Category Archives: Blog

The Impact of Hormone Therapy on Urinary Incontinence

Have you been struggling to hold in your urine? You are not alone. According to a study published in the Journal of American Urogynecologic Society, over 60% of adult women in the US suffer from this embarrassing condition. It is known as urinary incontinence (UI) and is a common postmenopausal ailment. Some of its other risk factors include pregnancy and multiple vaginal births.  

One of the treatments you may be recommended for managing UI is hormonal therapy. In addition to treating urinary incontinence, this therapy relieves several other postmenopausal conditions, such as vaginal dryness, night sweats, and hot flashes.  

What Is Hormone Therapy? 

Hormone Replacement Therapy (HRT) is a form of treatment that involves the administration of hormones, particularly estrogen, progestin (a form of progesterone), or both. A woman’s body stops producing these hormones after menopause, leading to conditions such as urinary incontinence. Reintroducing the hormones in various forms, including pills, patches, creams, and vaginal rings, can help reverse the effects of these ailments. 

Estrogen and the Urinary System

Estrogen is a hormone produced naturally in women within the ovaries. Its functions include: 

  • Keeping the vagina healthy
  • Thickening the lining of the uterus in preparation for implantation
  • Maintaining healthy levels of cholesterol in the blood
  • Assisting in curbing osteoporosis 
  • Influencing the use of calcium in the body 

HRT for Postmenopausal Women

If you are past menopause, getting a hormonal therapy prescription can boost your estrogen levels. Research suggests that it can help lower UI symptoms since more estrogen in the body leads to stronger and more elastic urinary tract tissues. 

HRT for Prostate Cancer Patients

Prostate cancer comes about due to the stimulation of cancer cells by hormones known as androgens. Testosterone is one of the most known androgens. Hormone therapy assists in killing prostate cancer cells or stunting their growth.   

HRT in Gender Transitioning

Hormone therapy helps in aligning an individual’s body with their identity. The treatment is administered to transgender individuals through a process known as gender affirmation, which blocks male hormones while activating the female ones, or vice versa, depending on your preferred gender. 

How Hormone Replacement Therapy Impacts Urinary Incontinence   

The effect that HRT has on UI depends on the kind of treatment conducted. Below is how they vary. 

Menopausal Hormone Therapy (MHT)

There are two ways of administering this treatment: 

  1. Estrogen therapy. This form of treatment helps in thickening and strengthening the genitourinary tract. By strengthening these tissues, it can lower the symptoms of UI, including stress incontinence and urine leaks.
  2. Combined (estrogen and progestin) therapy. For this mode of treatment, the impact on UI can vary. While estrogen can help reduce the symptoms, progestin can, at times, counteract the benefits gained. 

Androgen Deprivation Therapy (ADT)

Whereas ADT effectively slows and controls cancer growth, it may have adverse side effects such as urinary incontinence. The treatment resulting in lower testosterone levels could weaken the pelvic floor muscles, leading to UI. As a result, interventions such as pelvic exercises may be necessary in managing UI if you are getting ADT. 

Gender-Affirming Hormone Therapy (GAHT) 

The impact of GAHT on urinary incontinence largely depends on the type of hormones used in your procedure. For transgender women (assigned male at birth), the process results in reduced testosterone and thus could lead to relaxed pelvic floor muscles. As a result, you may experience urge incontinence, stress incontinence, and other forms of UI. 

For transgender men (assigned female at birth), the process results in decreased estrogen levels. It may lead to an overactive bladder and problems emptying the bladder

Hormone Therapy Risks and Considerations

While this therapy is beneficial to many women undergoing menopause and those experiencing urinary incontinence due to other reasons, it is also risky. The significant side effects associated with it include: 

  • Mood swings
  • Headaches
  • Breast soreness
  • Bloating
  • Irregular bleeding
  • Water retention
  • Nausea 

The treatment is also known to increase the chances of the following: 

  • Blood clots and stroke
  • Endometrial cancer (only in those who still have their uterus intact and are not taking progestin alongside estrogen)
  • Breast cancer upon long-term use
  • Dementia if one starts the treatment after midlife
  • Gallstone/ gallbladder issues  

If you are considering hormone therapy, reviewing the potential risks and benefits individually with your healthcare provider is essential. 

Alternative Treatments and Management

A number of substitute treatments exist for hormonal therapy, including: 

  • Alternative medicine, such as homeopathy, acupuncture, and acupressure 
  • Bladder training
  • Herbal medicine
  • Complementary therapy, where several interventions are used alongside traditional medicine
  • Non-hormonal prescriptions, such as antidepressants
  • Exercises and lifestyle changes that can help to manage symptoms

Urinary Incontinence Treatment in Middle Tennessee

Urinary incontinence is a prevalent condition affecting many individuals, particularly postmenopausal women. Hormone replacement therapy can help alleviate this affliction, mainly through estrogen supplementation to help revive the vigor of your reproductive tract. However, this therapy has several risks, and you should only do it after consulting with your doctor to know what is best for your unique case. If you have additional questions about the impact of hormone therapy on UI or about UI in general, contact our team to speak to a medical concierge.

Overview, Prevention Tips, and Home Remedies for UTIs

At least 3 in 25 men and 10 in 25 women acquire urinary tract infections once in their lifetime. UTIs occur when bacteria from the digestive tract infect your kidneys, ureter, urethra, or bladder.

Like any disease, urinary tract infections present with an array of discomforts. For instance, they cause pelvic pain and a burning sensation when urinating. UTIs also cause a strong urge to urinate, which can be intense for people with urinary incontinence.

