Urinary incontinence is a common condition that affects men and women of all ages. While this condition can be frustrating to manage, there is hope. The team at Affiliated Urologists offers the following treatment options to stop urinary incontinence in its tracks.
Behavioral and Physical Therapy
Behavioral therapy and physical therapy are non-invasive treatment options for patients suffering from stress, urge, mixed, and overflow incontinence. These therapies are considered the first line of defense for urinary incontinence because they are incredibly effective at strengthening the muscles of the pelvic floor. At Affiliated Urologists, our physicians specialize in a number of non-invasive and minimally invasive treatment techniques for urinary incontinence. For this particular treatment option, also commonly referred to as pelvic floor physiotherapy, patients learn how to perform kegel exercises through muscle contraction and relaxation. For details about pelvic floor muscle exercises, please visit Pelvic Floor Muscle Weakness.
Medications (for urge incontinence)
The physicians at Affiliated Urologists may recommend a combination of prescription medications to help patients control their urinary incontinence. Some of these medications include anticholinergics (Atropine), beta-3 selective adrenergic agonists (Myrbetriq), and antidepressants (Imipramine and Duloxetine). Each medication has a unique role in managing a patient’s urinary incontinence. For example, anticholinergics and beta-3 selective adrenergic agonists help calm an overactive bladder by blocking certain neurotransmitters that cause muscle spasms. Alternatively, imipramine and duloxetine, which are used to treat depression, help control specific brain chemicals that can cause urinary incontinence. Before a patient can be prescribed any kind of medication, he or she will need to first undergo a thorough evaluation from an Affiliated Urologists physician. This examination will determine whether or not prescription medication is a safe treatment option for patients suffering from urinary incontinence.
Medical devices such as a urethral insert or vaginal pessary may be considered for patients with moderate to severe cases of urinary incontinence. Depending on the type of device used, these therapeutic tools can stop the flow of urine, alter the position of the urethra or bladder, or support the safe evacuation of urine from the bladder. Some devices, like a vaginal pessary, are made out of compounds like latex or silicone to ensure comfort, support, and cleanliness. Patients suffering from this condition may benefit from a pessary, urine seal, urethral insert, bladder neck support device, or artificial urinary sphincter. An Affiliated Urologists physician will determine the best possible device for the patient's current condition and symptoms.
When behavioral therapies and medications are not enough to control incontinence, the urology experts at Affiliated Urologists may perform minimally invasive, interventional procedures. For example, our physicians offer bulking agents like Macroplastique or Coaptite to control stress or urge incontinence. During this procedure, the physician injects the bulking agent near the urethra to reduce urge frequency and leakage in order to improve urethral function. Additionally, Affiliated Urologists offer Botox injections to treat overactive bladder and incontinence. Botox injections reduce bladder spasms or contractions of the bladder to treat urinary incontinence. Another way to treat incontinence caused by overactive bladder is through Urgent PC, also known as Percutaneous Tibial Nerve Stimulation-PTNS. During this procedure, a small electrode is placed near the foot, sending electric impulses up toward the sacral nerves. This stimulation helps prevent the bladder from sending incorrect signals to the brain. Affiliated Urologists also offers another form of neurostimulation called InterStim. This device also uses electric impulses to stimulate the sacral nerves. However, it is implanted into the patient rather than connected externally through the tibia. Finally, our urology experts may provide catheters to drain urine and reduce incontinence.
If interventional therapies, medications, and lifestyle changes are not enough to control incontinence, the team at Affiliated Urologists wants to ensure a continuum of care is still being provided for patients. This is why our urologists are expertly trained in various minimally invasive surgical procedures. We believe having a urologist who is also a surgeon helps patients achieve complete relief from their urinary incontinence. Therefore, our physicians offer the suburethral/midurethral sling, bladder neck suspension, and artificial urinary sphincter procedures to help patients obtain a more permanent solution for their incontinence. Suburethral/midurethral slings and bladder neck suspensions help correct stress incontinence, or accidental voidance when sneezing, laughing, etc. The procedures correct the position of the bladder neck. The artificial urinary sphincter procedure is usually performed on patients who have lost control of their urinary sphincter muscle, usually after a separate surgical procedure. This procedure allows patients to control their urination and reduce urinary incontinence.