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Bladder and Bowel Control Center

Bladder issues can affect a patient’s emotional, psychological and social wellbeing. The Urology Group offers a broad spectrum of diagnostic testing and care.

Overview

Complete care for a variety of bladder control issues.

More than 33 million Americans experience some form of urinary incontinence or bladder condition, according to the National Association for Continence. For many, this is more than a medical problem. Bladder control issues can affect emotional, psychological and social well-being.

The Urology Group helps patients with a variety of bladder control and incontinence issues through a range of diagnostic testing and care options.

Services and Treatments Offered

Urodynamics: A test that measures bladder function.

This diagnostic study tests the ability of the bladder to store and dispose of urine by measuring bladder pressure and urine flow. It is typically recommended when the patient is experiencing symptoms of incontinence or urinary retention.

The procedure: A typical urodynamic test is an outpatient procedure, usually taking about 60 minutes, that involves the use of a catheter to fill the bladder. It is usually performed in two steps:

  • Uroflowmetry: The patient urinates into a device that measures flow and volume to identify the reasons for voiding difficulty, such as bladder muscle weakness or an obstruction.
  • Cystometrogram: In this step, a catheter is inserted into the bladder, which is then filled with sterile water until the patient experiences fullness and urgency. Bladder and urethra pressures are measured and the patient is asked to cough or bear down to cause leakage. This information can determine the treatment.

What to expect afterward:

The patient should be able to return home soon after the procedure, though may feel mild discomfort for a few hours when urinating. Drinking water may help to reduce the discomfort.

The physician may prescribe an antibiotic to prevent infection. Any signs of infection, including pain, chills or fever, should prompt an immediate call to the physician.

Biofeedback: Retraining pelvic muscles to alleviate incontinence and overactive bladder.

Biofeedback is a practice designed to help patients better understand how the body normally behaves. In the case of urge incontinence, biofeedback can help the patient recognize when the bladder is overactive and help contract the proper muscles to stop the need to urinate. Often, a sensor is used to monitor muscle activity in the vagina, rectum or pelvic floor.

Kegel exercise therapy: Exercises that strengthen the pelvic support muscles.
Kegels help to reinforce the muscles that control the flow of urine and can tighten the muscles of the pelvic floor. They may be prescribed for both men and women with incontinence or women with pelvic floor prolapse.

The exercise involves strongly contracting the pelvic muscles that hold back urine – many mothers may be familiar with the exercise from childbirth classes. These exercises should be performed as a regimen, meaning as many as 20 sets three times a day – but not during urination.

Neuromodulation therapies: The use of stimulus, such as electrical impulses, to alter nerve activity.
For patients whose conditions do not respond to behavioral modification or medications, The Urology Group operates a state-of-the-art neuromodulation clinic dedicated to the care of bladder dysfunction. Here, at our centrally located offices in Norwood, we use advanced medical devices and technologies to alter the activity of the nervous system.

Services and treatments offered:

Sacral nerve stimulation (InterStim® therapy): A tiny pacemaker manages the nerves controlling bladder function.
During this minimally invasive surgical procedure, a tiny pacemaker-like device is implanted through a small incision in the lower back and connected to a wire that is placed near the tailbone. This pacemaker calms the sacral nerves that control bladder function.

The physician will first perform a 15-minute test to see if the procedure will work. If the test delivers positive results over a three- to five-day period, the permanent pacemaker can be implanted.

What you should know:

  • Patients are sedated for the surgery, but should expect to go home within an hour after the procedure.
  • The procedure involves a permanent surgical implant.
  • The pacemaker batteries may need to be replaced after three to five years.
  • The success rate among patients with positive test results is up to 82%.
Botox injections: Botox is applied to relax the bladder muscle.
The physician injects Botox directly into the bladder muscle during a cystoscopy (a procedure that enables the doctor to view the affected area through a tiny camera).

The drug partially paralyzes the bladder, relaxing it so it can store more urine, but leaving enough control to empty itself voluntarily.

What you should know:

  • The treatment is not permanent – it typically lasts about nine months.
  • Botox can cause side effects, including urinary tract infection.
Posterior Tibial Nerve Stimulation (PTNS): Stimulation of the posterior tibial nerve.
PTNS is a non-invasive form of neuromodulation therapy (an alteration of nerve activity) that involves the stimulation of the posterior tibial nerve, which is near the ankle, on a weekly outpatient basis.

In the procedure, an acupuncture needle/electrode is inserted near the posterior tibial nerve and pads/electrodes are adhered to the foot. These electrodes are connected to a pulse generator, which sends an electrical signal up the tibial nerve to the sacral plexus in the pelvis, the group of nerves that controls bladder function.

Bladder augmentation: Using tissue to enlarge the bladder.
This surgical procedure enlarges the bladder with a patch made from the patient’s bowel tissue. The enlargement allows the bladder to hold more urine at lower pressure.

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