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Urinary Incontinence

Incontinence is the inability to control the passage of urine or stool.  Approximately 25 to 45 percent of  American women suffer with involuntary loss of bladder.  Incontinence can affect quality of life and be quite bothersome.  

 

It is important to understand that incontinence is a symptom and not a disease. Its cause may be quite complex and involve many factors.   The physician needs to complete an in-depth evaluation before beginning any treatment.

 

What can I do for this problem?

Getting help means taking the first step.  See your doctor.  Diagnostic tests for incontinence can be completed in the outpatient setting and are not painful.  Once these tests have confirmed the cause of the incontinence, the physician can make specific recommendations for treatment, many of which do not require surgery. If surgery is appropriate, it will likely be a bladder sling.

 

Treament options

  • Stress incontinence - Slings are used to treat Stress Urinary Incontinence (SUI). They are not effective in treating urge incontinence. There are a wide variety of slings, including the pubovaginal sling, the midurethral retropubic slings and the transobturator slings.Some slings are secured to the anterior abdominal wall fascia, or to the undersurface of the pubic bone. Other slings are not anchored. In the past 10 years, many surgeons are using a synthetic sling that is place transvaginally through small incisions.  These slings are called midurethral slings and have several advantages. 
    • First, they are minimally invasive and can be done as outpatient procedures.
    • Secondly, they are durable because the synthetic material is strong and inert. 
    • Finally, they are associated with fewer urinary symptoms, such as urinary retention (or inability to void) and urinary urgency, frequency, urge incontinence.
  • Urge incontinence - Medtronic offers an innovative intervention for overactive bladder and urinary retention called sacral nerve stimulation (InterStim® Therapy) in patients who have failed or could not tolerate more conservative treatments. The intervention provides urinary control therapy that addresses the nerve component of bladder control problems.