Understanding Urinary Incontinence (UI)

Urinary incontinence impairs one’s ability to control their bladder. Typically, this condition results from weakened pelvic floor muscles or nerve damage. Doctors may categorize it into one of the following incontinence types:

  • Stress incontinence: In this type of UI, urine leaks upon exerting pressure on the bladder. This pressure may be a result of activities such as coughing or laughing.
  • Urge incontinence: People with urge incontinence get a sudden and intense urge to urinate. The urge often leads to involuntary leakage before getting to the restroom.
  • Functional incontinence: Functional incontinence affects people with physical and mental limitations. These impairments, similarly, prevent patients from accessing the restroom in time.
  • Overflow incontinence: Patients with overflow incontinence have intermittent dribbling of urine.

Although not related, urinary tract infections often complicate UI. Patients with UTI and UI experience heightened urgency and frequency of urination. They find it hard to control their bladder.

Causes of UTIs

Escherichia coli is the major culprit for urinary tract infections. Normally, these microbes reside in the gastrointestinal tract and find their way into the urinary tract through the urethra. While UTIs affect anyone, some people are at greater risk. These individuals include:

  • Females
  • Sexually active people
  • Women at menopause
  • People with a suppressed immune system
  • Patients using a catheter

When to Consult a Healthcare Professional

While you can manage UTI symptoms at home, you should always seek a doctor’s counsel. Doctors can prescribe the right medication to prevent complications and recurrence. In particular, you should consult a doctor under the following circumstances:

  • Persistent, severe symptoms
  • Presence of blood in urine
  • Recurring UTIs

Home Remedies for UTIs

The most common remedies you’d want to try out when treating a UTI include:

1. Drinking Plenty of Water

Drinking plenty of water increases urine production. In return, the urine helps flush bacteria in the bladder and urethra. To flush out the bacteria, take at least 1.5 liters or 12 8-ounce cups of water daily.

2. Cranberry Juice

Cranberry is not a new remedy in the realm of medicine. People have used it to treat bladder and kidney infections for centuries. The juice’s medicinal value is linked to proanthocyanidins, a compound that prevents E. coli from sticking to urinary tract linings.

3. Vitamin C

Vitamin C helps manage UTIs in two main ways. For one, it supports the production of white blood cells, which fight infections. Moreover, the vitamins acidify urine, eliminating bacteria in the urinary tract.

4. Probiotics

Probiotics reduce the risk of UTIs by helping maintain a healthy gut and urinary tract flora. These good bacteria are available in fermented foods like yogurt. Moreover, you can purchase them as dietary supplements.

5. Baking Soda

Baking soda neutralizes the acidity of urine, reducing discomfort during urination. Using baking soda as a UTI remedy is straightforward. Dissolve half or one teaspoon in a glass of water. Take the mixture on an empty stomach.

6. Avoiding Irritants

Avoid douches, powders, and personal care products with irritants when you have a UTI. The irritants can exacerbate more discomfort in the genital area. Use fragrance-free products as they don’t have harsh chemicals.

7. Applying Heat

Suppose your UTI causes pain, soak a clean cloth or towel in warm water. Afterward, use the towel to warm-compress the lower abdomen. The compressions will help soothe cramping. Always ensure the compresses are not too hot so you don’t hurt your skin.

8. Emptying the Bladder Regularly

When nursing a UTI, urinate frequently to flush out bacteria in the urinary tract. Avoid holding in urine, as that can cause more discomfort.

Prevention Tips

There are many ways to prevent UTIs. For one, you can wipe from front to back after using the restroom. This practice minimizes the risk of spreading bacteria.

Other ways to keep the risk of UTI low include:

  • Urinating before and after sexual activity
  • Wearing breathable cotton underwear
  • Avoiding tight-fitting pants

Manage Your UTIs at Home

There are many remedies for UTIs, from taking enough water to warm compresses. Some of these treatment options reduce symptoms like pain, and others flush the bacteria out of the urinary tract. 

Since the home remedies don’t treat the root cause, ensure you seek medical attention alongside using the home remedies. Otherwise, the infections could spread to the kidneys and cause complications.

If you are experiencing symptoms of UTIs or urge incontinence, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Here at the Incontinence Institute, we can help you navigate the challenges associated with incontinence.  Contact us today for more information. 

Taking Control of Prostate Health: Awareness Month Insights

In the United States, over 3 million men who have been diagnosed with prostate cancer are still alive today, thanks in part to the health, fundraising, and educational activities of Prostate Cancer Awareness Month. 

What and When is Prostate Cancer Awareness Month?

In 1989, Dr. David E. Crawford reached out to several organizations and individuals to form the Prostate  Cancer Education Council with the aim of spreading awareness about the disease in order to increase early detection rates. That same year, the Council launched Prostate Cancer Awareness Week in the third week of September. 

Ten years later, the Urology Care Foundation designated the entire month of September Prostate Cancer Awareness Month, and in 2015 President Obama proclaimed National Prostate Cancer Awareness Month.

 Throughout the month, organizations across the country participate in charitable activities, educational events, and health screenings in order to:

  • Educate men and their loved ones about the risks, signs, and symptoms of prostate cancer
  • Provide life-saving prostate health screenings to increase early detection rates
  • Offer fundraising activities to help organizations that support prostate cancer patients and families
  • Campaign for research and public policies that help better manage and treat the condition

Prostate Cancer Awareness Month begins September 1st, and a light blue ribbon is worn to represent support. The Prostate Cancer Foundation provides activity ideas if you’d like to get involved.

What is Prostate Cancer?

Prostate cancer is a condition in which normal prostate cells become abnormal, and grow out of control. It affects the prostate gland, which is a gland located in the male groin that’s similar in size to a golf ball. 

When healthy, the prostate gland uses hormones called ‘androgens’ (such as testosterone) to regulate normal reproduction and male sexual characteristics. 

However, when cancer cells reproduce in the prostate gland, they use these androgens as their energy source in order to grow out of control and stop the healthy prostate cells from working properly. 

