Urinary incontinence, accidental loss of urine, is a common complication that we see in our office. Urinary incontinence is usually caused from a combination of vaginal deliveries, weight gain and age. Stress incontinence is usually noticed whenever there is increased abdominal pressure, such as coughing, sneezing, laughing, jumping or exercise. Although this can occur with the majority of women, it sometimes causes embarrassment or the need to wear a pad for protection. This type of incontinence usually can be corrected by outpatient surgery.
Urge incontinence usually presents as an intense need to rush to the restroom. The bladder actually goes into spasm, causing the urine to be forced out, without one’s control. This type of incontinence does not require surgery, but can usually be controlled with medication.
Mixed incontinence is a combination of both stress incontinence and urge incontinence and it can sometimes be difficult to distinguish whether one might best respond to medication or surgery. To help with this determination we offer urodynamic testing in our office.
Urodynamic testing consists of placing a small catheter in the patient’s bladder and a transducer in the vagina. The bladder is slowly filled with fluid. The pressure of the bladder and urethra can be monitored during this filling, as well as the intraabdominal pressure from the vaginal transducer. Bladder spasms are easily seen by spikes on the graph. Once the bladder is nearly full, the patient can be asked to cough, demonstrating leakage and the urethral leak point pressure can be measured. A post-void residual urine is also measured. Finally, a urethral closing pressure is measured. Once these tests are completed, a physician can review the charts to see if the patient would benefit from surgery.