Incontinence

If you or someone you know is affected by loss of bladder control, a medical condition called urinary incontinence, you are not alone. More than 30 million Americans suffer from this condition, which causes involuntary leakage of urine.

Despite its prevalence, most people with incontinence are reluctant to seek medical help. Either they are embarrassed or unaware that help is available. Many, instead, turn to absorbent pads and diapers, unnecessarily resigning themselves to living unhappily and uncomfortably with this debilitating – yet very treatable -- problem, in most cases.

Urologist Debra Fromer, M.D., specializes in male and female voiding dysfunction, including incontinence and enlargement of the prostate. The Department of Urology’s incontinence team includes urologists, gynecologists, and colorectal surgeons, who utilize the finest technology for the evaluation, diagnosis, and management of bladder, prostate, and pelvic floor disorders. In addition to medical expertise, our dedicated healthcare professionals have a genuine understanding of these disorders – one that respects confidentiality, and wins patient trust.

Evaluation
Each patient receives an in-depth evaluation to determine the severity and cause of incontinence to enable the physician to tailor therapy to his or her unique needs. This evaluation includes a detailed history and physical examination and questionnaires, and may include diagnostic tests such as voiding diaries, video urodynamics and/or cystoscopy, which are performed by our urologists and highly skilled nurses.

Treatments
The treatment of urinary incontinence is very specific to each patient depending on his or her evaluation. Treatments include:

• Behavioral modification: simple techniques to improve bladder function including pelvic floor muscle exercises, dietary modifications, alterations in fluid intake, and bladder retraining
• Pelvic floor biofeedback: physical therapy for the muscles of the pelvic floor. The goal of pelvic floor biofeedback is to gain greater control of the muscles. The technique can be used in the treatment of urinary incontinence, overactive bladder, urinary retention, pelvic floor disorders, and pelvic pain disorders.
• Electrical stimulation: a gentle electrical current is delivered to the muscles of the pelvic floor resulting in temporary contraction of the pelvic floor muscles
• Medical therapy: the use of certain medications designed to reduce overactivity of the bladder, which can aid in bladder control and decrease urgency of urination and urge incontinence
• Sling surgery and surgical reconstruction: a surgical procedure that cures stress urinary incontinence. By placing a sling of supporting tissue, most commonly a mesh, it acts as a “hammock” to support the urethra and prevent stress incontinence.
• INTERSTIM^® sacral neuromodulation: a novel technology whereby a gentle current is delivered to the nerve supplying the bladder and pelvic floor in order to treat overactive bladder, non-obstructive urinary retention, and pelvic pain disorders
• BOTOX® therapy: a procedure in which an agent that paralyzes muscular activity is injected into the bladder to reduce bladder spasticity. BOTOX^® therapy can be used to treat overactive bladder and urge incontinence.
• Artificial urethral sphincter: a surgical procedure whereby a cuff that can be inflated via a pump placed in the scrotum is wrapped around the urethra. It is used to treat stress urinary incontinence in the male.