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The most common types of urinary
incontinence include:
Transient incontinence.
Appears
suddenly, is present for six months or
less, and is usually caused by treat-
able factors. Potential causes are
delirium, infection, atrophy, pharma-
ceuticals, excess urine output, re-
stricted mobility and stool impaction.
Urge incontinence.
An involun-
tary urination that occurs soon after
feeling an urgent need to void. Urge
incontinence is the most common type
of urinary incontinence in older adults.
Stress incontinence.
Urine loss
prompted by a physical movement or
activity—such as coughing, sneez-
ing, running or heavy lifting—that
puts pressure (stress) on the bladder.
Stress incontinence is not related to
psychological stress. It is the most
common type of incontinence suffered
by women, especially older women.
In addition, women who have given
birth are more likely to have stress
incontinence.
Overflow incontinence.
An in-
ability to empty the bladder. Individu-
als with it may produce only a weak
stream of urine and may feel that their
bladder is never completely empty.
ixed incontinence.
Urine loss
having features of two or more types
of incontinence. Older adults often
experience a mix of both stress and
urge incontinence.
It’s time for women to stop being shy about
incontinence. More and better treatment op-
tions are available now than ever before to
control the condition and enhance a woman’s
quality of life.
✦
And aging baby boomers
are expected to be more proactive in dealing
with the condition than previous generations,
looking past the stigmas and seeking help.
Incontinence is the loss of bladder or bowel control.
The National Association of Incontinence estimates that
13 million Americans are incontinent and 85 percent of
them are women. Because incontinence is a symptom
and not a disease, the method of treatment depends on
diagnostic results.
Renate Hankins, 68, describes her bowel and urinary
incontinence as a “horrible problem.” Hankins explains
that she knew there was something wrong, but she didn’t
know that help was available, so she dealt with the condi-
tion by staying home.
She eventually sought help at the Incontinence and
Pelvic Floor Disorder Center at Methodist Specialty and
Transplant Hospital—the only pelvic floor center that of-
fers anal manometry, defecography, 3-D anal and rectal
ultrasounds, and complete bladder evaluation, all in one
facility. The Center is the only hospital-based program
available in San Antonio. It is one of very few diagnostic
centers nationwide devoted to evaluating urinary and
anal incontinence.
The staff conducted urodynamics with video and anal
rectal physiology testing and a defecogram.
What’s going on
“Using urodynamics and defecography studies, we find
the cause of the incontinence and determine the sever-
ity of bladder or bowel dysfunction,” says
Paul Morton,
Urgent matters
Specialized treatments at the Incontinence and Pelvic Floor Disorder Center
SP AK UP
MD
, who is medical director at the center as well as a
gynecologist. “We then help the referring physicians de-
termine the best course of treatment for what is often an
embarrassing problem for women and men.”
The urinary tract is the body’s drainage system for
removing wastes and extra water. Most urodynamic tests
focus on the bladder’s ability to hold urine and empty
steadily and completely. Defecography is an x-ray of the
area around the anus and rectum that shows how well the
person can hold and evacuate stool. The test also identifies
structural changes in the rectum and anus. The Center is
the only center in South Texas that performs anal rectal
physiology studies.
Tests at the Center are conducted on an outpatient basis
by trained nurses using advanced equipment. Evaluations
are provided for pediatric and adult patients. The Center
offers nonsurgical treatment options such as medication
and education using biofeedback, which is 95 percent
successful.
Tests indicated Hankins had stress urinary inconti-
nence, which was treated with the sling procedure. She
also had bowel constipation and incontinence due to
overflow and incomplete emptying. She was successfully
treated with a series of six weekly biofeedback sessions.
“The biofeedback taught me how to listen to my body,
and I relearned how to usemy abdominal muscles,” she says.
Colorectal surgeon
Seema Izfar, MD
, relies on the
Center to treat patients with fecal incontinence. “Many
conditions can cause fecal incontinence, from obstetric
injuries to previous anal-rectal surgeries,” she says. “For
many patients, the dysfunction has been present for a
while; then aging causes the weakening of muscles and
the bowel dysfunction becomes more noticeable.”
For more information on the Incontinence and
Pelvic Floor Disorder Center at Methodist Specialty and
Transplant Hospital, visit
or call
210-575-8171
. Center staff also can assist in obtaining
names of credentialed physicians to arrange a patient
referral.
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