One area of focus for Dr. Grisham and the Grisham Center for Female Pelvic Medicine is bladder dysfunction. This includes a variety of conditions including stress urinary incontinence (leaking when you cough, laugh, or sneeze), urge incontinence (overactive bladder), mixed incontinence (a combination of both stress and urge incontinence), and a condition known as interstitial cystitis which can cause pelvic pain and urinary urgency.
Many women believe that their symptoms are a normal part of “getting older” and think they must simply be tolerated; however, this is untrue. If symptoms affect your quality of life, a variety of effective treatments are available. In order to determine what treatment options are best for a patient, a thorough diagnostic evaluation must be performed.
Dr. Grisham begins the diagnostic process by completing a thorough history and physical examination and then provides specialized bladder testing known as multi-channel cystometrics. Once the diagnosis is determined, he then educates the patient on her treatment options which might include medication, biofeedback, pelvic floor exercises, neuromodulation, or minimally invasive procedures such as suburethral slings.
Medications are often useful in treating patients with urgency and frequency problems as well as both urge and mixed incontinence. These medications are known as muscarinic antagonists and include Detrol, Ditropan and Enablex.
Biofeedback is a technique used to teach patients self-regulation of a process which may not normally be under their control. In the case of urinary incontinence, it has had some success, usually when it’s coupled with pelvic floor exercises. Biofeedback is thought to improve incontinence by helping an individual improve body control through the strengthening of the pelvic floor musculature and developing pelvic neural pathways through a series of exercises aided by visual, verbal or electronic cues.
Neuromodulation is an exciting therapy which utilizes a minimally invasive screening test and implant procedure to provide effective urinary control through sacral nerve stimulation. This procedure can provide relief for patients where conventional therapies have been unsuccessful.
Finally, minimally invasive surgical procedures, which do not require a hospital stay, have been a god-send to those patients who suffer from stress urinary incontinence or mixed urinary incontinence. Procedures to treat these disorders have come a long way in the last decade, and include transobturator technique suburethral slings (TOT), as well as tension-free vaginal tape procedures (TVT).
During the last 13 years, Dr. Grisham has dedicated himself to learning all the various treatments available for urinary incontinence, and has performed classic procedures such as the Burch and MMK urethropexies, as well as fascial sub-urethral slings, TOTs and TVTs. He continues to seek new and improved therapies to help his patients, and in fact was the first physician to perform the minimally invasive transobturator technique suburethral sling at the Presbyterian Hospital of Plano.
| |
| |
“It has been exciting to see how these procedures have improved over time and have become less invasive and more effective with fewer side effects. I’m honored to be one of the first physicians to bring these techniques to the women of North Texas.” |
|
|
| |
To learn more about bladder dysfunction treatment options, click here. To schedule an appointment with Dr. Grisham at the Grisham Center, click here.
|
