Options of course vary with the specific problem you are having. In some cases, lifestyle changes alone are adequate, such as diet, exercise, weight control, and smoking cessation. Treatment options are non-surgical (e.g., pelvic floor muscle exercises, pessaries, medications, physical therapy) or surgical.
- Research has identified two basic kinds of major surgical procedures that seem most effective for treating stress incontinence in women - the retropubic urethropexy and the midurethral sling. Many minimally invasive slings made of polypropylene mesh are available. The mesh tape is placed underneath the midurethra through a small vaginal incision. They have shown high success rates with minimal risk and is usually the surgical procedure of choice. A more minor collagen injection into the urethra is also available for a few subset of patients.
- Interstim or a bladder nerve stimulating device can be used for patients with the worst cases of overactive bladder and/or urge incontinence.
Abnormal Bladder Emptying:
Options include treating a stricture of the urethra (rarely present), any treatable neurological abnormalities, Interstim and treating obstruction of the urethra with from pelvic organ prolpase with pelvic reconstructive surgery.
Pelvic Organ Prolapse:
Abdominal and vaginal surgeries to support the bladder, vagina, and rectum are available with high success rates. If uterine prolapse is present, hysterectomy is usually performed if child bearing has been completed. Surgeries must be tailored individually based on the components of a patient's prolapse.
These procedures are generally performed by colorectal surgeons.
- Sphincteroplasty, sphincter replacement, and sphincter repair are common options.
- Injection of biomaterials into the anal sphincter to increase the size of the sphincter.