Ending the Stigma
There will always be those certain medical conditions that don’t get talked about. They might be thought of embarrassing, gross, or just no one’s business but the patient and doctor’s. Keeping these conditions under wraps can actually negatively impact individuals who live with them by making it easier to spread misinformation and contributing to a sense of isolation. That’s why we believe it is our duty to research these uncomfortable topics and try to normalize conditions that are actually very common. Urinary incontinence is one such topic that is often avoided, despite being extremely common.
Urinary incontinence is the involuntary leakage of urine. While also defined as “loss of bladder control,” not all incontinence is due to a faulty bladder. Often it is the external urethral sphincter, a circular muscle that wraps around the urethra to hold in urine, that is weakened. There are many causes for incontinence ranging from a pelvic fracture to nerve damage (and loss of voluntary control). Mothers who have had vaginal deliveries, for example, may have incontinence due to overstretched and/or weakened pelvic floor muscles. Men who have undergone a prostatectomy may be left with nerve damage during surgery, causing the loss of control of the urethral sphincter.
Types of Incontinence
While there are many reasons for incontinence, the condition can be categorized by how it manifests and its associated symptoms. A person may be aware or unaware of involuntary urination, for example, and leakage may be associated with specific activities.
Stress Incontinence: This is the involuntary leakage of urine when the abdomen contracts and puts pressure on the bladder. Leakage may result from coughing, laughing, or performing physical activities that contract the abdomen. The “stress” part of the name refers to physical strain, not an emotional stress response.
This type of incontinence is likely due to a weakened or injured urethral sphincter that easily relaxes under pressure. Weak pelvic floor muscles also contribute to this type of incontinence, as keeping the urinary sphincter closed as part of their function. A person experiencing stress incontinence may not feel an urge to urinate or feel the leakage when it happens.
Urge Incontinence: Also referred to as “overactive bladder,” this type of incontinence is characterized by a strong and sudden urge to pee. The strong urge then leads to involuntary leakage of urine before reaching the bathroom. Causes include bladder cancer or inflammation, bladder stones, or nerve injury. This type of incontinence is especially disruptive and may interfere with daily life and even sleep.
Overflow Incontinence: This type of incontinence is characterized by the inability to fully empty the bladder. As a result, residual urine continues to leak after a trip to the bathroom. This may be due to partial blockage of the urethra from a growth or benign prostatic hyperplasia (BPH) that interferes with the draining of the bladder. Underactive bladder muscles, a prolapsed uterus, and nerve damage may also be at fault.
Mixed Incontinence: This type of incontinence involves mixed symptoms of both stress and urge incontinence. This may involve urine leakage while coughing and laughing as well as uncontrollable urges to urinate. A person with mixed incontinence may or may not be conscious of urine discharge.
PRP Injections for Incontinence
Platelet-rich plasma (PRP) injections can help treat incontinence, especially when the condition involves a weakened urethral sphincter. PRP injections deliver platelets (fragments of bigger cells that contain healing mechanisms) to target tissues and induce repair. This involves collagen synthesis, tightening, and improved function. Platelets are derived from the patient’s own blood which eliminates the risk of rejection and hypersensitivity in such a delicate area. Research suggests that PRP injections may even repair damaged nerves and contribute to the restored function.
References
- Matz, Ethan l, et al. Safety and Feasibility of Platelet Rich Fibrin Matrix …Investigative and Clinical Urology, 10 Oct. 2017, https://www.researchgate.net/publication/322268631_Safety_and_feasibility_of_platelet_rich_fibrin_matrix_injections_for_treatment_of_common_urologic_conditions.
- Runels C, Melnick H, Debourbon E, Roy L (2014) A Pilot Study of the Effect of Localized Injections of Autologous Platelet Rich Plasma (PRP) for the Treatment of Female Sexual Dysfunction. J Women’s Health Care 3: 169. doi:10.4172/2167-0420.1000169
- Nikolopoulos, Kostis I, et al. “Restoration of the Pubourethral Ligament with Platelet Rich Plasma for the Treatment of Stress Urinary Incontinence.” Medical Hypotheses, U.S. National Library of Medicine, May 2016, https://www.ncbi.nlm.nih.gov/pubmed/27063081.