From one woman to another. There is a solution.
It can be embarrassing when you laugh or cough, triggering an involuntary loss of urine. You're not alone as urinary incontinence affects one in four women. It can also impact men.
You are at risk if you are:
- Caucasian or Hispanic ethnicity
- Overweight or obese
- A smoker
- Constipated or have a chronic cough
There are both non-surgical and surgical treatments available locally that are providing relief. The Oswego Health female incontinence service offers a multidisciplinary approach to diagnose and treat urinary incontinence. This includes therapies for stress incontinence (SUI) and urge incontinence (OAB-wet).
Providing incontinence care at Oswego Health are board-certified urologists Elizabeth W. Bozeman, MD, and Gary Bozeman, MD, as well as nurses and physical therapists who work together to address multiple urological conditions. Our treatment plans are individualized and take the embarrassment out of discussing urinary incontinence issues.
Leading the incontinence team is Dr. Elizabeth W. Bozeman, who has 20 years of experience in female urology including, recurrent urinary infections, stone disease, interstitial cystitis and many other conditions of general urology. She is the leading expert in diagnosing and treating female urological conditions in the area.
What causes incontinence?
Urinary incontinence is the uncontrolled leaking of urine. More than 15 million American women suffer from urinary incontinence. Any leakage of urine is abnormal.
Pelvic floor muscles support the bladder and urethra. When they become weak or damaged, they may not work well enough to hold urine in the bladder.
Urinary incontinence is not a disease. It is a symptom of a wide range of conditions. These may include diabetes, stroke, multiple sclerosis, Parkinson’s disease, some surgeries or even childbirth or menopause for women. Certain types of medications can cause or make incontinence worse. These medications include diuretics, sedatives, narcotics, antidepressants, antihistamines, calcium channel blockers and alpha-blockers.
Stress Urinary Incontinence (SUI)
SUI is the most common type of leakage. This occurs when urine is lost during activity, such as walking, exercising, or even sneezing and coughing. The added pressure on the abdomen from these activities can cause urine to leak.
Overactive Bladder (Urgency Incontinence)
The major symptom of OAB is a sudden, strong urge to urinate that you can’t ignore. This"gotta go" feeling makes you afraid you will leak urine if you don't get to a bathroom right away. If you live with OAB, you may urinate many times during the day. You may also wake from sleep more than once a night to go.
- Urodynamics are bladder studies that measure bladder pressures during bladder filling and emptying to aid in determining the cause of urinary symptoms.
- Cystoscopy is a test which allows the inside of the bladder and urethra to be visualized.
Therapies and Treatments
A bladder diary can help you keep track of the fluids you drink and any leakage triggers. You may need to reduce your intake of caffeine or other drinks that irritate the bladder.
Pelvic Floor Exercises
Known as Kegel exercises, these exercises can help strengthen the external sphincter muscle and the pelvic floor muscles.
Specially trained therapists guide a patient through instruction of exercises that specifically target the pelvic floor muscles for strengthening.
BioFeedback uses computer graphs as a teaching tool to help a patient identify and learn to control the correct muscles by helping the patient locate the pelvic muscles. The graph indicates when the right muscle is squeezed or tightened.
In women, a small probe is inserted into the vagina (similar to a tampon) and in men an even smaller probe is inserted into the rectum. This probe senses the muscle activity and aids in learning how to properly exercise the pelvic muscles.
Sacral Nerve Stimulator (Interstim®)
This is an FDA-approved outpatient treatment for individuals who have not been successful using conservative therapy for symptoms of urinary urgency, frequency, urge incontinence and nonobstructive urinary retention.
It is performed in two stages where an electrode is placed through an existing opening in the sacrum. A testing period of a few days to few weeks is completed to ensure that the device works for the patient. If successful, an internal generator is placed, and if not, the lead is simply removed.
Botox, a neurotoxin, is injected in the bladder muscle through a small scope for OAB. It is a great alternative to medications and can be injected just twice a year to control urge incontinence.
Urethral Bulking Agent
An in-office or outpatient procedure where an agent is used to bulk the lining of the urethra through transurethral injections to treat urinary stress incontinence.
This is one of the most common surgical treatments for female stress incontinence and there are several different types. For simple stress urinary incontinence, a sling is the surgical procedure of choice.
The most popular are mid-urethral slings commonly done with mesh versus a Pubovaginal sling that is placed closer to the bladder neck. The tissue used to create the sling can be a piece of the patient’s abdominal wall fascia, a biologic tissue or synthetic material (mesh). Most women can expect more than 80 to 90 percent cure or great improvement from this surgery.
Prolapse repairs can be performed transvaginally. The other options include simple observation, or the use of a pessary.
Treatment of Operative Complications
Patients who have already undergone surgery for prolapse or incontinence that are having complications, a recurrence of their symptoms, or other difficulties are encouraged to contact Dr. Bozeman for medical assistance with the condition.
What to expect.
Drs. Bozeman, along with knowledgeable and compassionate nurses and anesthesia personnel, will provide exceptional surgery care in Oswego Hospital’s state-of-the-art surgery center.
Prior to surgery, you will meet with our pre-admission educators to complete pre-admission paperwork and to review pre-operative instructions. Any surgery-related lab work or physician-requested tests will also be conducted at Oswego Hospital.
On the day of your surgery, please use our separate surgery center entrance that takes you to the second floor surgery area. Registration is easy, and when the process is complete, patients will be directed to the waiting area until surgery. As you might expect, a caring and professional medical team will monitor each patient throughout your stay. A comfortable waiting area is available for your family member or friend who is accompanying you on the day of your surgery.
After surgery, you will recover in a comfortable and homey environment on the hospital's second floor, where a team of nurses will care for all your needs.