When Dalia was 28, she had her first child. She’d had a normal pregnancy, and like many of her friends, had some light leakage after birth, but nothing serious. Baby #2 followed two years later, and baby #3 one year after that. It was then that she really began to see a difference in her bladder control. “It was like the flood gates had suddenly opened,” Dalia said. “Any little thing could trigger an urgent bathroom visit.” Concerned, Dalia went to her doctor to ask what could be done. After trying several options that had no effect, or uncomfortable side effects, her doctor finally suggested a minimally invasive procedure to treat her incontinence. “I was really nervous at first – 'minimally invasive' sounded so scary,” she said. After reviewing all the options, Dalia’s doctor had recommended Interstim to treat her incontinence. Interstim therapy is a form of sacral nerve stimulation, where a device is implanted, usually in the buttocks and helps to block the messages sent by an overactive bladder to the brain, telling the brain that you need to use the restroom. After the procedure, she saw immediate improvement. “I can’t believe that I waited as long as I did to have this done,” she said. “It’s been a life changer.”
Many women like Dalia suffer from overactive bladder – the urgent and frequent need to use the restroom. It is estimated that over 33 million people in America struggle with the condition. And while there are many treatment options available, they don’t always work for everyone. Initial treatment options like physical therapy, diet regulation, and bladder retraining can do wonders for many, and medications can often help those suffering from OAB. However some still don’t find relief from these options, and some medications can cause unwanted side effects. Luckily, there are several minimally invasive or surgical options that are effective in improving OAB symptoms.
What are my options?
Sacral Nerve Stimulation.
This procedure, like the one Dalia had, regulates the nerve impulses in the bladder. A small pulse generator is implanted under the skin and blocks messages sent by your bladder to your brain, regulating the nerve impulses in your bladder and reducing the need to urinate unnecessarily. The device can remain in place for as long as you need it, and the process is an outpatient procedure that uses local anesthesia and mild sedation.
Augmentation Cystoplasty, is a procedure that increases the size of the bladder. Often used in severe cases after other treatments have failed, it enables the bladder to store more urine. Your doctor will take a small piece of tissue from your intestine and add it onto the wall of the bladder to enlarge it. In some cases, a catheter may be needed to empty the bladder after this procedure has been performed.
Urinary Diversion reroutes the tubes that lead from the kidneys to the bladder to outside of the body through the abdominal wall. Urine is then collected in an ostomy bag – a specially designed bag to be worn on the abdomen. This option does require some maintenance, however it allows you to live an active life post surgery.
Talk To Your Doctor.
Surgery is a common approach for many who have failed on other treatment plans, and your doctor will be able to help you find the best option. It is important to talk with your doctor to determine not only what type of surgery might work best for you but also when might be the best time to have it. For example, women who are still interested in having children may wish to wait, since childbirth may compromise any surgery that has already been performed. Additionally, be sure to ask your doctor about what you can expect post surgery – some surgeries are designed to treat specific symptoms of incontinence, so you may still need medication or physical therapy to treat the other symptoms you experience.
If you are considering surgery, a urological surgeon can help talk through your options. Visit the NAFC Specialist Locator to find one near you. (www.nafc.org/find-a-doctor)