Each year approximately 248,000 men will be diagnosed with prostate cancer, and those 55 and older are at increased risk. For non-Hispanic African American men and those with a family history of the disease, the risk may increase beginning as early as 40 years old.

It’s recommended to talk to your doctor or healthcare provider about yearly prostate health screenings once you reach the age of increased risk. This helps cut down on the chances of prostate cancer spreading, or metastasizing, to the tissues and organs surrounding the prostate gland and increases your chances of successful treatment.

What Causes Prostate Cancer?

The exact cause of prostate cancer is still unknown. Risk factors for the condition include:

Inherited Gene Mutations

Research indicates that certain inherited gene mutations can change prostate cells from normal-functioning to cancerous. These are mutations that are handed down from family members. For example, ‘tumor suppressor genes’ help repair DNA mutations, regulate cell growth, and properly trigger cell death. Likewise, genes known as ‘oncogenes’ ensure healthy cell division, growth, and lifecycles. It’s estimated that about 10% of prostate cancer is due to mutations in these tumor suppressor genes and oncogenes. This means that these genes’ normal healthy repair and regulation functions stop working, making it easier for prostate cancer cells to thrive.  

Acquired Gene Mutations

Acquired gene mutations are another underlying cause of prostate cancer. These are gene mutations that happen during men’s lifetimes, and they can lead to DNA cell replication errors that cause out-of-control growth of cancer cells. While it’s not always known why acquired gene mutations occur, they have been linked to certain lifestyle factors such as poor diet and a sedentary lifestyle. Naturally high levels of androgens may be another risk factor, and research is ongoing to determine the exact reasons these gene mutations occur.

Prostate Cancer and Incontinence

Does prostate cancer cause incontinence?

Prostate cancer may increase your risk of developing incontinence. There are actually a few reasons why prostate cancer and incontinence may occur:

  • An enlarged prostate gland: This can occur due to tumor growth or inflammation. The gland’s enlarged size puts pressure on the urethra. 
  • Post-surgical incontinence: Prostate surgery may weaken the muscles that control urine flow.  

When there’s pressure on the urethra, it narrows and this can lead to stress incontinence.  This happens when you cough, sneeze, or exert yourself physically.  The other type of incontinence is known as urge incontinence, and it’s an involuntary contraction of the bladder muscles. Both of these are types of urinary incontinence.

Prostate cancer incontinence can also occur due to radiotherapy therapy treatment or surgery that causes an injury or weakness in the rectal muscle layer.  This is known as fecal incontinence.

Advanced prostate cancer that spreads to the spine and forms tumors that damage the nerves controlling the bowels and bladder is a much less common cause of urinary and fecal incontinence.  

To find out if you might be experiencing prostate cancer incontinence, take our Urinary Incontinence Self-Assessment and Fecal Incontinence Self-Assessment.

How to Treat Prostate Cancer Incontinence

Incontinence related to prostate cancer may last just a few days or weeks, or it might be ongoing for several months or longer. Here are several treatment options available to help you better manage your symptoms, heal after treatment, and regain more control over your life.

  • Behavioral: Changing certain lifestyle habits can help you better manage prostate cancer incontinence. This would include keeping a regular urination schedule and monitoring when and how often you drink liquids. Certain dietary modifications can be helpful as well, especially for fecal (bowel) incontinence.
  • Medical: Urethral sling implants can be surgically inserted around the urethra and connected to the urinary wall to help with urine retention, especially for those dealing with stress incontinence. Hemorrhoid banding is used to block off blood supply to internal or sometimes external hemorrhoids that form as a consequence of fecal (bowel) incontinence. Artificial urinary sphincter pumps can be implanted under your stomach muscles to allow you to control when you release your urine manually. In addition, Botox® Treatment may be used for reducing overstimulation of the nerves connected to your bladder.
  • Exercises: Pelvic floor exercises like Kegels help strengthen your muscles so you gain control of your bladder and bowel.  Working with a physical therapist who utilizes biofeedback helps pinpoint the areas that need work so a personalized training plan can be set up for you.
  • Medications: There are several medications your doctor can prescribe to help with your symptoms, depending on the underlying cause of your incontinence. They include alpha-blockers, mirabegron, anticholinergics, Metamucil, and medications to help alleviate diarrhea. These typically will be in the form of a pill, liquid, or powder supplement, or sometimes a patch or cream.
  • Sacral Nerve Stimulation: This is a type of therapy that delivers tiny electrical impulses in order to regulate sacral nerve activity, which helps the nerves interpret brain signals properly in order to control bladder and bowel functioning. To send these electrical impulses, a device is implanted under the skin in the pelvic region above the buttocks. The types of sacral nerve stimulation (SNS) devices include:
    • InterStim: The InterStim II doesn’t need recharging and should be replaced every 5 years, while the InterStim Micro device needs to be recharged once a week for 20 minutes, and replaced every 15 years.
    • Axonics: This is the wireless version of an SNS therapy device. It requires recharging once a month for about an hour and is replaced every 15 years. 

Contact us today at the Incontinence Institute to connect with a doctor in the network who will work with you to diagnose and treat your prostate cancer-related incontinence symptoms.

What to Expect After Gallbladder Removal Surgery

Surgical removal of the gallbladder is a highly effective treatment for gallstones, offered in two main forms: open and laparoscopic cholecystectomy.

In the traditional open approach, patients usually stay in the hospital for two to three days. The surgeon makes a large six-inch incision in the abdomen to access and remove the gallbladder. Sometimes drainage tubes may be inserted to help remove fluids, and are typically removed after a few days.

The laparoscopic procedure, however, is less invasive. The surgeon creates four small incisions in the abdomen and uses a small video camera (laparoscope) to guide the removal of the gallbladder. This is typically done as an outpatient procedure, but proper postoperative care and lifestyle adjustments are vital for a speedy recovery and a smooth return to daily life. 

