Q: I think I have incontinence. What should I do?

Ask Our Expert About Incontinence

About Our Expert

Yong T. Zheng M.D. is interim chief of pelvic reconstructive surgery. 
 

Practicing Medicine Since

2001

Education

B.S. in Pre-Med cum laude, 1995, Sophie Davis Medical School, City University of New York

M.D., 1997, New York Medical College, Valhalla

Internship and Residency in Obstetrics and Gynecology

New York Medical College (Associate Chief Resident final year)

Fellowship in Female Pelvic Medicine and Reconstructive Surgery

LSU Health Sciences Center

Board Certification

Board certified in Obstetrics and Gynecology

Honors and Awards

Best Resident Research Project, 2001
Dean's List 1991, 1992, 1994

 

• I think I have incontinence. What should I do?
• I heard there are different types of urinary incontinence. What’s the difference between them?
• What causes incontinence?
• Can constipation cause incontinence?
• What are my options for treatment?
• Can men have incontinence?

Q: I think I have incontinence. What should I do?

A: Don’t let embarrassment, fear or wrong information about incontinence keep you from getting help. We understand how unpleasant and distressing this condition can be – and you’re not alone. Nearly 12 million people have urinary incontinence, but the good news is we can control your symptoms and ultimately cure your condition. Begin by talking with your doctor, who can offer treatment options based on the type and severity of your incontinence. If you need more help, your doctor may refer you to a urogynecologist (like myself) or a urologist, doctors who specialize in treating incontinence.

Q: I heard there are different types of urinary incontinence. What’s the difference between them?

A: Urinary incontinence is the unwanted loss of urine. If you suddenly lose urine at the wrong time and place, you may have urge incontinence. If urine leaks when you exercise, cough, sneeze, laugh or do other movements that press on your bladder, you may have stress incontinence.

Q: What causes incontinence?

A: There are different causes of incontinence. We commonly refer to urge incontinence as an “overactive bladder,” which occurs when your bladder muscle spasms or contracts. What causes the spasms? In most women, there’s no known cause. Occasionally, spasms happen because the bladder nerves are damaged by stroke, Parkinson’s disease, multiple sclerosis, Alzheimer’s disease, a brain tumor or aneurysm and spinal cord injuries. Other spasms can be caused by eating foods or drinking beverages that contain chemicals that irritate the bladder, an infection, lack of estrogen in the genital tissues or bladder, kidney stones, diabetes mellitus, chronic constipation, or drinking too much liquid or not enough.

Stress incontinence is caused by weak pelvic muscles and poor ligament support of the bladder and urethra, or a defect in the tube connecting the bladder to the urethra. Some experts believe incontinence can be caused by extreme stress on the pelvic muscles during childbirth. Multiple pregnancies, long pushing times and large babies, as well as activities such as chronic lifting of heavy items, chronic coughing and some sports activities, may increase your risk of incontinence.

Q: Can constipation cause incontinence?

A: Urge incontinence improves when we treat chronic constipation. I recommend gentle, natural dietary changes to treat constipation, including increasing daily fiber to 20-35 through foods and supplements. (A half-cup of All Bran cereal has almost 10 grams of fiber. One cup Raisin Bran has about 8 grams of fiber.)

Q: What are my options for treatment?

A: Changing your diet and doing special pelvic exercises, known as Kegel exercises, can improve urinary incontinence symptoms so well that only 20 percent of patients need more treatment. If you need additional treatment, there are medications, painless electrical stimulation and options for surgery.

Dietary changes
Dehydration can increase bladder spasms. Drink enough fluids so your urine is pale yellow in color. If your urine is colorless, you are drinking too much liquid and can safely drink less. The amount of fluids you need every day depends on how active you are and how much liquid is in the solid foods you eat. Talk with your doctor to find the right amount for you.

How can food affect incontinence? Citric foods and drinks, carbonated drinks, tomatoes, spicy foods, sugar substitutes, milk and milk products, corn syrup, honey, tobacco and alcohol can irritate your bladder. If you have incontinence symptoms, avoid caffeine. Don’t drink in the evening. It will help you avoid waking during the night to go to the bathroom.

Exercises
Performing pelvic muscle exercises, known as Kegel exercises, can significantly improve incontinence symptoms. Kegel exercises help strengthen and tone the pelvic muscles to improve and even prevent urinary incontinence. Be patient. It can take six weeks to see improvement in incontinence through Kegel exercises. But it’s well worth the time and effort.

Medications
Some medications prevent your bladder from contracting and tighten muscles to prevent urine leakage. We believe small amounts of estrogen cream applied to the vagina or hormone replacement therapy (HRT) can help, too. Talk with your doctor about the risks and benefits of taking HRT.

Electrical stimulation
Electrical stimulation helps women exercise their pelvic muscles and stimulates the nerves that control bladder function. A small instrument inserted into the vagina delivers tiny electrical pulses. That causes your muscles to contract and become stronger. Don’t worry – it may feel strange, but it doesn’t hurt and isn’t uncomfortable.

Surgery
If exercise, diet and other conservative treatments don’t help, surgery may be an option. Several kinds of surgeries help lift the urethra and/or bladder into their normal position. They are minimally invasive (there’s just a small incision) and you usually recover in four to six weeks.

Q: Can men have incontinence?

A: Yes, millions of men suffer from incontinence each year. Incontinence can result from treatment of prostate cancer, either surgically or with radiation. The good news is our surgical techniques are better than ever and are helping men regain their bladder control.

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