Close to 10 million women in America have incontinence. The number may actually be higher because many women don't seek help for their symptoms or don't even mention it to their health care provider...

General Information about Female Incontinence

About 10 million women in the U.S. are affected by an inability to control their urinary stream. Most of these women live with their incontinence for years prior to seeking treatment. Both the social implications of leaking urine unexpectedly and the costs of wearing multiple pads each day have an adverse impact on the patient's well-being. Today, there are multiple treatment options for these women, many of whom do not require surgery.

Causes of Female Incontinence

Stress incontinence

Weakened pelvic muscles allow the opening to the bladder to drop during periods of increased abdominal pressure - coughing, sneezing, lifting, or standing. This is known as urethral hypermobility. A more severe form is known as type-3 stress incontinence, or intrinsic sphincter deficiency. This is caused by a poorly functioning urethral sphincter (the muscle which closes off the bladder neck).

Urge incontinence

Due to inappropriate contraction of the bladder during filling with urine (bladder spasms).

This often occurs along with stress incontinence and usually disappears with correction of the stress incontinence. Women with urge incontinence often complain of leaking when they feel a strong urge to urinate but cannot reach a bathroom in time. Causes of urge incontinence include urinary tract infections (UTI), spinal cord injury, strokes, bladder obstruction, and old age. It is often treated successfully with a medication that relaxes the bladder (Levbid or Ditropan)..

Overflow incontinence

This is due to an inability to empty the bladder, causing urine to leak, similar to overfilling a bucket. It is secondary to either obstruction of the bladder or a poorly functioning bladder muscle. The causes in women include diabetes, spinal cord injuries, or multiple sclerosis. If obstruction is not the cause, there are no effective surgeries or medications for this type of incontinence. The treatment is usually clean intermittent catheterization (CIC) - draining the bladder every 6 hours by inserting a small tube through the urethra.

TCM Pathology

According to TCM theory, female incontinence is caused by either Spleen Qi deficiency or Kidney Qi deficiency. Spleen is the organ which produces center Qi to support individual organs in a certain position. It also controls all muscles in the body. When women have spleen Qi deficiency, they lose control of the muscles of the urethra and bladder. Kidney Qi, in charge of water transformation, becomes weaker with age, losing the function of vaporizing extra water in the body; therefore, more urine is being produced. Due to Qi deficiency of the above two organs, women will usually have more frequent urination and also uncontrolled leaking.

Symptoms associated to Spleen Qi Deficiency

• General fatigue
• Loose stools
• Low appetite
• Heaviness
• Prolapsed
• Sleepiness
• Edema

Symptoms associated to Kidney Qi Deficiency

• General fatigue
• Low libido
• Weak knees
• Low back soreness
• Cold hands and feet

Treatment of Female Incontinence

Kegel exercises

Used to strengthen the pelvic floor muscles. Women are instructed to contract these muscles ten times every hour. Vaginal weights or cones may be placed in the vagina to help women identify which muscles to contract (if the proper muscles are not used, the cones fall out of the vagina). These exercises are only effective in mild stress incontinence.

Biofeedback

A device is placed in the vagina to give women visual or auditory feedback when the proper pelvic muscles are contracted during Kegel exercises. This improves the success rate of Kegel exercises to about 50%.

Medications

Although there are some medications which can tighten the bladder neck, such as Sudafed, they are not very successful.

Intro bladder neck support prosthesis

A silicone device is place in the vagina to lift the bladder neck and prevent it from dropping with increased abdominal pressure.

Surgery

Either bladder neck suspensions or sling operations.

Collagen injections

A collagen paste is injected into the urethral tissue just past the bladder neck to help the sphincter muscle close the bladder.

Pubovaginal sling

This operation takes a piece of tissue from the abdominal wall and passes it under the urethra, forming a "sling".

TCM Treatment

Principles

Strengthen the Spleen and Kidney Qi to support bladder and promote water transformation.

Modalities

Acupuncture

Moxibustion

Herbs

Most people have improved after 3-4 weekly treatments

Life Style

Rest during the first month after labor

Escape from cold food and drinks

Avoid overexertion 

Dress warm in winter or cold days

TCM Could Be A Cure

This Edition Is Copyrighted by

Frank He, L. Ac.