Eating and Dieting After Gallbladder Surgery

The gallbladder has a vital role in digestion by storing, concentrating, and releasing bile, a liquid produced by the liver that aids in breaking down fatty foods.

When gallbladder surgery is needed, its absence doesn’t disrupt digestion much. Instead of being stored, bile goes directly from the liver to the small intestine. However, as your body gets used to this change, you might struggle with digesting certain foods in the first few weeks after the surgery.

During your home recovery, start by slowly reintroducing foods through dietary modification. Begin with clear liquids and soft foods to ease your digestive system back into action. You can gradually add low-fat and easy-to-digest foods to your diet as you feel better. If you experience bloating, diarrhea, or gas, you should temporarily avoid some foods. Opt for smaller, more nutritious meals like lean proteins, whole grains, fruits, and vegetables while skipping high-fat, fried, and spicy foods. For most people, getting back to a regular diet takes about a month after gallbladder surgery.

Stomach Changes After Gallbladder Surgery

It’s quite common to experience mild swelling and bloating after gallbladder surgery. Surgical gas is introduced into the stomach cavity during the surgical procedure to create sufficient room for the surgeon to work. Despite efforts to eliminate most of this gas after the surgery, some remain in the body. As a result, you might feel discomfort and bloating in your stomach.

This initial swelling following gallbladder surgery is perfectly normal. Although this effect is unavoidable, it’s temporary and manageable, and in most cases, the swelling should subside within a few weeks after the surgery.

Signs of Complications After Gallbladder Surgery

Apart from the expected digestive effects, gallbladder removal carries a small risk of complications. These include: 

  • Bile leakage
  • Bile duct injury
  • Injury to surrounding structures
  • Postcholecystectomy syndrome (PCS)
  • Bleeding (Hemorrhage)

Some people might experience ongoing symptoms like persistent fever, increasing pain, abdominal swelling, jaundice, nausea, and vomiting. These symptoms tend to be mild, but if they persist, consult your doctor for possible treatments, including removing any remaining gallstones through surgery or using medication to ease the symptoms.

How to Sleep After Gallbladder Surgery

Sleeping after gallbladder surgery might be a challenge due to the diminishing effect of pain medication over time. Here are some positioning tips for comfortable sleep:

  • Consider sleeping on your left side or back to reduce the pain.
  • Use pillows to provide extra support for your abdomen.
  • Sleep on your back with an elevated upper body
  • Gradually transition back to preferred sleep positions over a few weeks
  • Take pain medication.
  • Avoid heavy meals before bedtime.
  • Try aromatherapy or other relaxation techniques at bedtime.
  • Avoid distractions while in bed.

How Long After Gallbladder Surgery Can I Have Sex?

As soon as you feel physically ready, you can engage in sex, being cautious not to put pressure on your healing wounds until they’re fully healed. Typically, doctors advise waiting about one to two weeks before having sex, depending on your specific situation.

If you continue to feel any discomfort, it’s a signal that you might need more time to rest before attempting intercourse. Always prioritize your comfort and listen to your body during your recovery journey.

Resuming Activities After Gallbladder Surgery

  • Rest is essential during your recovery. Listen to your body and rest whenever you feel tired. 
  • Incorporate daily walks into your routine, gradually increasing the distance each day. Walking is beneficial in preventing blood clots in your legs and minimizing the risk of pneumonia.
  • Avoid strenuous activities like biking, jogging, weightlifting, and aerobic exercises until your doctor gives you the green light.

Most people can return to their regular lives after gallbladder removal. Successful adjustment often involves adopting coping strategies like lifestyle changes and managing fat intake for a smoother transition post-surgery. Although, some patients may experience fecal incontinence after gallbladder surgery.

Trusted, Confidential Incontinence Treatment in Middle Tennessee

If you have questions about stress incontinence treatment or other options, don’t hesitate to contact our team. A medical concierge is standing by to answer your questions and offer solutions befitting your needs. Want to learn more about treating incontinence? Visit our treatment options page.

Managing Adult Bed-Wetting: Causes, Remedies, and More

Adult bed-wetting is a medical condition that can cause discomfort and embarrassment. Dealing with the effects of adult bed-wetting can disrupt sleep patterns and can diminish an individual’s quality of life.

Individuals who suffer from adult bed-wetting, whether it is new to you or something you have endured for some time, can find help. It is important to understand the underlying cause, which can lead to an appropriate solution.

Overview of Adult Bed-Wetting

Adult bed-wetting, also called “nocturnal enuresis,” or nighttime incontinence, is a medical condition where an adult begins to release urine while asleep. While childhood bed-wetting occurs frequently and can have no serious underlying cause, adult bed-wetting is considered uncommon. Adult bed-wetting is also distinct from nocturia, which is simply when a person gets up on a regular basis at night to go to the bathroom.

Given the rarity of the condition, many patients feel that their adult bed-wetting is isolating and embarrassing. This stigma can make it difficult for patients to seek medical care, as they may assume that there are no effective treatments available.

If you find yourself among the 1%-2% of people who suffer from adult bed-wetting, you do not need to feel hopeless. You can take charge of your health, and find answers and treatments that work for you.

What Causes Bed-Wetting in Adults?

Adult bed-wetting often has treatable causes. You can talk to your doctor about possibilities, such as personal medical conditions. 

  1. Medical Conditions

Some underlying medical conditions can affect the bladder and urinary system so bed-wetting occurs in an adult. These include, but may not be limited to the following:

  • Diabetes 
  • Urinary tract infection
  • Neurological disorders
  • Stress and emotional factors

Emotional distress or underlying stress can present in adults as bed-wetting.

  1. Medication Side Effects

Some medications can relax the muscles that encourage the bladder to hold urine until the morning, causing bed-wetting.

