
RECTOCELE (POSTERIOR PROLAPSE)
When there is a prolapse in the rectal area it is referred to as a “rectocele” or “posterior prolapse.” Rectoceles occur when the front wall of the rectum pushes into the back wall of the vagina. Many rectocele patients are asymptomatic, however, if you have symptoms they topically included:
- Pain during intercourse
- Vaginal bleeding
- Sense of fullness in the vagina
- Difficulty having bowel movements
Uterine prolapse occurs when the uterus protrudes out of, or slips down into the vagina as a result of weakened pelvic floor muscles. The natural aging process, estrogen loss, pregnancy, childbirth, and repeated straining can all injure the supportive tissues in and around the uterus, and may contribute to subsequent uterine prolapse.
Patients suffering from a prolapsed uterus may experience one or more of the following symptoms:
- Urine leakage (incontinence) or urine retention
- Lower back pain
- Tissue protruding from the vagina
- Difficulty having a bowel movement
- Sensation of heaviness or pulling in the pelvic area
- Sexual concerns about vaginal looseness
- Feeling as though you are sitting on a small ball
INCONTINENCE/PROLAPSE TREATMENT OPTIONS
Symptoms associated with mild cases of bladder prolapse (cystocele) or uterine prolapse may be improved with non-invasive measures, such as exercises to strengthen the pelvic floor (Kegel exercises), while more severe cases may require additional treatment or surgery to reinforce the vaginal tissues, lift the prolapsed bladder, and/or tighten the pelvic floor muscles.
- Leakage protection products: this treatment category includes catheters, absorbent pads and protective garments, a vaginal pessary (rubber device that fits into the vagina to reinforce support of the uterus, bladder, vagina, or rectum), and urethral inserts
- Interventional therapies: InterStim Bladder control therapy (sacral nerve stimulation), pelvic muscle exercises (kegel exercises), suprapubic catheter, Botox injections into the bladder muscle, biofeedback therapy, bladder training, and other lifestyle changes
- Medications: antidepressants (i.e. imipramine, duloxetine), anticholinergics (formulated to calm overactive bladders), topical estrogen
- Surgical procedures:
- Biological reinforcement surgery (collagen grafting),
- Anterior colporrhaphy (anterior vaginal wall repair)
- Posterior colporrhaphy (posterior vaginal wall repair)
- Vaginal hysterectomy
- Suburethral sling procedure
- Bladder augmentation surgery
- Artificial urinary sphincter
- Uterosacral ligament suspension surgery
- Sacrospinous vaginal vault suspension (sacrospinous ligament fixation)
- Sacral colpopexy
Your Women’s Medical Center, PC physician will review all of your incontinence treatment options, helping you to select the most effective and least invasive course of action to address and resolve your incontinence symptoms. Some of these procedures may require a referral to a sub-specialist.
If you would like additional information about any of the gynecological services or treatments for incontinence/prolapsed bladder/uterine prolapse offered at the Women’s Medical Center, P.C., please contact our office today. We look forward to speaking with you, and to scheduling your initial appointment with one of our exceptional OBGYN specialists.