Urinary Incontinence

Urinary incontinence specialist:

Many women suffer from urinary incontinence which could arise due to various causes. Dr. Sikka effectively diagnoses and provides treatment to help the women with this condition.

What is urinary incontinence?

Urinary incontinence refers to involuntary leakage of urine. This condition affects personal hygiene as well as their social life in a way that can be very limiting.

What causes urinary incontinence?

There are several types of urinary incontinence found in women and each of their causes vary:

  • Stress incontinence: Urine leakage while sneezing, coughing, laughing or with any activity that increases abdominal pressure on the bladder is termed as stress incontinence. This usually occurs because the support underneath the urethra is weakened. This can happen as a result of pregnancy and childbirth or the aging process.
  • Urge incontinence: In this condition patients complain of leakage on the way to the bathroom as they cannot control it. This condition is a part of overactive bladder symptoms which include urinary frequency, urinary urgency and urge incontinence. In this condition the muscle of the wall of the bladder contracts involuntarily causing the patient to go to the bathroom multiple times during the day or night. Patients may have a sensation of urgency on the way to the bathroom and sometimes they may even leak urine on the way to the bathroom.
  • Mixed incontinence: It is a condition which involves the symptoms of both stress and urge incontinence

How is urinary incontinence diagnosed?

Urinary incontinence or leakage of urine is diagnosed based on history as patient complains of leakage of urine. Patient may need further testing such as an Urodynamic Study to help evaluate.

 a How is urinary incontinence treated?

Treatment of urinary incontinence depends on the type of incontinence and the severity of symptoms.

Conservative options:

Several conservative options can be helpful in managing patients with leakage of urine. We may advise patients to limit their fluid intake especially before going to bed if they are getting up at night multiple times to urinate. Avoidance of caffeinated and alcoholic drinks can help. The pelvic floor rehab, overactive bladder medications can also help with urinary urgency, frequency and urge incontinence symptoms

Minimally invasive options:

There are several minimally invasive options available to help patients with urine leakage. All these options are done in an outpatient setting and the patient goes home the same day.

  • Botox injections in the bladder: This is a very helpful procedure in properly selected patients who have symptoms of urinary frequency, urgency and urge incontinence. The botox injections are injected into the bladder muscle under local anesthesia. This procedure may decrease the need to take medications for overactive bladder. This treatment effect lasts from 3-9 months and can make a significant improvement in the quality of life.
  • Periurethral bulking: This procedure significantly helps patients with leakage of urine with cough, sneeze and laugh. This is a simple outpatient procedure which involves injection of a bulking agent in the middle part of the urethra. This forms cushions which give support to the urethra and prevents leakage of urine.

  • Sling procedure: Sling is a piece of small plastic mesh which is put as a support beneath the middle portion of the urethra. Urethra is the tube which brings the urine from the bladder to the outside. This is an outpatient procedure that significantly helps patients with leakage of urine with cough, sneeze and laugh. 
  • Sacral Neuromodulation: This procedure can be very effective for patients with urinary frequency, urgency, leakage of urine with urgency on the way to the bathroom, difficulty emptying the bladder and even in some cases of fecal incontinence. With this procedure, a thin lead wire is placed close to the sacral nerves in a minimally invasive fashion. This influences the way that the bladder nerves communicate to the bladder muscles. 
  • Percutaneous Tibial Nerve Stimulation: This procedure is very helpful for patients with mild symptoms of urinary frequency and urgency. This is a simple acupuncture like procedure in which a thin needle is placed above the ankle to allow for nerve stimulation in the office setting. The patient comfortably sits in the office for 30 minutes while the nerve supplying the bladder is gently stimulated.  It can to be done in a weekly fashion for 12 weeks and then can be repeated every month for 2 years.
  • Emsella: Emsella is a FDA approved breakthrough treatment for incontinence. This unique technology revolutionizes women’s intimate health and wellness by providing those suffering from incontinence with a completely non-invasive option. Read More