Urinary Incontinence: Treatment Options
Both non-surgical and surgical treatment options are available for urinary incontinence, depending on which form the patient is diagnosed with. Just as in vaginal prolapse, patients are given non-surgical and surgical options to choose from depending on the severity of their condition or wishes. With today’s minimally invasive surgeries, many more women are choosing to proceed with surgery since there is typically a one week period for recovery and the results are excellent.
Aguirre Specialty Care is pleased to now offer at-home devices for a variety of intimate concerns, such as stress urinary incontinence, bladder leakage, vaginal looseness and decreased sexual satisfaction.
At-home treatment options include:
Stop bladder leakage in the privacy of your own home. This voice-guided pelvic floor rehabilitation program can stop the symptoms of bladder leakage without in-office intervention. A customizable, comfortable probe delivers muscle stimulation to calm the spasms of the bladder while strengthening the pelvic floor. Each session is recorded for Dr. Aguirre to review and maximize your progress.
Get back to your pre-baby body with this at-home device specifically for mild stress urinary incontinence following childbirth. This cost-effective solution consists of a customizable probe that delivers specific muscle stimulation to strengthen the pelvic floor, eliminating leakage associated with coughing, laughing or exercising.
Introducing the world’s first intimate health and stimulation device, now available in Denver. This pleasurable at-home device stimulates and strengthens vaginal muscle tone for stronger orgasms and greater sexual satisfaction for both partners. By delivering a rhythmic internal massage, the vaginal canal is rejuvenated for results you can feel.
Non-surgical treatment options include:
Laser Vaginal Resurfacing with Alma’s FemiLift™ for the treatment of stress urinary incontinence and vaginal looseness. Aguirre Specialty Care is excited to introduce the first FDA-approved laser for vaginal resurfacing, In November 2013, Dr. Aguirre treated one of the first patients in the United States. This CO2 laser strengthens the supporting ligaments surrounding the bladder and urethra to reduce the symptoms of stress urinary incontinence. Using a revolutionary vaginal probe, laser energy is delivered safely to the full circumference of the vagina to promote collagen production and remodeling. Leading the nation in treatment options for urinary incontinence, ASC now offers patients an in-office, non-surgical, no downtime procedure for the treatment of vaginal looseness and stress urinary incontinence. This treatment is for those women who haven’t achieved the desired results from other non-surgical treatments and who may also want improved sexual gratification. Click here for more information on The Femlift™
Kegel exercises strengthen the pelvic floor muscles. These exercises can help control stress urinary incontinence, urge urinary incontinence, overactive bladder, fecal incontinence and can help slow the progression of vaginal prolapse. Kegel exercises must be done correctly and regularly to work.
Pelvic floor therapy
Pelvic floor therapy consists of a series of visits to a physical therapist with specialized training in the treatment of pelvic floor problems. The physical therapist uses a combination of the techniques listed below depending on the type of urogynecological condition present.
Behavioral modification - education on diet, fluid intake and other lifestyle changes to manage various bothersome symptoms.
Bladder training - learning to use the pelvic floor muscles to suppress overactive bladder symptoms (urinary urgency, frequency, nocturia and urge urinary incontinence).
Biofeedback - an intravaginal device used to train the pelvic floor muscles to contract or relax correctly.
Functional electrical stimulation - a device that can be used intravaginally or externally that delivers a gentle electrical current to activate or relax the nerves and muscles in the pelvis.
Manual therapy - pressure applied to and released from muscles in spasm to relax them and increase blood flow to the area for healing.
Joint and tissue mobilization - gentle manipulation to help calm the muscles and nerves of the pelvis.
Low-dose vaginal estrogen
Low-dose vaginal estrogen replaces declining estrogen in vaginal and urethral tissues easing symptoms of vaginal dryness, itching and irritation as well as urinary urgency, frequency and incontinence. Low-dose vaginal estrogen comes in a cream (Estrace™ or Premarin™), suppository (Vagifem™) or a ring (Estring™).
A vaginal pessary is a removable, diaphragm-like device worn in the vagina to support vaginal prolapse and/or decrease stress urinary incontinence. There are a variety of types and sizes of pessaries available. A pessary fitting includes two or more office visits to find a type and size of pessary that will work for you.
A urethral insert is a small disposable device worn in the urethra to temporarily block leakage of urine due to stress incontinence. The device is removed for urination.
Various overactive bladder medications
There are several brands of overactive bladder medications on the market to treat urge urinary incontinence. These medications work by relaxing the bladder muscle. Side effects are usually mild and include dry mouth, dry eyes, blurred vision, urinary retention, constipation, dizziness or drowsiness. Changing the brand or dose of medication can decrease side effects. The different brands of overactive bladder medications include:
Surgical treatment options include:
A sub-urethral sling is a small strip of material that is inserted through an incision in the vagina and placed beneath the urethra. It provides a firm surface against which the urethra can be compressed during physical activity to prevent stress urinary incontinence. There are a variety of types of sub-urethral slings.
RetroArc Sling™ and I-STOP™ Slings
These mid-urethral slings are made of synthetic FDA approved mesh material are placed in an outpatient setting under local anesthesia. Click here for more information on I-STOP Sling
A transurethral or periurethral injection is a simple outpatient procedure in which a substance is injected to narrow the urethra and prevent leakage.
InterStim™ Therapy is an FDA-approved treatment for urinary urgency, frequency, urge incontinence and retention. The InterStim™ is a small device that is implanted under the skin of one of the upper buttocks. It works by gently stimulating the sacral nerves to help the bladder function more normally. Click here for more information on InterStim™ Therapy.
The Axonics System is a newly designed therapy offered by Aguirre Specialty Care and aimed at helping individuals who struggle with bowel incontinence, overactive bladder, urinary retention and other urinary issues. Dr. Aguirre was the first surgeon in Colorado to implant the Axonics System in December 2019. This therapy is performed using a small neurostimulator implant that can be repeatedly recharged and controlled by the patient for at least 15 years.