Incontinence

Urinary incontinence  (any involuntary leakage of urine) can be a common and distressing problem that can profoundly impact quality of life. Bladder symptoms are much more common in women than men, and more common in older women than younger women. Urinary incontinence almost always results from an underlying treatable medical condition. Different types of incontinence include, stress, urge, mixed and overflow.

Workup

Cystoscopy

Cystoscopy is a simple office procedure that allows us to look at areas inside the urethra and bladder through a small scope that usually do not show up well on X-rays. We perform this procedure to look for foreign bodies, stones, tumors, bleeding, and infection inside the bladder. Cystoscopy can also be used to treat some bladder problems and may eliminate the need for more extensive surgery. This can be done in the office or as a day surgery.

Urodynamics

This is a term that describes a series of diagnostic tests used to show how your bladder functions. It involves placing a pressure sensitive catheter in the bladder which measures pressures during filling and emptying of the bladder. These tests will provide answers to clinical questions that arise about a patient’s bladder and outlet function if they are suffering from specific complaints such as incontinence, urgency, pain, slow stream, frequency, hesitancy and other urinary problems.

Treatment

Treatment options range from conservative treatment, behavior management, neuromodulation (Interstim, PTNS), bladder retraining, pelvic floor therapy, medications and surgery.

Sling Procedures

We are able to perform this procedure for women with severe stress incontinence caused by weak sphincter muscles.

Bulking Agents

We perform this treatment for stress incontinence, where Periurethral bulking agents are injected to increase tissue bulk around the urethra, in our office.

Pelvic Floor Retraining

This service involves biofeedback therapy to teach the patient how to coordinate the use of the abdominal muscles with the pelvic floor muscles. Pelvic floor retraining improves symptoms in approximately 70 percent of patients who have stress incontinence as well as those with excessive straining when attempting to stool.

Botox for the overactive bladder

Botox is a treatment for frequency, urgency and urge urinary incontinence in women who have been unresponsive to more conventional therapies or are unable to tolerate other medicines. It is a very simple procedure done in the office or as a day surgery. Through a cystoscope tiny amounts of Botox are injected into the bladder lining. Most women require repeated doses every 9-12 months.

Interstim

For symptoms of frequency, urgency and urge incontinence that have been unresponsive to other therapy, Interstim may be an option. Think of Interstim as a “pacemaker” for the bladder which interrupts unwanted signals going to the bladder. A simple test performed in the office can indicate if this therapy would be successful in controlling your symptoms. If so, a minor surgical procedure is performed to implant a small device like a pacemaker in the upper hip area to make the therapy permanent.