Don’t go so often

Millions of Americans suffer silently with urinary incontinence thinking there’s nothing to be done about it.

But there are many treatments for urinary incontinence, a condition that, contrary to popular belief, doesn’t automatically come with age.

“That’s a really important message to get through to people. Once they realize it’s not automatic and not natural, they realize, ‘Maybe there is treatment!’” said Nancy Muller, executive director of the National Association for Continence.

While there are long-established treatment options, some new ones are being offered as well.

This summer, an over-the-counter product called Oxytrol, which is a skin patch, should become available for women who have urge incontinence.

The condition is common and is usually caused by an overactive bladder that gets signals from abnormal nerves to contract at the wrong time.

Oxytrol will remain available for men with overactive bladder by prescription only.

Another new treatment option is the external delivery of broadband light to stimulate the production of collagen and elastin to tone the skin and muscles of the pelvic floor, said internist Dr. Kenyatta Shamlin-Haynes, who offers the treatment at Medical Spa of Baton Rouge, which she co-owns with her physician sister, Dr. Tasha Shamlin.

Genityte, developed by a Montana physician, is a treatment for the most common type of incontinence, which involves the urethra and is called stress incontinence — the kind that’s triggered by laughing, coughing and sneezing.

The patented treatment is not FDA-approved at this time and not covered by insurance, but the makers will be seeking FDA approval, said Shamlin-Haynes.

Results of a clinical investigation of Genityte were presented to the American Society of Lasers in Medicine and Surgery in 2009 and were promising.

Most importantly, people should remember that incontinence “is not a disease, and there are a number of reasons” for it, said Dr. J. Christian Winters, chairman and professor for the Department of Urology at the LSU Health Sciences Center, New Orleans.

“Someone who wants to be treated should find a physician well versed in understanding the various causes and multiple ways of treating it,” Winters said.

“Actually some of the most recent research shows the first line of treatment for (incontinence) is losing weight if you’re obese,” said the NAC’s Muller.

The use of kegel exercises — the contracting and relaxing of muscles of the pelvic floor — can also be helpful for both stress and urge incontinence.

Treatments for stress incontinence, in particular, include a pessary, a device used internally to support the uretha; electrical stimulation of the muscles involved; implants that allow the uretha to close more tightly and stitches that stabilize the urethra.

“Most women,” Winters said, “are treated with a sling ... that facilitates the closing of the uretha.”

The slings are placed through the vagina and can be made of the patient’s own tissue or a synthetic mesh.

While there is some controversy surrounding synthetic mesh slings, “if you look at the data and the FDA reports, the benefits outweigh the risks,” Winters said.

As far as drug therapy for stress incontinence, Winters said that, unfortunately, “there’s not an FDA-approved medicine today” in the U.S. for the condition.

There are several prescription medicines for those with an overactive bladder.

Other treatments of overactive bladder include non-invasive methods, such as scheduling urination; avoiding certain foods, which may differ for individuals; and implanting a type of pacemaker for the bladder.