Dr. Vikas Desai discusses urinary incontinence in women

Opinion
Video

“The bladder muscle can get weak as you get older, so developing urinary incontinence or ur-gency is very common as you get older,” says Vikas Desai, MD.

In this video, Vikas Desai, MD, describes his clinical practice and the different types of urinary incontinence. Desai is a urologist with Northwestern Medical Group in Winfield, Illinois.

Transcription:

Please provide an overview of your clinical practice.

I feel that my practice is more based in restorative urology. I like to use the word restorative because I kind of bring back things people have lost over the years. In terms of conditions that I treat, specific to female incontinence, I would say is overactive bladder, which sometimes can overlap into urinary urgency or urge incontinence and then stress urinary incontinence.

What types of incontinence do you treat? How are they similar and how do they differ?

The 2 main types of incontinence are stress incontinence and urge incontinence. And so it's kind of a big dichotomy that we try to really discern out when a patient presents where I try to figure out what's more important? Some people will come in with mixed incontinence, which is stress and urge together, but a lot of times they have one overarching incontinence that's more bothersome, and I really try to tailor the focus on that. If we get that better, they're going to be better off and happier, and then we can always focus on the other one secondarily. Stress incontinence, typically, I would say, is leaking when you cough, sneeze, or with activity. It prevents you from playing pickleball, maybe doing some yoga, working out. And so it can can be very debilitating, especially over the last few years with COVID people getting these coughs and stuff and things that might have not been so bothersome getting these exacerbating factors, or even during this time of year, when people's bronchitis or asthma start acting up. So it's something that's definitely bothersome. I would say stress incontinence, more times than not, we'll see in females of childbearing age, shortly after they've had childbirth down the line. So their pelvic floor muscles basically have just gotten weakened over time. And so those muscles are weak, and so they just can't hold the urine that they used to. In terms of urinary urge incontinence or overactive bladder, which I would say is kind of a progression of overactive bladder. Overactive bladder is going to the bathroom more often than usual. Typically, someone goes to the bathroom about 6 to 7 times a day, but they would be going more than 6 to 7 times, so maybe more like every 2 to 3 hours. And that can progress where they have no control of their urine and urge incontinence. And so that sometimes happens because the bladder muscle itself is weak; the bladder muscle can get weak as you get older, so developing urinary incontinence or urgency is very common as you get older, but there are other precipitating factors that we can go through that cause some of those symptoms.

This transcription was edited for clarity.

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