TMH Living Well: Uro-what? Urodynamics and incontinence
January 9, 2015
Unless you or someone you know has urinary incontinence, you've probably never heard of the term urodynamics. It's a common phrase used by urologists and gynecologists alike. Urodynamics simply refers to a series of tests that assess how well a person's bladder and urethra are working.
"I perform multichannel urodynamic tests to determine exactly what type of incontinence a woman has, because not all urinary incontinence is the same. Urodynamics give me an accurate diagnoses, which means I can tailor my treatment and get good results," Dr. Scott Ellis said.
Women suffer from urinary incontinence more than men, partly due to giving birth. But it's a misperception that women have to simply accept leaking or loss of control.
"I refer to incontinence as the silent shame. Women don't like to reveal they have it, unless I ask. So I make it a point to ask at every annual visit. Women who say they are incontinent often follow it with, 'I know there's nothing you can do about it.' That's simply not true," he added.
You may assume the main solution to urinary incontinence is surgical, since the transvaginal sling for stress incontinence has received a lot of attention in the past few years. Yet treatment for urinary incontinence is rich and varied, with new options being developed regularly.
"Solutions may be surgical, but they may be medical and even sometimes physical, depending on the type and severity of urinary incontinence. While we might not be able to cure incontinence 100 percent, we can significantly improve a woman's quality of life," Ellis said.
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Treatment options for urinary incontinence
TMH offers advanced laparoscopic surgeries for incontinence. Ellis has been performing laparoscopic surgeries for many years — which promise a smaller incision and faster healing time than traditional surgery. The hospital offers all types of surgeries for incontinence, and only needs to refer particularly complicated cases to urogynecologists in Denver.
Surgical options include the transvaginal slings for stress incontinence, with newer types that are less invasive, such as the single incision mini-sling or the suprapubic sling. Sometimes, a few, well-placed stitches makes all the difference.
Dr. Ellis is performing pelvic floor biofeedback at the hospital and is introducing a developing technique called sacral neuro-modulation for urge incontinence at TMH.
"With this promising treatment we place a small, pacemaker-like device near the sacral nerve that stimulates the nerve with mild electrical pulses. This improves continence, since the nerve helps control the bladder and surrounding muscles during urination. It has been well studied and shows good results for both urinary and rectal incontinence," Ellis said.
Another exciting treatment option is periurethral collagen injections to help strengthen the muscles, connective tissue and ligaments at the base of the bladder.
"Without making an incision, I inject material in and around a woman's urethra to make it stronger and thicker so it can better hold the pressure of urine," Ellis explained.
Sometimes, urinary incontinence can be controlled with medications that prevent bladder spasms or calm an overactive bladder. Other times it can be treated with physical exercises that strengthen the pelvic floor.
"There is a fair amount of pelvic floor rehabilitation and special bladder retraining exercises that women can do to ease their symptoms," Ellis said.
Ellis likes to do a thorough workup with urodynamics when someone complains of incontinence because sometimes he finds a more serious underlying issue.
"Certain neurological disorders, such as Multiple Sclerosis, can cause incontinence. It's good to rule out more serious causes," Ellis added.
Whether it is stress incontinence — that happens when you cough, sneeze or laugh — or urge incontinence — a feeling that you have to go immediately due to spasms in your bladder — or another reason for incontinence, physicians at TMH can help.
"We have all the advanced equipment and training that we need to make a great impact here at TMH," Ellis said.
To explore treatment options at TMH, call the TMH Medical Clinic at 970-826-2400.
This weekly article with tips on living well is sponsored by The Memorial Hospital at Craig — improving the quality of life for the communities we serve through patient-centered healthcare and service excellence.