What is Urinary Incontinence?
Urinary incontinence is the involuntary loss of urine. For some, leakage is an occasional few drops triggered by a cough or sneeze. For others, it’s a chronic sudden urge to urinate followed by a large loss of urine. Severe cases can be emotionally and socially debilitating. The risk of urinary incontinence increases with age. About 44% of adults over 65 have some degree of urinary incontinence. Women are twice as likely as men to develop this condition, due to pelvic floor stress incurred during pregnancy and childbirth, the loss of estrogen in menopause, and the anatomy of their urinary tracts.
What are the Different Types of Urinary Incontinence?
- Acute incontinence. This is a temporary condition caused by health issues such as: urinary tract infections, certain medications, even constipation. In these cases, treating the cause usually cures the incontinence.
- Stress incontinence. This is the accidental loss of urine that’s triggered by a sneeze, laugh, jog or other movement that puts pressure on the bladder. It’s the most common type of incontinence among women, and is usually caused by a weakened pelvic floor that doesn’t adequately support of the bladder. Consequently, the bladder drops down, presses against the vagina and prevents the urethra from being able to squeeze shut as tightly as it should.
- Urge incontinence. This leakage is caused by an overactive bladder, resulting from: stress, bladder irritation or neurological conditions, such as Parkinson’s disease.
How Does Dr. Thomas Treat Female Urinary Incontinence?
A premier expert in female incontinence, Dr. Thomas individualizes treatment based on the type and severity of each patient’s case, and always starts with the least invasive approach. Treatment options include:
- Behavioral training and pelvic floor therapy. These first-line treatments are highly effective for most patients. Behavioral training involves scheduled urination to help patients resist the initial urge to urinate and increase the intervals between bathroom visits. Pelvic floor therapy is a program of exercises designed to strengthen the pelvic floor and bladder. Both may be combined with biofeedback therapy, a technique that uses electronic monitoring of pelvic and bladder function to help patients gain control of these muscles.
- Impressa. This is a new collapsible silicone device designed to support pelvic organs prevent leakage from stress incontinence. The device is reusable and inserted via a tampon-like applicator
- Pessary. Another type of removable device used to support pelvic organs and prevent stress incontinence leakage, a pessary is more akin to a diaphragm. Pessaries come in an assortment of shapes and sizes and are individually fitted by Dr. Thomas.
- Medications. Medications are available that can calm an overactive bladder, increase the amount of urine the bladder can hold and improve the ability to completely empty during urination.
- InterStim™. This is a small device implanted under the skin of one of the upper buttocks. It works by gently stimulating the sacral nerves to help the bladder function properly.
- BOTOX®. These injections are effective for many patients with neurogenic bladder or with urge incontinence.
- Bulking injections. These are injectable gels that thicken the area around the urethra to control leakage.
- Urethral sling. When severe symptoms have not been helped by conservative treatment, a urethral sling may be considered. This is literally a sling made of a synthetic mesh that’s surgically inserted around the urethra and attached to the walls of the abdomen to lift the urethra back to its original position. Dr. Thomas uses robotic or traditional laparoscopy to perform this procedure. With unparalleled clinical experience, she has provided complication-free relief with this surgery for hundreds of women.
What Clinical Trials are Dr. Thomas Conducting for Urinary Incontinence Treatment?
Dr. Thomas is currently enrolling study patients for an FDA-approved clinical trial to evaluate a ground-breaking new investigational product that uses injections derived from a patient’s own muscle cells, autologous stem cells, to correct stress urinary incontinence in women. Participants must be women, at least 18 years of age who suffer from symptoms of stress urinary incontinence, which is leakage triggered by activities, such as coughing, sneezing or jumping, that put pressure on the bladder. Participation in the study is expected to entail approximately six clinic visits over a two-year period. Treatment is covered free of cost, and modest reimbursement for travel and time may be offered. Women who are interested in participating in this research can use the link below to determine if they meet necessary qualifications.