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Sacral Nerve Stimulation & Other Not-so-famous Treatments for Incontinence

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Written by Urologist and Sexual Health Expert Dr. Jennifer Berman

Are you investigating treatment options for your bladder leaks? Have you tried standard treatment options, like pelvic floor physical therapy, medication and surgery and they’re not working? In case your urologist hasn’t suggested alternatives, here are a few lesser-known treatments that may be helpful.

For Women - FemiLift

I highly recommend FemiLift. It’s a non-surgical vaginal tightening/resurfacing treatment that effectively restructures and restores damaged tissue with no pain, anesthetic, numbing cream or downtime.

As we age, we lose collagen everywhere, including the vagina. Similarly to normal skin, vaginal tissue is comprised of a thin top layer that rests on a deeper layer. The deeper layer contains a matrix of collagen. Combined with elastin, this provides structure and support to the skin.

As we get older, thinning of the collagen and elastin support matrix occurs leading to sagging of skin and vaginal wall tissue. FemiLift can stimulate regrowth of collagen and elastin for tighter tissue in the vaginal wall.

There are many factors that can affect the breakdown of vaginal collagen, like childbirth, aging, obesity and smoking. These triggers can degrade the vaginal tissue’s normal collagen and it becomes replaced with abnormal fibers that do not stretch or recoil. This creates tissue laxity and attenuated pelvic floor muscles. When vaginal collagen is broken down, side effects can include stress urinary incontinence, which is an involuntary leakage of urine that occurs during coughing, sneezing, laughing or anything else that increases abdominal pressure. Attenuated pelvic floor muscles can also lead to diminished sexual satisfaction because of loss of sensation, which can affect self-confidence.

In my opinion, FemiLift is a great new option for women who are experiencing stress incontinence with or without vaginal dryness and complaints related to sexual arousal.

For Men and Women - Injection Therapy

The FDA has expanded the approved use of BOTOX to treat adults with overactive bladder who cannot use or do not adequately respond to a class of medications known as anticholinergic.

Uninhibited urinary bladder contractions in people with some neurological conditions can lead to an inability to store urine. Current management of this condition includes medications to relax the bladder and use of a catheter to regularly empty the bladder. When Botox is injected into the bladder muscles, it causes the bladder to relax, increasing the bladder’s storage capacity and reducing episodes of urinary incontinence.

Injection of the bladder with Botox is performed using cystoscopy, a procedure that allows a doctor to visualize the interior of the bladder. Cystoscopy may require general anesthesia. The duration of the effect of Botox on urinary incontinence in patients with overactive bladder associated with a neurologic condition is about nine months.

Studies have shown that patients with both neurogenic and non-neurogenic overactive bladder have experienced a significant decrease in their symptoms as the result of Botox.

For Women and Men - Sacral Nerve Stimulation

This therapy has shown to be successful in four out of five patients with urgency incontinence and successful in two-thirds of patients with urgency-frequency.

Sacral nerve stimulation involves two stages: a test and a permanent implant. A benefit of this therapy is the test stimulation. This outpatient procedure allows patients to assess the effect of the therapy at home prior to consideration of a surgical implant procedure. The advantage of a single implant is that it delivers electrical stimulation without the need of repeated doctor’s office visits.

SNS is a reversible treatment and adjustments can be made at the doctor’s office with a programming device that sends a radio signal through the skin to the neurostimulator. Another programming device is given to the patient to further adjust the level of stimulation, if necessary.

Sacral nerve stimulation is indicated for the treatment of non-obstructive urinary retention and the symptoms of overactive bladder in patients who have failed or could not tolerate more conservative treatments.

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