Urinary Incontinence

The doctors at El Camino Health are experts in evaluating and treating all forms of urinary incontinence in men and women. Our urologists listen with care and compassion. Medicine is making significant inroads in the successful treatment of this embarrassing condition, and the results can be life-changing.

For Women, a Full Range of Therapies

Incontinence is most commonly separated into two major categories: urge incontinence (the leakage of urine on the way to the toilet) and stress incontinence (the leakage of urine with coughing, sneezing, laughing or exercise). Treatment depends on the type of incontinence.

Treatments for urge incontinence include:

• Behavior modification. Your doctor may recommend that you empty your bladder on a regular schedule. Keeping a daily bladder diary and avoiding certain beverages that irritate your bladder may also be advised.
• Pelvic strength training. Your doctor may prescribe pelvic floor physical therapy, in some cases with the use of biofeedback to aid muscle contraction and relaxation. We may also prescribe pelvic floor exercises through our Total Control Program.
• Medicine. For certain types of incontinence or overactive bladder, your doctor may recommend medicine. There are a variety of prescription drugs that can make overactive bladder muscles relax, allowing the bladder to fill more completely.
• Sacral nerve stimulation. We implant a small device to stimulate the nerves in charge of bladder control. It transmits mild electrical impulses that influence the bladder sphincter and pelvic floor muscles.

Stress incontinence may respond to physical therapy and behavioral modifications. However, if it persists, treatments include:

• Burch colposuspension. In this minimally invasive procedure, our specialist uses sutures to lift, suspend and stabilize the bladder neck (a group of muscles that connect the bladder to the urethra). This technique helps the bladder control the flow of urine. Surgeons consider this same-day surgery the "gold standard" of bladder neck suspension procedures, with the highest success rate and the lowest risk.
• Urethral sling surgery. Surgeons place a synthetic or biological graft at the mid-urethra (the tube that allows urine to pass out of the body). This procedure helps support the bladder opening and helps prevent leakage from coughing, laughing, sneezing, lifting or running.
• Sacrocolpopexy. Your doctor performs laparoscopic, open or robotic-assisted surgery to lift the vaginal contents and repair prolapse (when bladder, rectal, uterine or intestinal tissue bulges into the vagina) that may be causing stress incontinence. Your surgeon elevates the bladder neck area (the junction of the bladder and the urethra) by securing the uterus to the sacrum (a bone at the base of the spine) as an “anchor” for the vagina and the pelvic floor. Lifting the bladder, uterus and rectum can provide improved support, although a sling procedure may also be required to more fully control stress incontinence.
• Periurethral bulking agent injection. To prevent leaking of urine, our urologists inject a bulking agent, such as collagen, next to the urethra/bladder opening.

Our video, Innovative Treatments for Pelvic Pain and Incontinence, explains the latest treatments that are worth considering.

For Men, Innovative Treatments and Surgeries

For men, the most common causes of urinary problems are prostate diseases like benign prostatic hyperplasia (known also as enlarged prostate or BPH), neurologic diseases, an overactive bladder (OAB) or injury to the muscles that control the bladder (urethral sphincter) resulting from surgical treatment of prostate disorders.

Nonsurgical treatment of OAB can include natural herbal remedies or prescription medicines that help reduce symptoms, often by relaxing bladder muscles, thereby reducing the urge to urinate frequently.

For BPH, medicines can relax the muscles in the urethra at the prostate, effectively "opening" the channel, making it easier to urinate. If medicine proves inadequate, your doctor may recommend surgical treatment.

Many men have found that a regimen of doctor-prescribed physical therapy focused on strengthening pelvic floor muscles helps their incontinence issues, much like the physical therapy regimens that help women with incontinence issues.

Your doctor may recommend that you empty your bladder on a regular schedule. Keeping a daily bladder diary and avoiding certain beverages that irritate your bladder may also be advised.

If you have urethral sphincter damage or injury, your doctor can surgically treat it with a male urethral sling, which means placing graft material in the area between the scrotum and the anus to help tighten the urethra. Alternatively, an inflatable donut-shaped device placed around the urethra can act in place of the injured urethra, helping it close.

El Camino Health urology experts specialize in:

• Minimally invasive therapy. Difficulty in urinating that is related to BPH can be treated with minimally invasive therapy that lifts and holds the prostate away from the urethra, allowing urine to pass more easily. Minimally invasive therapy for male OAB includes sacral nerve stimulation, a procedure where we implant a small electronic device to stimulate the nerves in charge of bladder control. This is especially useful if medicines fail to control overactivity.
• Leading-edge surgical treatments. Our urologists can treat the urination difficulties related to BPH with GreenLight™ Laser Therapy PVP and PlasmaButton™ TUVP. Both approaches remove excess prostate tissue blocking the urethra, which allows you to urinate and empty your bladder more effectively.