Involuntary urine leakage is the most common complaint of my patients. There are two types of urinary leakage: the most common is leakage with any activity which increases pressure in the abdomen. Coughing, sneezing, lifting, jumping, laughing can cause high bladder pressure which is transmitted to the urethra. If the muscles around the urethra are weak or have been stretched by childbirth, leaking results. Many times, pelvic floor exercises, commonly called Kegel exercises, can lead to better urinary control. This “stress” incontinence is also associated with pelvic floor relaxation/abnormalities requiring further testing and treatment.
The second type of incontinence is associated with a profound feeling of “urgency”. This urgency results from an involuntary bladder contraction caused by a number of conditions including neurological problems, diabetes, hormone imbalances, pelvic relaxation and many others.
Usually, we evaluate this complex problem with URODYNAMIC STUDIES. This procedure takes about 30 minutes and involves a small catheter placed into the bladder through the urethra through which sterile saline is infused at a constant rate. The bladder fills slowly as the pressure within the bladder and abdomen is measures. We check other parameters during the test such as the bladder pressure it takes for you to leak, the pressure the bladder generates while voiding and the pressure within the urethra. Urodynamic testing gives us the information we need to advise therapy including exercises, behavior modification, medication and, sometimes, surgery.
A select few of our patients with urgency incontinence from a neurological condition may benefit from Botox injections into the bladder wall during cystoscopy. This is usually performed in the office with local anesthesia.
To make an appointment with Dr. Golden, in Spokane Valley, submit the contact form on this page, or call us at (509) 921-0099 today!