Choice of drugs and methods of treatment of urinary incontinence

Urinary incontinence is a condition when you can't hold your pee so that urine comes out suddenly. Although common to many people, one of these bladder diseases often causes the sufferer to wet the bed, causing embarrassment. You may need to take medication and follow a number of ways to treat urinary incontinence.

There are many ways you can treat urinary incontinence. Depending on your health condition and its severity, your doctor may suggest lifestyle changes, medication, therapy, or a combination of several methods so that you can return to normal urination.

Treatment of urinary incontinence through lifestyle

Before giving medication or therapy, doctors usually advise patients to make some lifestyle changes. Over the next few weeks, you may be asked to do the following.

1. Make notes of urination

Make notes in a small book that you can carry around with you. This book aims to record the time you urinate, whether you completely empty your bladder, the time you go to the bathroom, and other relevant information.

In the book, note a number of things such as:

Schedule time to go to the bathroom. This is so that you can urinate regularly.
Distance between you and the bathroom. Gradually increase the duration for 15 minutes until you are able to urinate every 3-4 hours.
Can you hold your pee. If you want to pee before your scheduled time, try to hold for about 5 minutes. Write down every complaint you experience.

2. Maintain ideal body weight

Before taking medication, people who experience urinary incontinence will usually be asked to live a healthy lifestyle. One of them is by maintaining body weight. The reason is, excess weight makes you more susceptible to urinary incontinence.

According to studies in women over 70 years of age, women with an ideal body weight and body mass index are at twice the risk of developing urinary incontinence than obese women.

In order for your body mass index to remain ideal, you must lead a healthy lifestyle such as:

brisk walk for 30 minutes on 5 days of the week,
reduce the number of calories you consume,
multiply eat fruits and vegetables,
avoiding sugary snacks,
reduce saturated fat, and
avoid processed foods.

3. Limiting consumption of everything that is diuretic

Alcoholic and caffeinated drinks are diuretics. Both increase the water and salt levels in the urine so that urine production increases. If you drink too much of this drink, your bladder will fill up quickly and urine may come out suddenly.

Medicines for hypertension and heart disease are also diuretics, which can worsen urinary incontinence. If you have bladder problems and need to take diuretic drugs regularly, try to consult your doctor about adjusting the dosage.

4. Doing Kegel exercises

Maybe you are a little familiar with this one exercise. Kegel exercises can strengthen the pelvic muscles that support the organs in the area, improve bladder control, and prevent urine leakage.

A study from the University of Otago in New Zealand showed that people who did routine Kegel exercises were 17 times faster than urinary incontinence. This exercise also helps treat incontinence in menopausal women.

Kegel exercises can be done lying down, sitting, standing, or walking. If this is your first time doing this, it's best to do it while lying down with your knees bent. Here are the steps:

Find the lower pelvic muscles first in a way like holding urine. The muscles that you hold are called the pelvic floor muscles.
Tighten your lower pelvis for five seconds, then relax for five seconds. Repeat 4-5 times, then increase the duration to ten seconds.
Focus on tightening your pelvic floor muscles for best results.
As you tone your pelvic muscles, try to breathe in a relaxed manner. Don't hold your breath and don't tighten your abs, thighs and buttocks.
Relax your pelvic floor again for 3 seconds.
Repeat three times a day, each with 3-10 repetitions.

5. Yoga

Yoga movements are not only beneficial for the muscles of the body, but also for the muscles in the bladder area. If these muscles are strong, the bladder can certainly accommodate urine optimally so that the urge to urinate is controlled.

The yoga poses recommended for bladder health generally involve the pelvic muscles, waist, and thighs. Try consulting a yoga therapist to find the most appropriate movements for your needs.

Use of drugs to treat urinary incontinence

If lifestyle improvements do not work, your doctor will suggest taking medication or hormone therapy. This method does not directly eliminate urinary incontinence, but rather restores normal bladder function.

Here are the drugs and hormones that are often used.

1. Anticholinergic drugs and alpha agonists

In urinary incontinence, the bladder muscles contract more frequently, so you constantly want to urinate frequently. Anticholinergic drugs can treat urinary incontinence by relaxing the bladder muscles.

Medicines in this group include oxybutynin, tolterodine, and solifenacin. All three work very well on the bladder, but there are possible side effects of dry mouth, constipation, and blurred vision.

The newest drug that is now being given to many patients is merbegron. Merbegron is an alpha agonist drug with a different way of working. However, its function is still to relax the bladder. There are fewer side effects, but they may trigger a rise in blood pressure.

2. Hormone therapy

Menopause-related urinary incontinence can be treated with estrogen hormone therapy. This hormone strengthens the walls of the vagina, bladder neck, and urethra. That way, the function of the urinary system returns to normal and the urine no longer leaks.

Electrical stimulation therapy

Electrical therapy is used when the medication does not significantly affect urinary incontinence. Also called neuromodulation therapy, this method uses low-voltage electrical currents in the same way as the innervation of the brain and bladder.

There are two types of electrical stimulation therapy, namely:

1. Percutaneous Tibial Nerve Stimulation (PTNS)

PTNS is a simple therapy to reset the nerve delivery between the brain and the bladder. To do this, the doctor will insert a small needle into the bottom of your foot. This needle is an electrode that functions to conduct electricity.

Electricity will flow from the device to the nerves in the legs, then continue to the nerves in the pelvic area. This signal gives orders to the bladder not to contract. The entire procedure takes 30 minutes and needs to be repeated up to 12 times.

2. Sacral Nerve Stimulation (SNS)

The SNS works by stimulating the sacral nerves located at the bottom of the spine. Stimulation in this area corrects the signal between the brain and bladder with the main function of preventing the bladder from becoming overactive (overactive bladder).

Your lower back will be attached with a kind of small cable. These cables enter the sacral nerves and control signals to the bladder. If necessary, the cords can be implanted permanently to restore and maintain a healthy bladder.

Surgery to control urine flow

In cases of severe urinary incontinence, lifestyle changes, medications, or electrical therapy alone are not enough. You may need several types of medication or surgery to improve bladder function.

There are various surgical procedures that can be performed, which are as follows.

1. Installation slings bladder

Sling is a medical device that is placed in the pelvic area to treat urinary incontinence. This tool functions like a cushion that supports the bladder. When properly installed, slings can treat incontinence for years to come.

2. Bladder neck suspension surgery

This is a surgical procedure to treat urine leakage in women. This major operation aims to lift the bladder neck towards the pubic bone. By adjusting the position of the bladder, its function can return to normal.

3. Installation of an artificial sphincter

At the end of the bladder, there is a sphincter (ring-shaped muscle) that regulates the flow of urine. If there is a disruption or decreased function of the sphincter, this will cause the urine to pass unwanted.

The artificial sphincter can replace the function of the weakened original sphincter. Once the bladder begins to fill, all you need to do is activate it so that the urine comes out with a controlled flow.

4. Use of medical devices

For some people with urinary incontinence, the best options may not be medication, therapy, or surgery. The use of medical devices may be more appropriate or considered safe. These tools include:

urine catheter of a kind indwelling catheter or intermittent catheter,
urine collection equipment outside the body,
absorbent products such as adult diapers, pads, or tampons, as well
vaginal pessary, that is, a special device to support the bladder.

5. Bladder reshaping surgery

This is major surgery to treat urinary incontinence which is really rare and complicated. There are two types of surgery, namely surgery to expand the bladder to increase its capacity and surgery to reset the flow of urine.

Urinary incontinence is a urinary disorder that can be treated with lifestyle changes, drug consumption, therapy, and surgery. The causes are very diverse, so you should consult your doctor first to determine the right treatment.