Advanced Treatments for Female Urinary Incontinence

What is Urinary Incontinence?

Incontinence is a common condition which causes bladder control issues and leads to uncontrollable urine leakage.

Learn more about the signs, symptoms, causes and risk factors for urinary incontinence here

Urinary incontinence can have a negative impact on quality of life, but embarrassment and stigma associated with the condition often prevent people from seeking treatment.

However, there are many treatment options available which can significantly improve or cure urinary incontinence. Understanding that incontinence is a symptom and not a disease is important and identifying the underlying cause or causes is often complex and requires an in-depth evaluation before treatment begins.

Talking to your doctor is the first step in treating urinary incontinence and taking control of your bladder. At Cleveland Clinic Abu Dhabi, the Female Urology Program offers routine and complex care options for the treatment of a range of urological concerns.

Diagnosing Urinary Incontinence

For many people, an evaluation can confirm a diagnosis. Some patients require additional diagnostic tests. These tests can be completed in an outpatient setting and are not painful. Once these tests have confirmed the cause of your urinary incontinence, your doctor can make specific recommendations for treatments, many of which do not require surgery. No matter how serious the problem seems, incontinence is a condition that can be significantly helped and, in most cases, cured.

Treating Urinary Incontinence

Urinary incontinence can be caused by many different factors. Your doctor will suggest a treatment plan after considering these factors and your specific symptoms.

Non-surgical options

Medication

Drugs can be very effective at returning normal function to the bladder. The type of medication used will depend on your specific needs. Your doctor may prescribe a low dose and then gradually increase the dose so they can evaluate how well the drug is working and reduce your risk of experiencing side effects. Your doctor should discuss with you the risks and benefits of using medications.

Self-help techniques

There are many things you can do to reduce some types of urinary incontinence:

• Empty your bladder regularly, especially before physical activity to alleviate stress incontinence.
• Avoiding caffeine can help to alleviate an overactive bladder.
• Avoid lifting heavy objects.
• Kegel exercises, also called pelvic floor exercises, help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles, you can reduce or prevent problems such as leaking urine.
• Using the bathroom on a regular schedule rather than waiting for the urge.

Electrical stimulation

Mild electrical impulses are used to stimulate contractions of the pelvic floor muscles. Devices for electrical stimulation can be implanted near the spine or activated by the urethra, vagina, or rectum (non-implanted devices). Electrical stimulation can be used for incontinence that does or does not involve neurological problems.

Surgical Procedures

If other treatments aren’t effective, there are a range of minimally invasive and highly effective surgical options to treat urinary incontinence.

Surgery and Procedures for Urge Incontinence

Sacral Neuromodulation

Sacral Neuromodulation (SNM) is a breakthrough solution that effectively addresses a number of bladder related problems, including overactive bladder, incontinence and prolapse. The ‘bladder pacemaker’ is an implanted system which improves bladder and/or bowel function by sending regular, gentle electronic signals to the nerves which control the pelvic floor. The small device is inserted into the lower back and a lead and battery are placed in your buttock. SNM offers freedom and confidence to many patients with more complex cases and for whom other treatments haven’t been effective.

Botulinum toxin (Botox)

Botox is injected into the bladder as a treatment for urge incontinence or overactive bladder syndrome. It relaxes the bladder, and the effects can last for several months. Some patients may find it hard to completely empty their bladder and a catheter may need to be inserted to drain the urine.

Posterior tibial nerve stimulation

Stimulating the tibial nerve in the ankle, which contains fibres that begin in the same places as the nerves which go to your bladder and pelvic floor, affects these other nerves and helps to control the urge to urinate. The treatment offers relief from urge incontinence and overactive bladder syndrome in people for whom Botox injections of SNM are not suitable.

Surgery and Procedures for Stress Incontinence

Laparoscopic Colposuspension

Small incisions are made in the lower tummy and the neck of the bladder is lifted and stitched in the lifted position. For women, colposuspension can offer long term relief from stress incontinence leakage.

Sling Surgery

A cut is made on the lower tummy and vagina and a sling (made of tissue from another part of the body or donated tissue) is placed around the neck of the bladder. This supports it and prevents it from leaking urine.

Vaginal Mesh Surgery

Also called tape surgery, a piece of synthetic mesh is placed behind the urethra to support it. The mesh then stays in the body permanently.

Urethral Bulking Agents

A less invasive option in which a substance is injected into the urethra walls increasing the size of the urethral walls. This allows the urethra to close and stay shut with more force.

Artificial urinary sphincter

The ring of muscle which usually prevents urine from flowing from the bladder into the urethra is called the urinary sphincter. The procedure is used more often in men than women. An artificial sphincter can be fitted which consists of three parts; a circular cuff which is placed around the urethra and can compress to prevent urine flow, a small pump which controls the flow to the cuff, and a reservoir in the stomach from which fluid passes to the cuff as the device is activated and deactivated.

Effective Treatment Options for Urinary Incontinence are Available.

Urinary incontinence may be a common condition, but you don’t have to put up with it. Take control of your bladder and talk to the Female Urology Program team at Cleveland Clinic Abu Dhabi. Led by an experienced female urologist, the program offers routine and complex care options for the treatment of a range of female urological concerns.