New Nonsurgical Treatments Available for Incontinence

St. Luke’s Episcopal Hospital is offering two nonsurgical treatments for patients experiencing incontinence or the loss of bladder control – a problem that affects millions of Americans, the majority of them women.

Normally, the bladder stores urine that has been continually produced by the kidneys until is convenient to urinate, but when any part of the urinary system malfunctions, incontinence can result. A broad range of conditions and disorders can cause incontinence, including pelvic surgery, injuries to the pelvic region or spinal cord, neurological diseases, infection, degenerative changes associated with aging, and pregnancy or childbirth.

The first nonsurgical treatment is called pelvic floor biofeedback, which uses biofeedback to strengthen the muscles of the pelvic floor. Pelvic floor muscles are very important in urinary control, and strengthening these muscles can help patients gain better control of their urine. Biofeedback is a method that allows the patient to see on a computer screen that they are exercising only those muscles that effectively prevent urinary leakage. The procedure is simple, has no side effects, and creates no real discomfort for the patient.

The second nonsurgical option being used involves the injection of "bulking" material into the tissues around the urethra which results in a closing of the sphincter (urinary control valve), thereby providing protection against incontinence by increasing the resistance to the leakage of urine. Before this option is utilized, physicians perform tests on the bladder and sphincter to make certain that the incontinent patient is a good candidate for this type of treatment. Patients are treated on an outpatient basis with a local anesthetic.

"We’ve had much success with pelvic floor biofeedback and injection therapy," said Dr. Rodney Appell, one of the urologists at St. Luke’s Episcopal Hospital who specializes in this problem. "Approximately 80 percent of those affected by urinary incontinence can be cured or improved. Despite this high success rate, only one out of every 12 people affected seeks help, mostly because they aren’t aware that there are nonsurgical options available to them."

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