Incontinence treatment offers improved quality of life By Peter C. Mandel, M.D. Patients living with incontinence should not be embarrassed or uncomfortable discussing the condition with a doctor.This 24/7 condition affects the daily quality of life for more than 13 million people in the U.S.But those who seek treatment may find that symptoms can be minimized or eliminated completely. Depending upon the severity of the condition, incontinence can be treated with exercise, medication, injections or surgical intervention. Bladder incontinence is surprisingly common but predominately affects women and seniors,who are prone to the condition as a result of age,pregnancy, medication, bladder infection or pelvic muscle weakness. For men, the majority of cases are a result of longterm prostate enlargement. Other external factors can also exacerbate symptoms, including bladder irritants such as caffeine, alcohol, certain citrus fruits; smoking; obesity; and holding urine for extended periods of time. Treatment methods vary depending on the severity of the condition. In less severe cases, Kegel exercises (repeatedly tightening the pelvic muscles) have proved to be a simple but surprisingly effective method for strengthening bladder muscles. Medications can minimize symptoms, but discuss possible side effects with your doctor. Bulking agents, such as collagen, can also be injected into tissue surrounding the urethra to help keep the urethra closed and reduce urine leakage. When symptoms of stress incontinence or overactive bladder don't respond to treatment or are more severe, surgical options may be appropriate. Several procedures can be performed using minimally invasive, laparoscopic techniques allowing patients to avoid hospitalization.There are benefits and risks with surgery for incontinence.The biggest benefit is that incontinence may be permanently eliminated while the risks are those faced with any surgical procedure. Surgical incontinence treatments fall into two main categories — the sling procedure, used primarily for stress incontinence, and the bladder neck suspension procedure, an open surgery that strengthens and reinforces the urethra and bladder neck.The sling procedure can be performed laparoscopically while the bladder neck suspension is performed with an abdominal incision which requires longer recovery time. Today, because of the many treatment options, incontinence no longer needs to be a chronic condition restricting you from enjoying your favorite activities. Call your doctor to discuss new treatment options that will offer you the best results. Lessoning the burden of incontinence may be just a phone call away. Dr. Mandel is a board-certified ob/gyn and on staff at CentraState Medical Center in Freehold.He can be reached at Women's Physicians & Surgeons in Freehold by calling 732-431- 2999.