Urinary incontinence is the uncontrolled leaking, dripping or gushing of urine. It may occur in men or women. There are many causes of incontinence and tens of millions of Americans with a thorough history and physical examination. Often no further evaluation is required and treatment is rendered in the first visit. Evaluation may require additional testing including a urine analysis, measurement of the amount of urine left in the bladder after voiding (done with a 30 sec ultrasound test in office) or more complex testing of the bladder function with urodynamics or bladder structure with cystoscopy.
The 2 main types of incontinence are STRESS incontinence and URGE incontinence.
STRESS incontinence occurs with exertion or when a person applies a stress to the bladder. These include leaking with activities such as; coughing, sneezing, laughing, jumping, lifting, nose blowing,running, steps, walking, standing from a seated position, rising from supine position and even sex. The most common reason that this incontinence occurs is a lack of support for the urethra (the urine channel we void through). That may be the result of prior surgery, child birth, trauma and aging. The treatment of stress incontinence can be in the form of the following;
- Conservative measures including muscle strengthening and behavioral changes
- In office treatment where a material is injected around the urethra to “bulk” and improve its ability to close
- Outpatient surgery known as the “SLING”- The midurethral sling is the gold standard treatment for female stress incontinence despite media attention or commercials stating otherwise. (SUFU statement) This procedure is done minimally invasively with a small (2cm) incision in the vagina. It takes less than 15 minutes and patients are sent home the same day. Most patients go home without a catheter and resume normal activity within weeks. The success exceeds 95%. Patients’ satisfaction is very high and the durability (its ability to keep you dry for a long time) is exceptional. Surgeons at NEOUS have performed hundreds of sling operations in the past decade.
URGE incontinence occurs in 33 million American men and women. It is the involuntary loss of urine that occurs when the desire to void cannot be delayed (“gotta go”). This type of incontinence is usually associated with frequent trips to bathroom, waking at night to void and urgency to get to the bathroom. It is not usually caused by a structural abnormality that is fixed surgically. This incontinence can be caused by aging, medications, neurological diseases, urinary tract infections, bladder stones or tumors but most commonly the reason is unknown.
Dr. Scolieri has developed a simple, easy to follow care path that patients can begin to improve their quality of life and eliminate this type of incontinence. This care path is based on the American Urological Association Guidelines for treating this disorder. It is science based and effective. The following are the options that we use to provide the most comprehensive treatment for this incontinence in the area;
- Behavioral Modification includes dietary changes and fluid monitoring
- Pelvic Floor Rehabilitation
- Medical therapy
- Botox injection
- Posterior tibial nerve stimulation
Men and women do not have to suffer the anxiety, isolation, embarrassment, cost and diminished quality of life because of incontinence. Northeastern Ohio Urological Surgeons offer all of the treatments available to treat incontinence and return patients to normal quality of life.
Dr. Michael Scolieri is a board certified urologist specializing in female urology, female pelvic medicine and reconstructive surgery at Northeastern Ohio Urological Surgeons in Canfield, Salem and Alliance Ohio.