Urinary incontinence, the loss of bladder control, is a common problem. Over 25 million adult Americans experience temporary or chronic incontinence. Although seen commonly in the aged population, urinary incontinence is not inevitable as we get older. The severity of this problem ranges from occasionally leaking urine during activities to having an urge that is sudden and then accidents happen. Most people experience minor leakage of urine.
Symptoms
Stress incontinence- leakage of urine when you exert pressure on the bladder by coughing, sneezing or Valsalva when lifting heavy objects
Urge incontinence- patient experiences a sudden severe urge to urinate followed by leakage.
This can be caused by infection or a neurologic disorder or diabetes
Overflow incontinence- constant dribbling due to inadequate emptying of the bladder
Functional incontinence- a physical disability inhibits the patient from getting to the bathroom in time or a physical impairment prevents the patient from undressing quickly (such as unbuttoning the pants)
Mixed incontinence- more than one type of the above
Risk Factors
Gender- women are more likely than men due to pregnancy, childbirth and menopause.
Age- the muscles in the bladder and urethra lose tone and strength as we age. Also, the bladder volume is reduced as we age
Tobacco- tobacco use increases the risk of urinary incontinence
Obesity- extra weight increases pressure on the bladder and surrounding tissues
Neurological diseases- some neurological diseases and diabetes increases risk
Family risk- if a family member experiences urinary incontinence the risk of other family members increases especially urge incontinence
Complications
Mental health- due to embarrassment, social and personal relationships suffer, and this impacts personal life
Skin- rashes and skin infections are common from a chronically wet environment
Urinary tract infections- repeated urinary tract infections are common and antibiotic resistance may develop
Economic- diapers and other devices needed are costly and not covered by all insurance programs
Causes
Food and certain drinks can act as diuretics and cause overstimulation of the bladder
- Alcohol
- Caffeine
- Sodas and sparkling drinks
- Sweeteners
- Chocolate
- High spicy foods
- Vitamins such as Vit C
- Medications, sedatives and muscle relaxants
Treatable causes
- Urinary tract infections
- Constipation- increased stool can cause pressure and the result are bladder nerves to be over stimulated
Medical Problems causing incontinence
Pregnancy- fetus can put pressure on the bladder.
Childbirth- vaginal delivery can damage supporting tissue and weaken muscles needed for bladder control. 25% of vaginal deliveries can have subsequent incontinence
Age- loss of muscle tone as we age
Menopause- less estrogen and vaginal dryness, urethra and bladder dysfunction
Neurological diseases- Multiple Sclerosis, strokes, spinal injuries, tumors and other diseases that block signals from the nerves involved in bladder control
Cancers- prostate cancer or treatment of prostate cancer
Treatment
Treatment for urinary incontinence depends on the etiology and severity of the underlying cause.
Behavioral training- such as bladder training, double voiding, scheduled times for toilet trips and fluid management
Pelvic floor exercises- Kegel exercises especially effective for stress incontinence and urge incontinence
Medications
- Anticholinergics- used to treat overactive bladder and urge incontinence. Common examples are Ditropan and Detrol
- Mirabegron (Myrbetrig) -This medication relaxes the bladder musculature and can increase bladder capacity. Also, aids in total emptying of the bladder
- Alpha Blockers- these medications relax bladder neck muscles and prostate muscles. Commonly used in men with symptoms of prostate enlargement
- Estrogen- topically used to rejuvenate tissues of the bladder and urethra
Other Devices
- Electrical stimulation
- Urethral insert
- Pessary- used for vaginal prolapse
- Botox into the bladder to relax overactive muscles
- Nerve stimulators
Surgical Procedures
Sling procedures- material is placed under the urethra and provides closure of the urethra
Bladder neck suspension- tissue used to support the urethra and bladder neck
Prolapse surgery- for women who have bladder prolapse
Artificial urinary sphincter- a ring is placed in the urethra and bladder neck and remains closed until a valve implanted under the skin is pressed and the valve opens
Platelet Rich Plasma is an autologous blood concentrate rich in growth factors and cytokines, that has been used in virtually all fields of medicine to restore and regenerate damaged tissues.
Studies
- Therapeutic Efficacy of Urethral Sphincter Injections of Platelet Rich Plasma for the Treatment of Stress Urinary Incontinence due to Intrinsic Sphincter Deficiency: A Proof of Concept Clinical Trial
Int Neurourol J 2021 Mar;25(1): 51-58 PMID 33504126
Purpose- The aim of this study was to investigate the efficacy of autologous platelet rich plasma in the treatment of stress urinary incontinence due to sphincter deficiency refractory to medical treatment
Conclusion- Urethral PRP injection is safe and effective in increasing urethral resistance and improving stress incontinence. PRP could be an alternative treatment modality for male and female patients with moderate stress incontinence due to nonneurogenic causes.
- The Use of Platelet Rich Plasma as a Novel Nonsurgical Treatment of the Female Stress Urinary Incontinence: A Prospective Study
Female Pelvic Reconstr Surg 2021 Nov 1;27(11): e668-672 PMID 34534197
Objective- The aim of this study was to evaluate the efficacy and safety of platelet rich plasma for the treatment of stress urinary incontinence.
Conclusions- Platelet Rich Plasma injections were both effective and safe at least in the short term and could be offered as an alternative outpatient procedure for the treatment of stress urinary incontinence.
- The Efficacy and Mid-term Durability of Urethral Sphincter Injections of Platelet Rich Plasma in the Treatment of Female Stress Urinary Incontinence
Front Pharmacol 2022 Feb 8;13:847520. PMID 35211026
Aim- This study investigated the therapeutic effects of repeated urethral sphincter injections of autologous platelet rich plasma in the treatment of stress urinary incontinence in women due to intrinsic sphincter deficiency refractory to medical treatment or after the first anti-incontinence surgery.
Conclusion- The study demonstrates the efficacy and safety of repeated urethral sphincter injections of autologous PRP. Repeat PRP urethral injections can increase urethral sphincter resistance and decrease the severity of stress incontinence in women with the therapeutic effect lasting up to 12 months in most of the patients who responded to PRP treatment, with acceptable adverse events.
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet Rich plasma Kits are FDA cleared and designed for safety, sterility and effectiveness. They are cost effective and easy to use. Our kits have been scientifically manufactured to provide a consistent platelet concentrate, devoid of red blood cells with a minimal number of leukocytes, critical to the regenerative cascade.
Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. The activation is a critical step in the release of cytokines, growth factors and bioactive proteins and is accomplished with LED light. This negates the use of chemical additives such as Calcium Chloride, Thrombin or Collagen.
Juventix Regenerative Medical supplies a Bio-Incubator that transforms the Platelet Rich Plasma into an injectable Platelet Rich Fibrin. The Platelet Rich Fibrin, commonly called the “second generation of platelet products” has different growth factors and cytokines than original PRP. These different cytokines provide a broader range of clinical uses due to their anti-inflammatory properties.
Juventix Regenerative Medical also offers many other products and services to be a “one stop shop” for all the needs of the regenerative practitioner, all FDA approved or cleared.
RESTORE, REVIVE, REGENERATE-JUVENTIX REGENERATIVE MEDICAL
Regenerative Regards,
Dr. Robert McGrath
