Ready for Relief?

April 01, 2013

Providence experts offer real solutions for urinary incontinence

Let’s face it, bladder problems can be embarrassing, uncomfortable and lifestyle-limiting. The good news is that summoning the courage to talk to your doctor can bring relief.

Here’s a rundown of common bladder problems and how they can be treated.

Urge Incontinence

What it is:  Also called overactive bladder, this condition causes frequent urination.

Signs you have it:  You scout out any new room to find the closest bathroom in case you have a strong urge to go. You often can’t make it to the bathroom in time.

How it’s treated:  Treatments include pelvic floor exercises, diet, medication and biofeedback therapy to “reset” pelvic floor muscles, says Michael Hyman, MD, chief urologist at Providence Saint Joseph Medical Center and also on staff at Providence Holy Cross Medical Center.

The next step may be neuromodulation. Jennifer Mehdizadeh, MD, a urologist at Providence Tarzana Medical Center, offers peripheral tibial nerve stimulation and sacral nerve stimulation, the latter of which is delivered through an implantable device. “By doing neuromodulation, you can return that nerve to a pattern of signaling that helps the bladder get under control,” she says.

Stress Incontinence

What it is: The most common type of urinary incontinence in women, this condition causes you to leak urine when “stress” or pressure is placed on the bladder.

Signs you have it: You have an accident when you exercise, sneeze, cough or laugh.

How it’s treated: Sometimes the ligaments and structures that hold the urethra in place lose integrity. A sling can be inserted to keep the urethra in place. “We’re talking about what is usually a 25-minute outpatient procedure that requires a small incision and a small number of stitches,” Dr. Hyman says.

Pelvic Organ Prolapse

What it is: The uterus, bladder or other organ falls out of normal anatomical position.

Signs you have it: You may have incontinence, frequent urinary infections, pressure, pain or even a bulge in the vaginal area.

How it’s treated: “There is a range of treatments available— including mesh repair, pelvic floor physical therapy, the insertion of a supportive device called a pessary or the use of biologic material to re-suspend the prolapsed organ,” Dr. Mehdizadeh says.

Dr. Mehdizadeh and Dr. Hyman urge women to learn about these options and speak to their physicians to help determine the best treatment for them because each case is different.

“These are conditions you don’t have to live with,” Dr. Hyman says.