Urge incontinence

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Female urinary tract

Male urinary tract

Augmentation cystoplasty is the most frequently performed surgical procedure for severe urge incontinence. In this reconstructive surgery, a segment of the bowel is added to the bladder to increase bladder size and allow the bladder to store more urine.

Possible complications include those of any major abdominal surgery, including bowel obstruction, blood clots, infection, and pneumonia.

There is a risk of developing urinary fistulae (abnormal tubelike passages that result in abnormal urine drainage), urinary tract infection, and difficulty urinating. Augmentation cystoplasty is also linked to a slightly increased risk of developing tumors.

DIET

Some experts recommend a regimen of controlled fluid intake in addition to other therapies in the management of urge incontinence. The goal of this program is to distribute the intake of fluids throughout the course of the day, so the bladder does not need to handle a large volume of urine at one time.

Do not drink large quantities of fluids with meals -- limit your intake to less than 8 ounces at one time. Sip small amounts of fluids between meals. Stop drinking fluids approximately two hours before bedtime.

Additionally, it may be helpful to eliminate your intake of foods that may irritate the bladder, such as caffeine, spicy foods, carbonated drinks, and highly acidic foods such as citrus fruits and juices.

BLADDER RETRAINING

Management of urge incontinence usually begins with a program of bladder retraining. Occasionally, electrical stimulation and biofeedback therapy may be used in conjunction with bladder retraining.

A program of bladder retraining involves becoming aware of patterns of incontinence episodes and relearning skills necessary for storage and proper emptying of the bladder.

Bladder retraining consists of developing a schedule of times when you should try to urinate, while trying to consciously delay urination between these times. One method is to force yourself to wait 1 to 1 1/2 hours between urinations, despite any leakage or urge to urinate in between these times. As you become skilled at waiting, gradually increase the time intervals by 1/2 hour until you are urinating every 3 to 4 hours.