Stress Urinary Incontinence Treatment

• Am I afraid to be too far from a bathroom or a change of clothes?
• Have I stopped exercising or playing sports?
• Have I changed the way I live because I’m afraid of urine leakage?
• Have I become uncomfortable with myself and my body?
• Have my symptoms changed my relationships with friends or family?
• Am I avoiding sex because I am worried that I will leak and become embarrassed?

If you answered yes to some or all of these, you should know there is hope. There are many ways to manage and treat stress urinary incontinence.

If you answered no to most of the questions above but have leakage with urgency, you may have the signs and symptoms of an overactive bladder. Learn more about OAB here.

• Healthy lifestyle changes such as weight loss and smoking cessation.
• Pelvic Floor Therapy and Rehabilitation
• Females can be offered a continence pessary or other vaginal insert
  – A pessary is a firm, yet flexible device that is inserted into the vagina to reposition and support the urethra and/or the uterus.
• Males may be offered a penile clamp.
• There are currently no medications available to treat stress urinary incontinence.

Urethral Bulking Injections

• Urethral injections are used to “bulk up” the urethra. The bulking agents are injected into the urethral sphincter to improve the way the sphincter closes, thus reducing urinary leakage. Offered medications/agents: – Macroplastique – Durasphere – Coaptite
• Urethral bulking is not a permanent fix and will have to be repeated to maintain consistent dryness. Can be done with local anesthetic in the office or general anesthetic in an outpatient hospital procedure setting. The procedure generally takes about 30 minutes.

Urethral Slings (Female)

• A small strip of material (sling) is placed under the urethra and stops it from moving downward during activity. The sling acts as a hammock to support the urethra and the neck of the bladder. Two most common types: – Mid-urethral sling Doctor uses a narrow strip of synthetic mesh- Autologous Traditional Sling. Doctor takes a strip of your own tissue from your lower abdomen or thing and uses it as a sling. The ends of the sling are stitched in place through an incision in the abdomen.

Urethral Slings Male

• Used for mild stress incontinence only. Men who have had radiation therapy of the prostate or urethra may not be able to have this type of surgery.
• A surgical incision is made between the scrotum and rectum and surgical mesh is used for the sling. This acts as a hammock to lift or support the urethra and sphincter muscles of the pelvic floor and bladder neck.

Artificial Urinary Sphincter for Men

• The most effective treatment for male stress urinary incontinence is to implant an artificial sphincter device. This surgery puts a device with three parts into your body: (1) a fluid-filled cuff (the artificial sphincter) attached around your urethra; (2) a fluid-filled, pressure-regulating balloon, inserted in your belly; (3) a pump you control, inserted in your scrotum.
• When you use the pump, the fluid in the balloon moves out of the cuff of the artificial sphincter allowing the urine to flow. The cuff slowly refills with fluid and closes the urethra to prevent leaks.