Women's Physicians and Surgeons

Urinary Incontinence

Millions of women suffer from the embarrassment of involuntary leakage of urine. There are many treatments that are available, both medical and surgical. At Women's Physicians and Surgeons we offer in-office urodynamic testing in order to determine the cause of your incontinence. The majority of patients evaluated by urodynamic testing are found to have nonanatomic (nonsurgical) causes. These patients respond very well to medical and behavioral modification management. If surgery is needed, urodynamic testing allows us to determine what kind of operation will be best for you. Urodynamics is a test performed in the office which takes approximately 20 minutes. We place an extremely thin catheter in to the bladder and fill the bladder with sterile water. During the filling of the bladder, using sophisticated equipment, we continuously measure pressures within the bladder. During the testing you will be asked to cough and sometimes to even stand(this is to try to mimic the circumstances in which you leak). Based on the analysis of the pressure tracings, we can determine the cause of your incontinence and the best means to correct it.

Treatments and Medications:
   Medications are used when the cause of your leakage is due to the bladder spontaneously contracting giving you urge symptoms and/or leakage.

Behavioral Modifications:
   Sometimes urodynamic testing allows us to determine that there are certain triggers that are causing your incontinence. Behavioral modification can sometimes alleviate the cause of the incontinence without resorting to either medicine or surgery.

Kegel Exercises:
   Kegel exercises are often helpful for mild anatomic causes of urinary incontinence. They involve squeezing the perineal muscles, holding the squeeze for 3 to 5 seconds and slowly releasing. Repeating a series of 10 of these exercises three times a day can sometimes alleviate mild urinary incontinence.

Surgery:
   Surgery is used to correct anatomic weakness which may be caused by childbearing or aging. Urodynamic testing combined with physical examination helps us to determine what type of surgery is best for you. Although some surgeries require a long recuperation time, Womens Physicians and Surgeons is please to be on of the few practices to offer the Tension Free Tape procedure. Tension Free Tape procedure is a minimally invasive same-day surgery that can be performed under local anesthesia and IV sedation. Two ½ inch incisions are made just above the pubic bone and one ½ inch incision is made in the vagina. The surgery takes approximately 30 minutes and you go home the same day. We have had impressive results with this minimally invasive surgery.