How to Treat Urinary Incontinence

How to Treat Urinary Incontinence Dr. Travis: Well, Carly in Gainesville, Florida writes to us: “Dear doctors, I’m in my early thirties and after two kids, I have a little urinary problem that my husband calls ‘pee dribble’. What causes that and, more importantly, what fixes it?” Dr. Lisa: Well, that’s nice of him to call it pee dribble, yeah? Dr. Spitz: Well, pee dribble, yeah. Pee dribble, as he called it, is more formally known as urinary incontinence and it’s a common condition. It affects women very frequently after child birth because their pelvis becomes a little weaker after going through the trauma of delivering that baby but it also affects women who are in their older years 50’s, 60’s, as the bladder becomes a little less supple and a little more spastic. Here’s a model of the bladder. This is the bladder full and I’m going to take this clamp off. Dr. Drew: And it’s pink. We know it’s a woman’s bladder. Dr. Spitz: That’s right. So, if a woman’s control muscles are a little bit weak and she coughs or strains, there’s a little bit of a dribble. But if a woman’s muscle is spastic and she can’t really control it, it’ll just empty out on its own, squeezing and make a mess. Dr. Travis: And you can’t control it! Dr. Drew: It’s just like the guys getting it on the floor, maybe. Dr. Spitz: So, there’s a range from just dribbling a little to leaking a lot. Dr. Lisa: Right. Dr. Spitz: And some women actually have to wear diapers. And there are treatments for this. In the case of the dribbling because of the weak muscles, you can strengthen those muscles with minimally invasive surgeries. And in the case of the spastic bladder that wants to squeeze by itself, you can take medications so that the bladder isn’t so spastic and doesn’t involuntarily contract, sort of like, this is your bladder on drugs. Any questions? In men, it’s a little bit different. In men, the most common cause of – Dr. Drew: And this is going to be the man right here. Dr. Spitz: Yes, of course. Taller. Streamline. In men, as the prostrate gets bigger, it blocks the flow of urine out of the bladder. So, a woman doesn’t have a prostate getting in the way but a man does. It’s like that tunnel that squeezes off that bladder and as it slows down the flow of urine, that column of urine that’s coming out of the man slows down. So, when a man is at Dodger’s stadium is he’s got a little bit of a big prostate and he urinates, when he’s done, there’s still a little bit of urine left in that of urethra, a kind of fluid and that hasn’t finished dripping out. And it sort of finishes dripping out as he goes to get his second beer or hotdog. And that’s that post-void dribble that we call. That’s it. So, that explains it and there are ways to treat it. In men, there are medications that can increase the ability of that prostate to open up and let the urine flow or shrink the prostate or there’s procedures to reduce the size of the prostate.