  1. Alcohol and Caffeine Consumption

Both alcohol and caffeine, especially around bedtime, can stimulate the bladder and lead to bed-wetting. Limiting the amount consumed before bedtime may help improve your condition. 

  1. Sleep Disorders

Sleep apnea, a common sleep disorder, may lead to bed-wetting. If you suffer from sleep apnea, talk to your doctor about how it may be causing your nighttime incontinence.

Home Remedies for Bed-Wetting in Adults

Sometimes, lifestyle modifications can manage the effects of bed-wetting in adults. These might include:

  1. Monitoring Fluid Intake

While dehydration should be avoided, monitoring fluid intake, especially before bedtime, can make bed-wetting more unlikely.

  1. Pelvic Floor Exercises

Some patients find relief from their adult bed-wetting by strengthening the pelvic muscles that control urine flow.

  • Limiting caffeine and alcohol consumption
  • Establishing a regular bathroom routine
  • Managing stress through relaxation techniques

Treatments for Bed-Wetting in Adults

If home remedies do not relieve your symptoms, consult with a healthcare provider. Your doctor can help you decide on a path forward to treat bed-wetting, which may include:

  1. Behavioral interventions

Behavioral interventions can help manage bed-wetting and disrupt the pattern, so you feel more comfortable. Your doctor may recommend a system of:

  • Bed-wetting alarms to wake the individual at the first sign of moisture
  • Bladder training techniques
  1. A Review of Your Medications

Your doctor may review your medications and see if any could be adjusted to relieve the extra pressure on your urinary system and end bed-wetting.

  1. Medical Procedures

Some interventions like Botox injections or nerve stimulation for refractory cases may offer specific patients relief.

 Support and Coping Strategies

How can you cope with the emotional impact of adult bed-wetting? These tips may help:

  • Seek counseling or support groups.
  • Maintain your self-esteem through positive self-talk.
  • Openly communicate with partners or roommates about the steps you are taking to manage your medical condition.
  • Use protective bedding and take other practical measures to relieve the discomfort of adult bed-wetting.

Seeking Treatment for Nighttime Incontinence in Middle Tennessee

Adult bed-wetting is a medical condition that can be managed through home remedies and with the help of an experienced healthcare provider. If you have suffered from an onset of adult bed-wetting, work with your doctor to explore various options and find the approach that is best suited to your individual situation. The Incontinence Institute can help you partner with a provider who can guide you through the potential causes of adult bed-wetting. Together, we can find a treatment plan that works for you. Contact our team today!

Tips to Navigate the Challenges of Functional Incontinence

According to the Cleveland Clinic, functional incontinence affects over 30 million people in the United States. People living with functional incontinence often have underlying medical conditions, or physical obstacles, that stop them from reaching the bathroom in time. Many rarely recover from the conditions that contribute to functional incontinence and bear long-term consequences, carrying with them the burden of embarrassment and shame. In some cases, patients also report feelings of depression and anxiety.

Understanding Functional Incontinence 

Functional urinary incontinence occurs when a person recognizes the need to urinate but is unable to access a restroom due to a separate medical or environmental issue. This condition makes the patient lose control over their bladder or fail to recognize the need to pee. Most people who are commonly affected by the condition have other underlying conditions, such as:

  • Cognitive disorders such as delirium, dementia, and intellectual disabilities
  • Neurological disorders such as Parkinson’s disease, stroke, and multiple sclerosis
  • Musculoskeletal disorders such as arthritis
  • Irritation on vaginal tissues
  • Urinary tract infections (UTIs)
  • Medications such as sleeping pills, diuretics

Functional limitations differ from other forms of incontinence since functional incontinence affects people with a functioning urinary system. 

The Social Stigma Surrounding Incontinence 

We all know a trip to the restroom is a private endeavor, yet incontinence interrupts this norm. Those living with incontinence are no stranger to the embarrassment that accompany the stigma of accidents or frequent trips to the restroom.

The stigma surrounding incontinence not only causes stress but also creates a stronger desire for privacy, which can delay seeking proper treatment. Those affected often change their regular routines, leading to feelings of isolation and withdrawal. The fear of being seen as weak or dependent by others also weighs heavily on their minds. Overcoming these misconceptions and seeking support can lead to a more fulfilling and confident life.

Mental Health Challenges in Functional Incontinence 

Without proper management, people with incontinence associate themselves with shame, social isolation, rejection, and insecurity about their body image. The first step in responding to functional incontinence is to accept and understand the problem. We advise you to seek help from people you trust, such as close friends and family. Support groups also play a significant role in responding positively to the situation since you may interact with professionals who understand how to handle situations or people with similar experiences.

Break the Silence: Talking About Incontinence

Incontinence is often kept under wraps until it becomes too difficult to hide. However, breaking the silence is essential, particularly in the context of caregiving. Through education and open discussions about functional incontinence, we can reduce the shame and stigma surrounding this condition. By fostering awareness, we empower everyone to develop effective coping strategies when living with or caring for someone affected by incontinence. 

Exercising Proper Self-Care: Mental Well-Being

Functional incontinence can take a toll on mental health more than physical aspects. Managing it effectively often involves counseling and therapy, with cognitive-behavioral therapy being particularly beneficial. By nurturing increased self-esteem and reducing anxiety and depression in the long run, we can better support those dealing with functional incontinence.

Elevating Quality of Life 

Empowering patients with coping strategies is the key to conquering functional incontinence and living comfortably. Companies are stepping up with digital solutions, incorporating real-time sensors and wearable devices that allow individuals to manage their conditions independently. Embracing technology enhances the overall quality of life for those facing this challenge.

Fostering Supportive Communities 

Creating awareness about functional incontinence requires a collective effort. Support groups play a pivotal role in this endeavor, providing a space where patients can connect with peers and share valuable insights. Social media serves as an effective tool for spreading awareness and reminding individuals that they are not alone. Empowering patients through advocacy and shared experiences boosts self-esteem and strengthens the community.

