URGE INCONTINENCE
Urge incontinence occurs when the large bladder muscle becomes too active and
contracts too often. These contractions are what causes the strong, sudden urges
often seen in an overactive bladder. A person may experience symptoms such as:
Urinary frequency - urinating more than 8 times per 24 hours
Nocturia - waking up to urinate 2 or more times a night
Urgency - strong, sudden desire to urinate
Urge incontinence - accidental loss of urine due to a sudden and unstoppable
urge to urinate
To determine the cause of incontinence your doctor uses a variety of diagnostic
tools. A voiding diary can provide insight into the specific type of incontinence,
as well as the severity of the problem. Urodynamic testing will often pinpoint
an abnormality in bladder filling or emptying. Combining urodynamics with video
monitoring can provide invaluable clues as to how well the bladder and urethra
function as a unit. A direct inspection of the inside of the urethra and bladder
can eliminate other causes of urinary incontinence,such as tumors or stones. These
diagnostic tests can all be performed quickly, easily and conveniently in an office
setting.
Once the specific cause of urinary incontinence has been detected, therapy can
be instituted to improve and correct the problem. Dietary and lifestyle changes
can often have a positive impact on urinary control. Avoiding known bladder irritants,
such as alcohol and spicy foods, can reduce urgency, frequency, and sometimes
painful urination. Biofeedback can also reduce urgency and frequency.
Non-invasive technology, such as NEOCONTROL can improve, and even cure
some forms of stress urinary incontinence. This painless, office-based procedure
uses magnetic stimulation of the pelvic nerves to strengthen the muscles of the
pelvic floor often weakened during childbirth. Drug therapy has been especially
helpful in controlling the debilitating effects of an overactive bladder. Recent
advances in the delivery of these medications have significantly reduced the side
effects, and improved patient compliance.
Safe, effective stimulation of the sacral nerves using the INTERSTIM implant has
proven rewarding in controlling even the most intractable overactive bladder.
It has even shown some promise in restoring normal voiding in patients with atonic
bladders who were once required to catheterize themselves.
A variety of minimally-invasive surgical procedures have been developed to help
those for whom no other therapy has been successful. Abdominal and vaginal urethral
suspension procedures are highly effective in curing stress incontinence. For
those with intrinsic urinary sphincter dysfunction (ISD), transvaginal sling procedures,
commonly performed under local anesthesia and sedation, have resulted in cure
rates in over 90% of women. The TVT procedure has successfully restored many women
to healthy, active lives. For men and for women, in whom no other therapy has
provided control of their urine, surgically implanted inflatable urinary sphincters
have achieved significant successes.
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