Bladder dysfunction encompasses 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.
Bladder dysfunction impacts millions of women, and unfortunately many believe that their symptoms are a normal part of “getting older” and must simply be tolerated. However, if your symptoms affect your quality of life, a variety of effective treatments are available.
Evaluation and Diagnosis
Dr. Grisham will begin the diagnostic process by completing a comprehensive health history and physical examination, followed by specialized bladder testing known as multi-channel cystometrics. Sometimes referred to as urodynamic testing, the process involves taking measurements to evaluate your urinary function and efficiency, and it is the gold standard of incontinence testing.
Once the diagnosis is determined, he will educate you on your 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.
Minimally Invasive Procedures
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).
The Grisham Center for Female Pelvic Medicine and Restorative Surgery is a cutting-edge facility dedicated to improving quality of life of women who suffer from pelvic organ prolapse and bladder dysfunction. It is one of the first facilities of its kind in the nation, and we are proud to utilize the most advanced techniques to restore normalcy to our patients’ lives.
If you think you may be suffering from urinary incontinence or other bladder dysfunction, we encourage you to call or email us to schedule an appointment for an evaluation.