Urinary Incontinence and Chicago Urogynecology

After childbearing, you may experience occasional leakage of urine when you cough, laugh, or sneeze.  Many women consider this normal.  However, this condition is a result of changes in the muscle and structure of the pelvic floor that, without treatment, can get worse with time.  This is called Stress Urinary Incontinence. We offer innovative surgical and non surgical treatments for annoying urinary incontinence caused both by Overactive Bladder and Stress Urinary Incontinence.  In addition, we specialize in the office evaluation of urogynecology problems with testing such as urodynamics.

Effective Treatment for Stress Urinary Incontinence.  

 

Stress urinary incontinence is a common type of bladder control problem in women. It refers to leakage of urine during events that result in increased abdominal pressure, such as sneezing, coughing, physical exercise, lifting, bending, and even changing positions. SUI may occur when the structures that help hold urine in your bladder become weak.

Mid-urethral slings are newer procedures that you can have on an outpatient basis. These procedures use synthetic materials that the surgeon places midway along the urethra to treat Stress Incontinence and improve women's health. The two general types of mid-urethral slings are retropubic slings, such as the transvaginal tapes (TVT), and transobturator slings (TOT).  Dr. Williams is one of the FIRST in Chicago to adopt the Altis, a more refined and adjustable sling with only ONE incision! 

 

How is the Single Incision Sling surgery performed?

 

In sling surgery, a mesh tape is placed under your urethra like a sling or hammock to keep it in its normal position. The tape is inserted through tiny incision in your vagina, with NO exit points.  The anchor is placed in a strong layer of tissue near the top of the pubic bone.  This type of surgery takes about 30 minutes and may be done under local anesthesia so you can cough at the surgeon's request to test the tape's support of your urethra.

 

How effective is a midurethral sling?

 

Most studies give an efficacy rate of approximately 85%, meaning 85% of patients are markedly improved or dry.

 

What can I expect after sling surgery?

 

Approximately 2-3 hours after your surgery, you will be asked to urinate to test how your bladder and urethra respond to the surgery.  Most patients are allowed to go home the same day.  

TVT surgery usually causes minimal pain and discomfort. Although you may resume most routine activity in 1 week, you will be advised to refrain from from sexual intercourse or strenuous activities for 6 weeks.

 

What are the risks of Single Incision, TVT, TOT sling surgery?

 

You may need to have a thin, flexible tube (catheter) placed into your bladder through your urethra to allow urine to drain while you recover from surgery or to teach you to do self-catheterization temporarily.  Most patients are able to empty their bladder completely within one week.  There is also a slight risk of bladder spasticity after the surgery.

 

Urgent PC Relaxation Room.

Treat Urgency Urinary Incontinence/Overactive Bladder without drugs.​

What is Overactive Bladder Syndrome?

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OAB causes the bladder muscle to contract (squeeze involuntarily). This causes an intense urge to urinate, known as urgency. Urgency can occur many times during the day and night. In some cases, accidental urine leakage occurs with the urgency. This is called urge incontinence, which is the inability to control the urinary bladder function. There are many types of incontinence, urge incontinence being one of then. A disease that affects the bladder nerves, such as multiple sclerosis, can lead to OAB. Other conditions, such as urinary tract infection (UTI) or prostate problems in men, can lead to OAB.  But the exact cause of OAB is often not known.The Urgent PC Neuromodulation System is a unique way to treat urge incontinence without medications. It is a combination of a hand-held stimulator, thin needle electrode and a lead set.  Using principles of Acupuncture, the stimulator generates electrical impulses that are delivered to the patient through the lead set to treat Overactive Bladder, also known as urgency incontinence.

 

How does Urgent PC work?

 

The Urgent PC system delivers a specific type of neuromodulation called percutaneous tibial nerve stimulation (PTNS).  During treatment, a small, slim needle is inserted near your ankle at a specific trigger point. The needle/electrode system is then connected to the battery-powered stimulator. During your 30-minute treatment, mild impulses from the stimulator travel through the needle electrode, along your leg and to the nerves in your pelvis that control bladder function. This overactive bladder treatment process is also referred to as neuromodulation.

 

How do I get the treatment?

 

You will receive your 12 sessions of Urgent PC in our relaxing, spa-like atmosphere.  During each 30 minute session, we will evaluate your progress and monitor your bladder diet and diary.  

 

How effective is Urgent PC for urge incontinence?

 

60-80% of patients see improvement in their symptoms. Urgent PC may even work where other treatments, such as medications, have failed.

 

Painful Bladder Syndrome/Interstitial Cystitis

Interstitial cystitis is a painful condition of the bladder. It causes the bladder wall to be tender and easily irritated. This leads to uncomfortable symptoms. Interstitial cystitis is chronic (ongoing). This means it has no cure. But you can manage the symptoms to help you feel better. 

Your bladder stores urine until it’s passed out of the body. It is not clear what causes interstitial cystitis. However, doctors note some changes in the bladder that may be responsible. The protective lining that keeps urine away from your bladder walls seems to become thinner. The walls seem to stiffen and harden so your bladder can’t expand to hold urine. During certain tests, doctors may see pinpoints of bleeding (glomerulations) on your bladder wall. In rare cases, health care providers may also find a crater (called a Hunner's ulcer).

What are the symptoms of interstitial cystitis?
Symptoms in women may get worse during their period. Symptoms may go away for a time (remission), but they often come back again. Symptoms include:

  • The frequent and urgent need to urinate

  • Pain or pressure in the bladder area, often relieved for a short time after urinating

  • Pain in the genitals or anus

  • Painful sexual intercourse


What causes interstitial cystitis?
Possible causes include:

Damage to the protective bladder lining, allowing urine to irritate your bladder wall

Infection of your bladder

Allergic reaction in your bladder

Nerve problems

Substances found in the urine that are irritating to your bladder

How is interstitial cystitis treated?
Treatment may involve a combination of medications, lifestyle changes, surgery and other methods. There is no single known effective treatment. It may take some time to find the right combination of treatments for you.

Medication options include:

  • Pain medications. These may be used for a short time to help ease discomfort.

  • Antispasmodic medications. These may help relax the bladder muscles. This may decrease the need to urinate.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). These may help reduce inflammation and ease pain.

  • Antihistamines. These may help reduce inflammation and ease pain.

  • Antidepressants. In low doses, these may block pain and help ease symptoms.

  • Pentosan polysulfate sodium (Elmiron) and similar medications. These can restore the bladder lining.

  • Bladder instillation. In some cases, medication may be flushed directly into the bladder using a catheter.

Other treatments may include:

Biofeedback. Biofeedback uses sensors placed on your abdomen to allow you to see signals given off by your bladder muscles. This may  help you control your bladder muscles and reduce symptoms.

Electrical stimulation. Electrical signals may help block nerve sensations to and from the bladder. This may improve blood flow and strengthen pelvic muscles. This is sometimes called TENS.

Lifestyle changes include:

Avoiding foods that irritate your bladder and worsen symptoms. These may include alcohol, spicy food, chocolate, and caffeine among others.

Bladder retraining. This involves holding urine for longer and longer periods. The goal is to stretch the bladder and increase the amount the bladder can control.

Stress management. While stress does not cause interstitial cystitis, any type of chronic pain can make be helped by learning techniques to help manage stress. Exercise may help, too.

 
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