Answers for Urinary Incontinence Concerns
Mar 26, 2013
Colorado - Denver Metro , Colorado - Denver North Metro , Colorado - Denver South Metro
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A: Urinary incontinence is any involuntary leakage of urine. This is most often caused by physical activity, sudden urge to urinate or both.
Q: What if I also leak stool?
A: Involuntary leakage of stool (fecal incontinence) often accompanies urinary incontinence and can cause significant embarrassment to women of all ages. Fortunately for many patients, the FDA has recently approved the use of a neuro-stimulator (Interstim) to treat fecal incontinence. This has been used in over 100,000 patients for treatment of urinary incontinence, urgency and urinary retention with great success in the United States. Neurostimulation has been used in Europe for fecal incontinence with success for many years as well and now women with incontinence of all types are able to benefit from this technology. It is especially exciting to think that one treatment may solve two different problems.
Q: What would an evaluation for this involve?
A: Most women find this is a very embarrassing problem that can be difficult to discuss. It is important to feel comfortable with your doctor and their staff. I find it helpful, in my office, to have patients work exclusively with female staff throughout their care. This starts with a thorough one on one discussion about the exact nature of the problem. Once this is established a physical exam is performed. This includes a pelvic exam which should be carried out in a gentle and dignified manner. Some testing may be necessary to evaluate the exact cause of your leakage. This may include a cystoscopy (a small camera inserted into the bladder through the urethra to evaluate anatomy), as well as a urodynamics test (insertion of a small catheter in the bladder to assess function). These should all be performed in the most comfortable environment possible and cause minimal if any discomfort.
Q: What can I do to treat urinary incontinence?
A: There are many options for treatment which range from simple exercises, medications, injections
and many very minimally invasive procedures. These can include Kegel exercises, biofeedback, anti-
cholinergic medications, slings and neurostimulation. These can all be performed in an outpatient setting and often have minimal, if any, recovery time.
Q: Who should I see for these problems?
A: I recommend that you seek outa specialty trained physician who specializes in incontinence and pelvic floor dysfunction. Fellowship trained urologists and urogynecologists are the most qualified to deal with incontinence issues. You should not hesitate to ask your doctor if they have completed specialized training and how many of these procedures they have performed in the past. In the hands of an expert these procedures have significantly higher success rates and less complications. Most importantly you should feel comfortable with your doctor and that your treatment plan is tailored to your individual needs.
Editors Note: This article was submitted by Dr. John Tillett, MD, Specialists in Urology.
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