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Urinary Incontinence

Overview

Urinary incontinence, or loss of bladder control, is estimated to affect nearly 17 million people, both male and female. Urinary incontinence is not a disease itself, but rather a symptom of a wide variety of conditions. Most people take bladder control for granted—in fact, bladder function is a highly synchronized process between the brain, spinal cord and bladder. Urinary incontinence can severely impact people’s everyday lives, but fortunately there are a great many treatments to cure or improve urinary incontinence.

Urinary incontinence can be categorized into several types, the most common being:

  • Stress incontinence:  This form of incontinence can impact both men and women. Stress incontinence occurs when the muscles that hold and release urine are weakened or damaged. For women, prior pelvic surgery, childbirth and menopause may result in stress incontinence. Men can develop stress incontinence from various treatments for prostate diseases.
  • Urge Incontinence:  This form of incontinence occurs from improper contraction of the intrinsic bladder muscles causing leakage of urine. This can happen whether the bladder is full or not. Urge incontinence can result from many issues, including bladder inflammation, cancer or kidney stones.  In many cases, the problem is neurological in origin from diseases such as multiple sclerosis (MS), Parkinson’s disease, a stroke or spinal cord injury.

Why NorthShore

The team at the John and Carol Walter Center for Urological Health includes board-certified urologists, dedicated support personnel including a nurse navigator, patient service associates, nutritionists and integrative medicine experts. Our team also includes a full complement of dedicated basic scientists who are committed to improving the care for men and women affected with urological disease.

Additionally, urologists from the Walter Center work closely with their physician colleagues from other specialties at NorthShore to provide patients with a multidisciplinary approach to care.  In the case of urge incontinence, which can be caused by neurologic issues, this may include close collaboration with physicians at the NorthShore Neurological Institute and the Center for Pelvic Health.

Treatment

Treatment for urinary incontinence depends on the severity of symptoms and its impact on a person’s day-to-day activities. Urodynamic testing may be recommended after initial consultation with a physician if a specific cause for your incontinence cannot be determined. Board-certified urologists at the Walter Center are experienced in using a wide variety of treatments best suited for each individual patient.

Options for treatments for incontinence may include:

  • Diet Modification:  Making changes to your diet, such as limiting fluid intake or eliminating caffeine, may address a person’s incontinence.
  • Medications:  There are a variety of drugs that can be prescribed to improve bladder function.  Your physician will discuss which is right for you.
  • Biofeedback:  This technique involves monitoring and training the pelvic muscles responsible for urine control.
  • Surgical Interventions:  Urologists can perform a variety of surgeries to help with urinary incontinence in serious cases. These could include:
    • Suburethral sling, in which a sling is surgically constructed to lift the urethra into place.
    • Artificial Sphincter, a device that can be surgically implanted allowing patients to control their urine.

  • Neuromodulation:  Sometimes referred to as a “bladder pacemaker”, involves stimulation of the sacral nerve plexus to help control the bladder and pelvic floor muscles responsible for bladder function.  Neuromodulation can be accomplished two ways:
    • Sacral Nerve Stimulator, by permanently implanting a small nerve stimulator is placed next to the sacral nerve to provide non-painful electronic pulses that improve bladder function. It is usually done as a minor outpatient procedure
    • Posterior Tibial Nerve Stimulation  (PTNS), which stimulates the sacral nerve plexus through gentle stimulation of post tibial nerve in the ankle.  It is done in office by the physician or nurse over several weekly sessions.

For More Information

For more information or to schedule an appointment, please call 847.503.3000.