General Urology
Bladder Control Issues
Millions of people suffer from bladder control problems such as urinary frequency, urinary urgency, nighttime urination, urinary incontinence, slow urinary stream and incomplete bladder emptying.
Millions of people suffer from bladder control problems. Symptoms may include urinary frequency, urinary urgency, nighttime urination, urinary incontinence, slow urinary stream and incomplete bladder emptying. The treatment of these symptoms depends on the underlying cause and may be different for each patient.
We specialize in the diagnosis and treatment of all types of bladder control problems and symptoms. Our team of urologists, urogynecologists and advanced practice providers will carefully gather your history, perform any specialized tests and determine a diagnosis and treatment plan designed specifically for you.
Overactive Bladder is caused by the layered, smooth muscle that surrounds the bladder behaving unpredictably, sometimes without known cause, which results in increased bladder pressure and the urgent need to urinate. Normally, the muscle around the bladder remains relaxed until the conscious initiation of urination. The urge to urinate is normally in response to the volume of urine in the bladder. Any change in urination from this normal pattern can be considered Overactive Bladder.
Contributing Factors
- Underlying chronic infections of the urinary tract such as chronic cystitis, prostatitis and/or urethritis
- Obstructive diseases such as Benign Prostatic Hypertrophy (BPH) and urethral strictures
- Underlying neurologic disease processes such as diabetic-associated Multiple Sclerosis and Parkinson’s disease
Symptoms
- Frequency urination
- Urgency to urinate
- Urge incontinence (the strong need to urinate followed by leaking and complete voiding)
After discussing your history and performing a physical exam, your provider may order tests such as a urinalysis, cultures, or ultrasounds to further evaluate the cause of overactive bladder. Urodynamics testing is sometimes necessary.
Primarily, the cause of the condition is treated as an underlying infection or the underlying disease. Some treatments may be used such as:
Bladder Retraining
A voiding diary is kept of all episodes of urination and leaking and is then analyzed for a pattern of urination. This timetable is used to plan when to empty the bladder to avoid accidental leakage.
Medication
Drugs such as oxybutynin and tolterodine are taken orally to relax the smooth muscle of the bladder, reducing contractions and voiding accidents.
Sacral Nerve Stimulation
Also called sacral neuromodulation, this is an electrical nerve stimulation device that is implanted under the skin of your lower back, next to the nerve that controls the bladder. It is placed under local anesthesia, with testing performed to determine whether it is effective. Once the stimulator is in place, this therapy is long-lasting, with a battery that lasts an average of 10-15 years before needing to be replaced.
Posterior Tibial Nerve Stimulation (PTNS)
This procedure uses a small needle to stimulate a nerve in your ankle, with treatments given in the office once a week for 12 weeks and periodically thereafter.
eCoin
This involves placement of a nickel-sized nerve stimulator surgically under skin near the ankle. It is performed with local anesthesia/numbing.