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Urinary Incontinence Treatments

We offer a number of non-surgical and surgical treatment options.

Non-Surgical Treatment of Urinary Incontinence

Lifestyle Modifications

Fluid Management

  • Decrease your intake of fluids to a total of 50-60 ounces per day provided you don’t have a medical condition that prohibits limiting fluids.
  • Avoid or decrease certain types of fluids, including caffeinated beverages (e.g., soda, teas and coffee), alcohol or acidic juices (e.g., grapefruit or orange juice).

Bladder Training

There are different types of bladder training that can improve your symptoms of stress and urge incontinence. 

  • Classic bladder training (habit training) — This type of training can be helpful if you have symptoms of an overactive bladder (urgency, frequency or urge incontinence). You'll first keep a bladder diary and then set up a voiding schedule to slowly increase the time between urination. You can increase your voiding time by 15 minutes every week with the goal of urinating every 2-3 hours. This training teaches you to suppress the urge to void before the scheduled time. Performing pelvic floor contractions (Kegels) can also help suppress the urge.
  • Timed voiding During this training, your doctor sets times for you to empty your bladder. This is commonly used with medication for overactive bladder.
  • Prompted voiding Your caregiver prompts you to go to the bathroom on a regular schedule, every 2-4 hours. The goal is simply to keep you dry. This therapy is common for frail elderly, bedridden or Alzheimer's patients.
  • Pelvic muscle rehabilitation (Kegel exercises) — Pelvic muscle exercises (PME) can be used alone or in conjunction with biofeedback therapy, vaginal weight training and pelvic floor stimulation.
  • Pessaries — A pessary is a device worn in the vagina to help support the prolapsed organ. While it may ease your symptoms, it does not repair the prolapse. A pessary can be taken in and out either on a daily, weekly or monthly basis. Pessaries come in many different shapes and sizes and must be fitted by a doctor.

Your doctor may prescribe medication by itself or in conjunction with other non-surgical treatment options. 

An Alternative Procedure: Botox®

If medications and lifestyle changes have failed to help your overactive bladder, you may be eligible for Botox. This treatment can stop urine leakage and a constant need to urinate (urge incontinence).

Botox injection treatment:

  • Requires mild sedation
  • Takes 10 minutes
  • Lasts six months; can be repeated twice a year
  • Takes place in an outpatient surgery clinic

To access your bladder, the doctor performs a cystoscopy, inserting a tube through your urethra. After filling the bladder with saline, the doctor injects the bladder with Botox. 

To avoid contracting a urinary tract infection, you'll need to follow the procedure with a short course of antibiotics. 

Surgery Options for Urinary Incontinence

InterStim® Therapy for Urinary Control

This minimally invasive, two-staged treatment can help those with urge incontinence and voiding dysfunction (inability to empty the bladder). The Interstim device, which is similar to a pacemaker, is also approved by the FDA for bowel leakage.

Trial of InterStim® Therapy

Your doctor inserts a thin, flexible wire into your anus where the sacral spinal nerve is located near the tailbone. Your doctor attaches the wire to an external test stimulator that can be worn on a waistband. This device, which can fit into the palm of your hand, causes sacral nerve stimulation to help the bladder, sphincter and pelvic floor muscles to work more effectively together.

During the two-week trial period, you can adjust the intensity of the current until you find the right balance between an overactive and inactive bladder.

Long-term InterStim® Therapy

If you experience a 50 percent or more improvement in your bladder function during the trial, you may qualify for an outpatient procedure to place a neurostimulator under your skin in the upper buttock. The neurostimulator connects to a wire that sends mild electrical pulses to the sacral nerves to continue to help with your urine incontinence issues. 

Vaginal Surgery: Slings

Sling procedures are surgeries that treat stress urinary incontinence symptoms. Your doctor places a piece of tissue or artificial mesh underneath the urethra. It acts as a layer of support so that the urethra is closed off when there is increased pressure in the abdomen (laughing, coughing, sneezing and exercising).

Materials commonly used include your own fascia (the tough covering around muscles), a piece of animal tissue specially treated for human use or polypropylene mesh.

The following are common sling procedures:

  • Tension-free vaginal tape (TVT/sling)
  • Pubovaginal sling uses a piece of a your own fascia or piece of animal tissue. It requires a small abdominal incision ranging from 2-4 inches on the lower abdomen.
  • Transobturator tension-free vaginal tape (TVT-O) also uses a mesh but differs slightly from the TVT. Your doctor places the mesh around the pubic bone and exits at the crease of the inner thigh.

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