The Department of Urology at Stony Brook offers patients the full range of diagnostic tests and treatments for incontinence. Our urodynamics laboratory is capable of advanced bladder testing including video-urodynamics. We offer biofeedback training and electrical stimulation therapies for pelvic muscle rehabilitation. All of the types of surgery mentioned are available at Stony Brook.
What is Urinary Incontinence?
Incontinence is any involuntary loss of urine. It affects approximately two million Americans and accounts for billions of health care dollars spent annually. Incontinence affects both men and women. It is not a normal part of aging. It is a sign of an underlying condition.
What causes incontinence?
Incontinence has many causes. It can be the result of trauma, surgery, childbirth or hormonal loss post-menopause. It can be related to diseases such as diabetes, stroke, multiple sclerosis or spinal cord injury.
What are the types of incontinence?
The two most common types of incontinence are called stress and urge. Stress incontinence is loss of urine when a person coughs, laughs or sneezes or with activity such as walking, running or lifting. Urge incontinence is when urine starts to flow before the person has time to get to a restroom. A person can have both stress and urge incontinence. This is referred to as mixed incontinence.
Other types of incontinence include overflow incontinence. This is when the bladder never empties properly and continuously drips urine. Functional incontinence is when a person can not reach a restroom in time due to physical limitations.
How is incontinence diagnosed?
Your doctor or health care provider will want to take a complete history and perform a physical examination. Sometimes, additional tests are needed to determine the type of incontinence. These include blood and urine tests as well as X-Ray studies of the urinary tract. The urologist may wish to look inside the bladder using a cystoscope. A special test called urodynamics can evaluate the function of the bladder.
What treatments are available?
There are many treatment options available to help people with urinary incontinence. Management options include pads, diapers, external or internal catheters and clamps. Behavioral treatment options include dietary modifications, timed voiding and pelvic floor retraining. Pelvic floor exercises (also known as Kegel exercises) can help to strengthen the muscles that support the bladder and prevent urine leakage.
Drug therapy is most effective for urge incontinence. A variety of agents are available to help relax the bladder and prevent the involuntary contractions that cause urine leakage. Some people may benefit from electrical stimulation therapy combined with Kegel Exercises. With electrical stimulation therapy, a small current is passed along the muscle paths leading to the bladder to help reset the nerve pathways to function properly.
There are also many surgical options for treating incontinence. Collagen injections can be placed at the opening of the bladder to help tighten the closure of the bladder. For women, urethral slings or supports can be placed. Bladder suspension surgery can benefit women who also have bladder prolapse (dropped bladder). Men with incontinence can also have urethral slings. The artificial urinary sphincter involves surgical placement of a cuff around the urethra that can be inflated or deflated by the person based on their urge to urinate.