Urinary Incontinence Treatment – Brockton, MA
If you are suffering from an overactive bladder, embarrassing bladder leaks or other issues related to urinary incontinence, our Brockton, MA urogynecologists have the state-of-the-art solutions you need. At ESP Medical, we proudly provide the latest treatments for stress urinary incontinence, urge urinary incontinence, fecal (bowel) incontinence and overactive bladder.
These treatments allow you to regain control over your quality of life by medically treating the underlying cause of your urinary health concerns.
Vikas Merchia, MD, FACOG, has been a practicing Gynecologist and Obstetrician since 1996, and has offered OBGYN services in Brockton, Massachusetts since 2006. Dr. Merchia is board certified by the American Board of Obstetrics and Gynecology (ABOG) in General Obstetrics and Gynecology, and in Female Pelvic Medicine & Reconstructive Surgery.
What is Urinary Incontinence?
Having urinary control relies on the intricate coordination of the muscle tissue of the bladder and urethra, skeletal muscle, voluntary inhibition and the autonomic nervous system. When the system is disturbed, urinary incontinence is the result.
Incontinence is classified into two basic groups, and can be caused by a number of factors, including diseases of an anatomical, pathological, or physiological manner. It can also be caused by diseases such as spina bifida or multiple sclerosis, which are muscular innervation disorders.
The first classification group is known as acute and temporary incontinence, which is most often caused by the following:
- Limited mobility
- Childbirth
- Injuries to the brain or spinal cord
- Weak bladder or pelvic floor muscles
- Vaginal prolapsed
- Hormonal changes following menopause
- Neurological disorders
- Stress incontinence
The second is known as chronic incontinence, which is most often caused be the following:
- Injuries to the brain or spinal cord
- Weak bladder or pelvic floor muscles
- UTI (Urinary Tract Infection)
- Excessive consumption of caffeine or alcohol
- Constipation
- Vaginal prolapse
- Hormonal changes following menopause
- Interstitial cystitis
- urge incontinence
- Neurological disorders
Types of Urinary Incontinence:
- Stress – loss of bladder control upon sneezing, coughing, laughing, etc.
- Urge – loss of urine with a feeling of urgency to do so. Also, involuntary contraction of the bladder occurs.
- Mixed – a combination of the aforementioned two.
- Overflow – the bladder never completely empties – it constantly drips urine.
- Nocturnal enuresis – nighttime bed-wetting.
Incontinence Treatments
There are many treatments for incontinence. An examination of the urine may help identify causes and conditions. Specialized tests, such as urodynamic, endoscopic and imaging will provide more extensive evaluation and insight into further treatment. You may be asked to keep a diary for a period of time, keeping track of what you drink and when your body voids it. There are injections, medications, surgical and non-surgical treatments, and self-catheterization.
Incontinence may also be managed by making changes to your lifestyle. Your doctor may recommend you do Kegel exercises daily, integrate foods into your diet to avoid constipation, stop smoking, as nicotine can irritate the bladder, avoid overconsumption of certain types of medications, and forcing yourself to urinate only every three to six hours, which ‘retrains’ your bladder or on the opposite end of the spectrum, to practice a technique known as double voiding, in which you urinate, wait a few seconds and then urinate again.
Other incontinence treatments include:
- Medical management of incontinence
- Bladder Botox
- Physical Therapy
Bladder and Bowel Incontinence
Stress Urinary Incontinence
NonSurgical Neuromodulation / Interstim Therapy
At ESP Medical, in many cases we can treat an overactive bladder without surgery, using state-of-the-art minimally invasive technologies. Percutaneous (or Posterior) tibial nerve stimulation (PTNS) is one office based form of neuromodulation used to treat overactive bladder (OAB). This new technology can effectively reduce or eliminate urinary urgency, urinary frequency, and urge incontinence (bladder leaks).
A second innovative, minimally invasive form of neuromodulation – InterStim – treats overactive bladder as well as fecal urgency and incontinence.
Benefits of Neuromodulation for Incontinence
- Treats the nerves that control the bladder
- Helps restore normal bladder function
- Non-surgical, minimally invasive procedure
- No side effects; No injections; No catheters
- You can try it out first to see if it helps you!
ApexM, InTone & InTone MV
At ESP Medical, our urogynecologists also offer state-of-the-art ApexM, InTone & InTone MV for urinary & fecal incontinence.
These amazing new medical devices, manufactured by women’s health company Control Medical, LLC, offer non-surgical, drug-free treatments for female urinary incontinence.
InTone and Apex remedy bladder leakage by utilizing patented muscle stimulation algorithms, active resistance and biofeedback – which work in tandem to to dramatically increase muscle strength in the pelvic floor.
Additionally, InTone and Apex send calming signals to the detrusor muscle in the woman’s pelvis – which decreases muscle spasms and retrains the muscles for renewed control of urination.
Fecal (Bowel) Incontinence
Also known as fecal incontinence, bowel incontinence is the involuntary loss of bowel control. A number of following situations are considered fecal incontinence:
- stool leaks out when passing gas
- stool leaks out due to daily live exertions/physical activity
- the feeling of having go, but not able to make it to the bathroom in time
- stool is seen in the underwear after a normal bowel movement
- complete loss of bowel control
Bowel incontinence is too often a problem that causes embarrassment, keeping a person from finding out about treatment options. Bowel incontinence occurs in 7 percent of adults. It is more common in women than men, and prevalence raises with age as well (particularly after menopause).
Causes of Bowel Incontinence
- vaginal delivery — obstetrical trauma, pudendal nerve injury
- natural muscle weakening with age
- anal surgery for another condition
- radiation or chemotherapy
- spinal cord injury
- stroke
- conditions associated with chronic diarrhea or constipation
- systemic (whole body) disease such as diabetes or scleroderma
Treatment for Bowel Incontinence
Through our advanced continence center, several visits working closely with a specially trained nurse practitioner can determine treatment options to improve bowel control.
Comprehensive testing may be indicated to learn more about each patient’s specific needs, including anorectal manometry and ultrasound.
Treatment begins with behavioral modifications such as dietary and fluid modification, pelvic floor therapy, bowel habit retraining; pharmacotherapy, education and treatment. Medication and other non-surgical, minimally invasive treatment options, including Interstim, may also be recommended by our skilled and caring Urogynecologists.