A common, treatable condition.

Urinary incontinence is the unintentional release of urine. If you think you may have urinary incontinence, it's important to know that it can be treated - you don't have to live with it. Today there are many treatment options that can help you gain control over this condition and improve the quality of your life.

Stress incontinence (sudden urine loss) is the unintentional release of urine during normal everyday activities. This is the most common type of urinary incontinence in women, accounting for 60 percent of all cases.

If you have this condition, you may lose urine when you:

  • Laugh, sneeze, or cough 
  • Walk, exercise, or lift something 
  • Get up from a seated or lying position 
  • You may also go to the bathroom frequently throughout the day to avoid accidents.

Stress incontinence has two basic causes. Usually it is caused by a weakening in the pelvic floor muscles that support the organs of the lower urinary tract. A strong pelvic floor keeps the urethra tightly sealed until it's time to urinate. A weakened pelvic floor cannot hold the urethra in its correct position, since any movement that puts pressure on the bladder (such as a sneeze) may cause the urethra to lose its seal and allow urine to escape.

Another cause of stress incontinence is intrinsic sphincter deficiency (ISD). Normally, the sphincter muscles hold the urethra closed until it's time to urinate, when they relax their grip and allow urine to flow. However in women with ISD, the sphincter muscles don't function as they should, which can cause urine to leak during movements that put pressure on the bladder.

Some of the other factors that may contribute to stress incontinence include:

  • Pregnancy and childbirth 
  • Menopause or estrogen deficiency 
  • Gynecologic surgery 
  • Obesity Strenuous exercise

Urge incontinence or overactive bladder, as it is sometimes called, is a sudden, intense urge to urinate, followed by a loss of urine. You may feel like you never get to the bathroom fast enough, or you may be awakened several times a night by the strong urge to urinate. Urge incontinence is most commonly caused by overactive bladder muscles, not by weakness in the pelvic floor.

Overflow incontinence may make you feel as if you never completely empty your bladder. It may be caused by dysfunctioning nerves or a blockage in the urethra that prevents the flow of urine. This leaves the bladder at least partially full at all times.

Mixed incontinence is a combination of both stress and urge incontinence. It's a type that occurs often in women.

Surgery 

When other therapy approaches fail, surgery may be required to treat the underlying cause of incontinence. Surgical treatment may deliver the most reliable, permanent results. There are many different kinds of surgeries, and each is recommended for a specific type of cause of incontinence.

Many women fear the pain and recovery from surgery and are reluctant to explore this option. However, several of today's procedures are simpler and less invasive than those used in the past. If appropriate, your doctor will recommend the right procedure for you.

Gynecare TVT, is a minimally invasive surgical procedure, appropriate for some women with stress urinary incontinence. The procedure can be performed under local anesthesia and takes only about half an hour to complete. The recovery period following the procedure is short, and patients experience few complications and minimal scarring after surgery. Gynecare TVT is a doctor-applied ribbon-like strip that stops urine leakage the way your body was designed to - by supporting your urethra. You can go back to your routine in just a day or two.

InterStim Therapy for Urinary ControlInterStim Therapy for Urinary Control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and signficant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments.

InterStim Therapy uses a small device to send mild electrical pulses to a nerve located in the lower back (just above the tailbone). This nerve, called the sacral nerve, influences the bladder and surrounding muscles that manage urinary function. The electrical stimulation may eliminate or reduce certain bladder control symptoms in some people. The system is surgically placed under the skin, typically in the upper buttock or abdomen.

For more information about InterStim Therapy for Urinary Control, please contact Jennifer Malossi, MD at 607-729-7666. 

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