From simple behavioral changes to surgical procedures, treatment options vary depending on your specific condition and individual needs. Because there is no one-size-fits-all approach to care, the Center coordinates with specialists from across disciplines to provide treatment.
Biofeedback helps you gain greater awareness of body functions, in this case your pelvic muscle and abdominal muscles. Surface sensors or a vaginal/rectal sensor are used to evaluate your pelvic muscle strength and endurance and help you isolate the right muscle to exercise or relax. The goal is to relax, strengthen and support your pelvic organs to reduce or stop urinary leakage.
Bladder retraining uses fluid changes, pelvic muscle exercises and other ways to decrease the urge to urinate and provide bladder control. As a result, it reduces urgency and frequency, and leakage.
Botox therapy is used to treat nerve damage to the bladder that causes the bladder muscle to be overstimulated, which impairs your ability to control your urine. The Botox paralyzes the nerves that cause the muscle to relax, thereby reducing the frequency and urgency of urination. The treatment has to be repeated every three to six months, but many patients say they like the fact that the paralysis is reversible.
Bowel training utilizes behavioral changes to obtain better bowel function. Factors such as bowel schedule, diet, stool consistency, activity, positioning, muscle activity are all a part of this process.
Medications can be used to reduce urinary frequency, urgency and leakage on the way to the bathroom. These medications are even more effective when used with bladder retraining.
MonaLisa Touch is a gentle laser treatment to the tissue of the vaginal wall and vulva that restores the collagen, elastin and vascularization in the area. Individuals are usually seen in the office for three sessions to assist with vaginal changes from menopause or cancer treatment. This treatment has been available nationally since 2012.
Neuromodulation
- InterStim therapy acts as a pacemaker for the bladder and bowel. It resets the nerves of the bladder/bowel to decrease urinary frequency, urgency, and leakage on the way to the bathroom as well as bowel symptoms. Testing is done before device placement to make sure this treatment works for you.
- Peripheral tibial nerve stimulation (PTNS) sends mild electrical pulses to the nerves associated with bladder function to change the bladder activity. This is accomplished through the tibial nerve, located in the lower leg and accessed with an acupuncture needle. Patients receive this treatment weekly for 12 weeks, then switch to a monthly treatment schedule.
Pelvic muscle exercises strengthen the pelvic floor muscles and relax the bladder muscle, so you can hold more urine. The pelvic muscles support the urethra, uterus, bladder, small intestine and rectum.
Pelvic muscle stimulation involves the delivery of small amounts of electrical energy to the nerves and muscles of the pelvic muscle and bladder. This causes the pelvic muscle to contract, which helps you identify the muscle and strengthen it without causing pain or injury. In addition, it can help relax the bladder muscle. To do this a small sensor is placed in the vagina or rectum. The sensor is attached to a battery-operated device that controls the stimulation. This can be done in the home or office. Home units are usually not covered by insurance, but they are available through online retailers at reasonable prices.
A pessary is placed in a women’s vagina to support the bladder and/ or compress the urethra. It can also be used to treat pelvic organ prolapse. Pessaries are selected and fitted by a nurse practitioner or gynecologist. While some types of pessaries can be removed and inserted by the patient at home, others require an office visit for removal and cleaning. Available in several shapes and sizes, patients may need to try several to find one that is most comfortable and effective.
Urethral bulking agents can be injected into the wall of the urethra to make it fuller. This bulking closes the lumen of the urethra and helps restore the mucosal seal, which is important in keeping patients dry.
Urethropexy /sling surgery is a minimally invasive procedure that uses material to aid in the stability of the urethra and thereby help the closure of the urethral sphincter.
Vaginal cones/weights (for women) are used at home as a training aid for pelvic muscle exercises. The cones/weights are placed in the vagina with the goal of holding it in place by contracting the pelvic muscle. Patients begin by holding for 5 minutes and working up to 15 minutes, one or two times per day. Cones/weights are not typically covered by insurance and are available in packages of 6 varying sizes, ranging in price from $30 - $50.
Vaginal dilators are graduated vaginal inserts used to reduce spasms of the pelvic muscles and assist with a narrow or short vaginal canal. This is a treatment for women who are unable to have intercourse or who have pain with intercourse. Patients purchase a set of dilators and are taught how to use them by our specially trained staff.