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Treatment Options
Below is a listing of treatment options which will be explored in relation
to your medical assessment during your examination.
- Behavioral Modification: The adjustment
of fluid intake and voiding schedule to control overactive bladder
symptoms. For some patients with OAB simple changes in the timing
or amount of fluid intact and/or the use timed voiding may avert episodes
of urgency and urge incontinence.
- Pelvic Floor Muscle Rehabilitation: Strengthening
the pelvic floor muscles can enable better control of urgency and
OAB symptoms. The program of pelvic floor muscle training is based
upon pelvic floor muscle exercise. Biofeedback is a non-invasive modality
to measure and record pelvic floor muscle activity and can be used
to teach proper pelvic floor muscle exercise technique and to monitor
patient progress.
- Insertable Devices: Temporary prostheses
such as a pessary can be used to address problems with pelvic prolapse
which may accompany bladder symptoms. Urethral inserts may be used
for selected patients with stress incontinence.
- Medications to control OAB are the mainstay
of treatment for this condition. Commonly used medications include
Detrol LA, Ditropan XL and Oxytrol. These medications are intended
for long term use and are generally much better tolerated than the
generic form of oxybutinin.
- Surgery
- Pubovaginal
Sling: The cause of stress incontinence in most women
is a lack of support for the bladder neck. The PV sling procedure
corrects stress incontinence by reconfiguring the fascial support
for the bladder neck.
- Interstim: An implantable bladder pacemaker. The device
uses mild electrical stimulation of sacral nerves to regulate
the behavior of the bladder and pelvic floor muscles.
- Collagen Injection: Some women have stress incontinence
without bladder neck support. In this case, injection of a small
volume of collagen into the region of the sphincter may improve
urethral coaptation and prevent stress incontinence.
- TURP/TUIP: For men with prostatic obstruction transurethral
resection of the prostate (TURP) or transurethral incision of
the prostate (TUIP) are the most commonly employed operative procedures.
These surgeries are performed with anesthesia using a small scope
passed through the urethra to eliminate the obstructing prostate
tissue.
- Artificial Urinary Sphincter: The artificial urinary
sphincter is an implantable device that is used to restore continence
to men who have persistent urinary leakage following radical prostatectomy.
- Urinary Tract Reconstruction: Patients with severe
bladder dysfunction caused by neurologic disease or spinal cord
injury may benefit from tailored urinary tract reconstruction
to facilitate urine storage, bladder emptying, or urinary diversion.
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