Treatment Options for Voiding Dysfunction
Below is a listing of treatment options which will be explored in relation to your medical assessment during your examination.
The adjustment of fluid intake and voiding schedule to control overactive bladder symptoms. For some patients with OAB simple changes in the timing or amount of fluid intact and/or the use timed voiding may avert episodes of urgency and urge incontinence.
Pelvic Floor Muscle Rehabilitation: Strengthening the pelvic floor muscles can enable better control of urgency and OAB symptoms. The program of pelvic floor muscle training is based upon pelvic floor muscle exercise. Biofeedback is a non-invasive modality to measure and record pelvic floor muscle activity and can be used to teach proper pelvic floor muscle exercise technique and to monitor patient progress.
Temporary prostheses such as a pessary can be used to address problems with pelvic prolapse which may accompany bladder symptoms. Urethral inserts may be used for selected patients with stress incontinence.
Medications to control OAB are the mainstay of treatment for this condition. Commonly used medications include Detrol LA, Ditropan XL and Oxytrol. These medications are intended for long term use and are generally much better tolerated than the generic form of oxybutinin.
Pubovaginal Sling: The cause of stress incontinence in most women is a lack of support for the bladder neck. The PV sling procedure corrects stress incontinence by reconfiguring the fascial support for the bladder neck.
An implantable bladder pacemaker. The device uses mild electrical stimulation of sacral nerves to regulate the behavior of the bladder and pelvic floor muscles.
Some women have stress incontinence without bladder neck support. In this case, injection of a small volume of collagen into the region of the sphincter may improve urethral coaptation and prevent stress incontinence.
For men with prostatic obstruction transurethral resection of the prostate (TURP) or transurethral incision of the prostate (TUIP) are the most commonly employed operative procedures. These surgeries are performed with anesthesia using a small scope passed through the urethra to eliminate the obstructing prostate tissue.
Artificial Urinary Sphincter
The artificial urinary sphincter is an implantable device that is used to restore continence to men who have persistent urinary leakage following radical prostatectomy.
Urinary Tract Reconstruction
Patients with severe bladder dysfunction caused by neurologic disease or spinal cord injury may benefit from tailored urinary tract reconstruction to facilitate urine storage, bladder emptying, or urinary diversion.