Embracing Holistic Care 

Recognizing the impact of functional incontinence on both mental and physical health, a compassionate and inclusive approach is essential. By understanding the patient’s perspective and tailoring treatment plans accordingly, we can achieve more effective and positive outcomes. Sensitive and comprehensive care paves the way for successful procedures, methods, and results in managing functional incontinence.

Trusted, Confidential Incontinence Treatment Near Nashville, TN 

Functional incontinence can bring about mental health challenges like stress, anxiety, low self-esteem, or depression. To improve the quality of life for those affected, we advocate a holistic approach encompassing awareness, education, and unwavering support. Reach out to an Incontinence Institute medical concierge who comprehends the complexities of incontinence beyond the bladder. Find solace in the expertise of our trusted physicians who will stand by your side, empowering you to overcome functional incontinence and embrace a more fulfilling life. Don’t face this journey alone – take the first step towards relief and confidence by contacting our team today. Want to learn more about treating incontinence? Visit our treatment options page.

Cystoscopy vs Ureteroscopy for Your Urinary Tract Symptoms

Two common procedures, cystoscopy and ureteroscopy, are used to diagnose and treat bladder, urethra, kidney, and ureter issues. In this article, we’ll explore the similarities and differences between the two methods to help make an informed decision about your medical needs when experiencing urinary tract difficulties.


A cystoscopy is a medical device with a long thin tube containing a light and lens for viewing. This tube is inserted into the urethra and bladder to see any anomalies. 

Rigid and flexible cystoscopes are available depending on the issue you are having. Flexible cystoscopes are generally used to spot troublesome areas. A rigid cystoscope is slightly wider and can accommodate small surgical instruments inserted into the tube for biopsies or treatment. You will be awake during a flexible cystoscopy procedure, but general anesthesia or the numbing of the lower half of your body may be applied for a rigid cystoscopy procedure.  

Common symptoms requiring a cystoscopy are blood in the urine, frequent urinary tract infections, urinating problems, and chronic pelvic pain. Common conditions diagnosed and treated with cystoscopy are:

  • Bladder infections and UTIs 
  • Bladder stones 
  • Hematuria (blood in urine) 

The advantage of getting a cystoscopy is that it can find early signs of cancer, infections, narrowing, blockage, or bleeding in the urethra and bladder. The disadvantage is that biopsies and treatments can’t be done during a flexible cystoscope procedure if the surgeon sees an abnormality. A rigid cystoscope procedure would have to be scheduled to follow.


A ureteroscopy is functionally the same as a cystoscope, being equipped with a lens and a light. The difference is that the ureteroscope is longer, allowing a surgeon to insert the instrument into the urethra, through the bladder, and into the ureter leading to the kidney. When having a ureteroscopy procedure, general anesthesia is necessary.

You might need a ureteroscopy if you have the following symptoms:

  • Severe pain in your back or side
  • Blood in the urine
  • Burning when urinating

These symptoms can be indicative of common conditions that are diagnosed and treated with a ureteroscopy, such as:

  • Kidney stones 
  • Ureteral strictures 
  • Ureteral tumors 

The advantage of a ureteroscopy is that a doctor can see kidney stones located in the ureter and kidney and remove the stones instantaneously. The disadvantage is that the surgeon will have to place a stent in the ureter to facilitate the drainage of urine to the bladder. The surgeon will then need to remove the stent at a later date.

Similarities between Cystoscopy and Ureteroscopy

Both of these procedures are done as outpatient procedures in most cases. However, if you were under general anesthesia during these processes, you’ll need someone to drive you home when you’re released.

Differences between Cystoscopy and Ureteroscopy 

Because the diagnostic and treatment target areas are different for each procedure, the risks and complications will be specific to those target areas. A ureteroscopy can cause infection or injury to the ureter or kidneys, while it’s most likely the bladder and urethra will be affected by complications and risks after a cystoscopy.

Treatment Plans Following Cystoscopy and Ureteroscopy 

After both a cystoscopy and a ureteroscopy, the doctor may prescribe an antibiotic to prevent infection. A cystoscopy will cause belly pain, blood in the urine, and pain when urinating for up to 48 hours. Drink several glasses of water a day to flush out the bladder and take over-the-counter pain relievers to ease the pain. 

A ureteroscopy may cause more pain which prescribed pain medication may ease. You may feel pain in your bladder and burning when you urinate. If the kidney stone the surgeon treated was large, you may have to pass stone fragments still present in the days following the procedure. Follow your doctor’s diet and medication recommendations to prevent future stone formation.

Cystoscopy and Ureteroscopy Procedures in Middle Tennessee

There are similarities and differences between cystoscopy and ureteroscopy procedures, but both are important in the early diagnosis and treatment of urological conditions. Because these procedures target different issues in the urinary tract, it’s important to consult with a healthcare professional for personalized advice. At the Incontinence Institute, we specialize in urinary tract diagnostic and treatment options. Contact our team to find out if a cystoscopy or ureteroscopy is the right option for you.

Understanding Interstitial Cystitis Diagnosis and Treatment

Interstitial Cystitis (IC), also known as painful bladder syndrome, is a stressful condition. The disease is not contagious and does not spread or worsen over time. However, you may experience various issues affecting your social life and sleep.

IC is difficult to diagnose, and there is no cure, but treatments are available to help ease the illness. The first step toward managing your symptoms is understanding the basic facts about this condition.

Understanding Interstitial Cystitis

If you’re experiencing urinary pain that lasts for over six weeks and is not due to a kidney condition or infection, then it may be IC. You may be experiencing a chronic bladder condition that results from bladder wall inflammation. IC causes the bladder to harden, reducing the amount of pee it can comfortably store. In some cases, you may need to pee as many as 40 to 60 times per day.

