Treatments for urinary incontinence should be discussed extensively with a doctor

Published: Friday, Jan. 13 2012 6:30 p.m. MST

Dr. Orrenzo Snyder, urologist, is photographed in his West Valley office on Thursday, Jan. 12, 2012.

Laura Seitz, Deseret News

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SALT LAKE CITY — Urinary incontinence can be a symptom of a poor diet, bad genetics or a result of various medical issues.

Fortunately, a variety of treatments exist to subdue the obviously inconvenient side effects and curtail the constant urge to urinate.

"You can live with it, in moderation, but sometimes the symptoms are so severe that it needs to be taken care of once and for all," said Dr. Orrenzo Snyder, a urologist at Intermountain Healthcare's Riverton Hospital.

He said medications, surgery and even non-surgical procedures exist to provide relief for urinary incontinence. Some surgical methods carry risks and Snyder said it is important that patients understand those risks before a decision is made.

Ultimately, "it's a quality of life issue," he said, adding that many sufferers stop going to social activities or adjust their lifestyles to put up with annoying side affects that can end up making a mess of any situation.

Urgency incontinence — when a person can't make it to the toilet in time — is caused by an overactive bladder. It can be treated with any one of seven available prescription anticholinergic medications or a change in diet.

Caffeine, which is a diuretic, and carbonation, as well as artificial sweeteners, can also irritate the bladder, leading to an increased need to urinate, or at least a sensation to do so.

In cases that don't respond to medications, Snyder said nerve stimulation could help to control bladder spasms. The procedure requires a small electrode to be implanted in the sacral nerve of the spine, leading to a 50 percent improvement in urgency episodes, and the need to use fewer absorbent pads.

Minor cases of stress incontinence, which is urine leakage resulting from multiple childbirths, weight gain, jogging or otherwise putting pressure on the bladder, can be treated with regular practice of Kegel exercises or surgery. Kegels help to strengthen the pelvic floor muscles and give the bladder a stronger internal structure to lean upon.

Because the majority of incontinence problems are due to vaginal prolapse, a hernia in the vaginal wall, surgery is often recommended to hold the bladder in place. A recent FDA warning has prompted increased diligence in the use of surgical mesh for bladder surgeries.

Snyder said the mesh is still safe to use, and complications only occur in 2 to 3 percent of patients, "but patients should know the risks involved." He usually turns to medications before opting for surgery of any kind.

As a specialist, he usually sees patients after other methods have failed. Bladder issues are easiest to repair, he said, when an individual is otherwise healthy.

Snyder and Dr. Christopher Hutchison, an OB-GYN, will be featured on Saturday's Deseret News/Intermountain Healthcare Health Hotline, where they will take questions about female urinary incontinence. From 10 a.m. until noon, individuals can call 1-800-925-8177, or post questions online at the Deseret News' Facebook page, www.facebook.com/desnews.

E-mail: wleonard@desnews.com, Twitter: wendyleonards

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