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Nearly 20 million American women suffer from urinary incontinence. There are, however, many new, exciting, and effective treatments for women who suffer from this problem.
The evaluation of incontinence is not difficult. Dr. Lazare will talk to you, examine you, and do a few simple tests. It is important for you to keep a voiding diary, which records the number of times you urinate, the volume you urinate, and the amount of fluid that you drink.
There are three basic types of female incontinence – urgency incontinence, stress incontinence, and mixed which is a combination of the two.
Urgency incontinence is marked by a sudden strong urge to urinate that results in the leakage of urine. Causes of urgency incontinence include infection, low estrogen levels secondary to menopause, and various neurologic disorders including stroke, spinal cord injury, multiple sclerosis, and Parkinson’s disease.
There are several medications to treat urgency incontinence. Ditropan and Detrol are called anticholinergics, and they help to relax the bladder muscle. Side effects include constipation and dry mouth. Mirabegron is a relatively new medication that is classified as a B3 agonist. It also relaxes the bladder muscle. The main side effect of Mirabegron is hypertension.
Two treatments that are effective for severe urgency incontinence are electrical stimulation and botulinum toxin type A, or Botox. Dr. Lazare will discuss these therapies with you during your appointment.
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Stress incontinence results in the loss of urine immediately after you cough or sneeze. It is due to the loss of pelvic muscular support to the bladder and to the urethra.
The primary symptoms of stress incontinence are the leaking of urine with physical movement or activity. This may include exercise, lifting, coughing, laughing, or even sneezing.
Female stress incontinence is due to lack of support to the bladder and to the urethra. This loss of support is most commonly cause by:
- Pregnancy and childbirth- especially vaginal delivery
- Pelvic surgery including hysterectomy
There are a number of techniques and treatments available to help treat stress incontinence in females, including the following.
The treatment of incontinence is a step-wise process and starts with behavioral modification. Patients should urinate regularly according to a schedule. Also, Kegel exercises can be helpful because they help to strengthen the pelvic muscles.
Mid Urethral Sling
Finally, for patients with severe stress urinary incontinence, the mid urethral sling is a very safe and effective treatment. The procedure is quick and performed on an outpatient basis.
Risks include difficulty urinating following mesh insertion. Urinary retention is an uncommon complication. Removal of the mesh due to urinary retention is rarely necessary.
You should understand that the mid urethral sling involves the insertion of mesh. Mesh insertion for slings has generally not been a problem. Mesh infection and erosion, however, is possible in a small percentage of cases. If this occurs, the mesh must be removed.
The long-term success rate of the sling is about 80%. The success rates of anti – incontinence procedures, in general, are higher when mesh is used. The risks of procedures that utilize mesh, however, are slightly higher than the risks of procedures that do not involve mesh. Mesh, therefore has its advantages and disadvantages.
If you are tired of living with female stress incontinence and would like to gain control over your bladder once again, contact Dr. Lazare at our Brooklyn, New York office today! We will take the time to answer any questions you may have and ensure a comfortable and professional treatment experience.