IC often affects people of all ages. However, it can appear in your mid-40s. This condition is a widespread problem that affects approximately 1.2 million Americans, primarily women. Women are five times more likely than men to have IC.

Interstitial cystitis affects people differently. Some people may only have slight discomfort, while others may experience severe pain and urgent, frequent needs to pee. This may result in life problems such as:

  • Emotional issues due to lack of sleep
  • Lack of social life and exercise as a result of isolation and withdrawal
  • Anxiety and despair

Recognizing Symptoms and Seeking Diagnosis

Some people might confuse IC for a urinary disease because of similar symptoms. Thus, it is essential to remember that IC symptoms are caused by bladder irritation and last for more than six weeks, whereas other urinary issues are caused by bacterial infection.

Some of the common symptoms of IC include:

  • Frequent and urgent urination
  • Pain during sex
  • Pressure and discomfort in the bladder, genital area, and pelvic area
  • Bleeding and ulceration
  • Glomerulations on the bladder wall
  • Irritated, scarred, or inflexible bladder wall

The signs and symptoms of IC differ from one person to another, and are often confused with a urinary tract infection. If you’re experiencing the above symptoms, ensure that you consult a healthcare provider for a diagnosis, which may include the following:

  • Examining your medical history: The doctor may request that you keep track of your symptoms by monitoring the amount of fluids you drink and the amount of urine you pass.
  • Conducting a physical exam: It includes examining your pelvic or genital area.
  • Urine testing: The doctor can also collect your urine sample to look for symptoms of a urinary tract infection.
  • Urine cytology: Your physician may collect a urine sample and examine the cells to aid in cancer diagnosis.
  • Cystoscopy: This is the process of inserting a thin tube with a tiny lens or cystoscope through your urethra to view the inner wall of your bladder. They may also take a biopsy for further examination under a microscope.

Treatment Approaches for Interstitial Cystitis

IC has no cure, but there are treatments to alleviate its symptoms. These include:

  • Lifestyle changes: For instance, you can train your bladder to store more urine to avoid urinating more frequently. Wearing loose clothing and engaging in low-impact exercises can also be beneficial.
  • Medications: Non-steroidal anti-inflammatory medicines like ibuprofen can assist in alleviating discomfort and thus help you improve your IC signs and symptoms.
  • Physical therapy: You can work with a physical therapist to relieve pelvic pain caused by muscular soreness and tight ligaments in your pelvic floor.
  • Surgery: Some doctors may suggest minimally invasive methods to treat bladder ulcers. However, this is only a choice if other treatments are ineffective.

Find the Right Doctor for Interstitial Cystitis

Understanding the symptoms and diagnosis of interstitial cystitis is important to get the right treatment option. If you’ve been experiencing pressure and discomfort in your bladder for more than six weeks, it’s time to see a doctor.At the Incontinence Institute, we provide the best healthcare solutions to help you get healthier. Contact us today to learn more about our services and techniques for diagnosis.

Botox in the Bladder: Relieving Incontinence with Botox Treatment

According to the Illinois Department of Public Health, approximately 13 million people in the US suffer from incontinence, with 85% being women. The medical field has witnessed exciting advancements in treating various forms of incontinence, including using Botox as a potential treatment. 

People with incontinence may experience limitations in their daily activities, social interactions, and overall quality of life. While traditional treatment methods, such as pelvic floor exercises and medication for incontinence, have benefited many patients, they may not provide adequate relief for everyone. This innovative approach has shown promising results in relieving individuals struggling with this debilitating condition.

How Botox Helps Treat Incontinence

Incontinence, the involuntary loss of bladder or bowel control, can occur in anybody, but it’s more prevalent in older adults. Botox works by inhibiting the release of acetylcholine, a neurotransmitter responsible for muscle contraction.

When injected into the targeted muscles involved with bladder control, Botox temporarily blocks the hyperactive contractions that lead to urgent and uncontrollable contractions. This relaxation effect helps increase the bladder’s storage capacity, allowing it to hold more urine before feeling the urge to urinate. 

The effectiveness of Botox in managing different types of incontinence

Botox has shown success in managing various types of incontinence, including:

  • Overactive bladder – Clinical studies have shown that Botox can significantly reduce urgent and frequent incontinence episodes. The effects of Botox injection last for several months, requiring repeat treatment to sustain the benefits. 
  • Neurogenic bladder – This condition causes bladder dysfunction due to nerve damage or neurological conditions such as multiple sclerosis or spinal cord injuries. Botox can relax the overactive muscles, reducing involuntary contractions. 

Consult with a healthcare professional before deciding to use Botox as a treatment option for incontinence. Consider factors like medical history, individual circumstances, and potential risks. 

The Botox Procedure for the Bladder

The first step is scheduling a consultation with a urologist or a urogynecologist. During this visit, they will review your medical history and conduct various physical examinations to determine if Botox is an appropriate option. They may also require comprehensive evaluations and diagnoses like urodynamic testing to determine the underlying cause of incontinence. 

A thorough evaluation ensures the treatment plan is tailored to your needs to maximize its effects. If Botox is deemed appropriate, the healthcare provider will continue with the treatment plan. 

The administration of Botox injections in the bladder

The procedure occurs in the outpatient setting, reducing the need for anesthesia or sedation.  You will lie down with support to your legs, and the healthcare provider will sterilize the area around the bladder to reduce the risk of infection. Injections to the bladder are performed using either:

  • Cystoscopy – It involves the insertion of a thin, flexible tube with a camera through the urethra to the bladder. The healthcare professional will accurately guide the needle injecting Botox into specific areas.
  • Ultrasound guidance – Ultrasound imaging can also guide the needle into the bladder. It provides real time visualization, helping the accurate administration of the injections. 

Botox administration takes around 15 – 30 minutes. However, the pre-procedure preparations, discussions, and post-procedure monitoring may affect the overall duration. 

Side Effects of Using Botox for Incontinence

Like any medical procedure, Botox may present some side effects and potential risks, including;

These side effects are not a major cause for concern. Less common but serious side effects include;

  • Allergic reactions like itching, skin rashes, breathing difficulty, and swollen face, lips, and throat
  • Systemic spread of toxins, causing muscle weakness, breathing difficulty, and swallowing problems

Before considering Botox for incontinence, thoroughly discuss with a healthcare provider for an informed decision and personalized treatment plan.

Determining if Botox is Right for You

A healthcare provider will determine factors such as your medical history, the type of incontinence, and previous incontinence treatment outcomes. Botox is not recommended for;

  • Pregnant or breastfeeding women
  • Individuals with active UTI
  • People with neurological conditions or muscle disorders
  • People with known sensitivity or allergy to Botox

Only a qualified healthcare provider can offer evaluation, such as urodynamic testing and treatment recommendations regarding Botox for incontinence. 

Regain Your Quality of Life With the Incontinence Institute

The Incontinence Institute supports individuals with incontinence with the best treatment options available. Our team of healthcare providers understands the mental and physical trials this condition can cause. Our Tennessee urologists are ready to provide you with the best treatment option to help you enjoy your life again. Contact our medical concierge to start your healing journey. 

Incontinence After Back Surgery: Practical Guidance for Patients

Dura mater is one of three membranes that are woven around the length of your spine and continue up and around your skull. It is the outermost of three layers and responsible for protecting your central nervous system (CNS). During back surgeries, there is some risk of nerves getting damaged and interrupting the CNS. This means your brain may have a hard time communicating with your bowels and bladder, causing urinary incontinence

Back Surgery and its Effects on the Bladder

Back pain is a common medical problem that has a range of symptoms and causes. It can be the result of sudden trauma, like a car accident; occur as we age due to bone and tissue degeneration; or be a side effect of other medical conditions like arthritis. Regardless of how it started, back pain can cause debilitating discomfort.

Types of back surgery

Your doctor will do a physical exam, take x-rays, and evaluate your medical history and symptoms before determining a diagnosis. Additionally, they may suggest doing exercises, stretches, or prescribe other medical treatments like epidural injections to relieve the pain. If the pain persists, surgery may be the next viable option.

  • Spinal fusion involves the use of devices such as metal plates and screws to connect two vertebrae together.  Over time they will fuse together, acting as one bone. This will intentionally limit the mobility of the vertebrae that’s causing pain when it’s in use.
  • Laminectomy is the removal of vertebrae or bone spurs to relieve pressure on the nerves.
  • Discectomy is the removal of the parts of the disc that are causing pain to relieve pressure on the nerves.
  • Foraminotomy is where the surgeon enlarges the hole in the bone where the nerve root opening is, relieving pressure on the nerves caused by the narrowing of the spine.

Potential Bladder Issues After Spinal Surgery

As long as the neural pathways along your spine still exist, recovery is possible, but it doesn’t hurt to understand the characteristics and different types of post-surgical incontinence.

  • Stress incontinence happens when pressure is put on the bladder. Symptoms might include leaking urine when you make sudden or harsh movements, sneeze, cough, or lift something heavy.
  • Urge incontinence is an involuntary squeeze or spasm of the bladder that causes an immediate urge to urinate. Sometimes it’s a feeling of having to go or actual leakage may occur.
  • Mixed incontinence both the feeling of an overactive bladder and stress factors may be experienced by the patient.

Prevalence and Risk Factors for Post-Surgical Incontinence

Spinal surgery is related to lower urinary tract dysfunction in 38%–60% of patients. The nerves along your spinal cord may get impinged or damaged and can hinder your body’s neuronal circuit. Your neuronal circuit is essentially the network of nerves that communicate with your brain to deliver functions to the body, i.e., your bladder and urethra.

Risk factors include but are not limited to:

  • Body Mass Index
  • Age
  • The type of surgery performed
  • Overall health
  • Medical history
  • Management of symptoms post-surgery

Post-surgical incontinence can be a disheartening experience. It’s uncomfortable and leaves patients feeling embarrassed and vulnerable. Fortunately, there are options for relieving symptoms and regaining control. The first step is to take a quick assessment and seek professional help.

Management and Treatment Options

After consulting with a doctor and determining which type of incontinence you have, they may take additional steps to help formulate a treatment plan. This includes a urinalysis to check for infection, bladder journal to identify patterns and amount of incontinence episodes, and other urine tests to check for any obstructions.

Non-surgical approaches to manage incontinence after back surgery

  • Pelvic floor exercises and physical therapy will help strengthen the muscles around your bladder.
  • Lifestyle modifications such as quitting tobacco, exercising more, and avoiding liquids that have more trouble being processed by your bladder.
  • Planning scheduled times to use the restroom so your bladder doesn’t get too full.
  • Dietary modification such as eating a diet rich in fiber so as to prevent getting constipated and having bowels press against your bladder.

Medical interventions for incontinence

  • Supplements and herbs will help fight off infection and give your body the nutrients it needs, specifically for urge and stress incontinence.
  • Nerve stimulation techniques such as sacral neuromodulation involves devices that are implanted below the skin and above the muscle in your back. It delivers electric impulses to the nerves that control the muscles around the pelvic floor.

Surgical options for incontinence after back surgery

  • Sling procedures treat stress incontinence by surgically connecting a sling to your abdominal wall and lifting the urethra to it’s normal position.

Post-Surgical Incontinence Relief in Middle Tennessee

At the Incontinence Institute, we understand the indignity that urinary incontinence brings to both men and women. Our mission is to help patients understand what it is, decide on a treatment plan through a variety of methods, and to be a resource for the 33 million American adults who suffer from incontinence. Contact us today to get started!

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.

Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

Contact Us

Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067