Memorial Hermann-Texas Medical Center

Urology and Continence Center

Bladder Health

At the Memorial Hermann Urology and Continence Center our highly qualified, experienced specialists use technologically advanced equipment to create comprehensive, personalized diagnostic evaluation and treatment plans for men’s and women’s incontinence and pelvic floor disorders.

About Urinary Incontinence

• As many as 25 million Americans suffer from incontinence, and about 80 percent of them are women.

• Researchers estimate that less than half of them have been evaluated and treated, because of embarrassment or lack of information about available treatments.

• Up to 5 percent of men 64 years of age and younger and up to 15 percent of men older than 64 experience bladder leakage.

• Urinary incontinence is not limited to older adults. Young people are also affected, including athletic women, new mothers and people coping with illness, birth defects or physical trauma, such as surgery or spinal cord injuries.
     
• In more than 70 percent of individuals, urinary incontinence arises from an underlying condition that can be corrected or improved with appropriate treatment.

Causes of Urinary Incontinence

Stress incontinence can result from multiple vaginal births, pelvic surgery, chronic coughing, obesity, heavy lifting, frequent straining during bowel movements or pelvic organ prolapse.

Urge incontinence, also known as “overactive bladder,” results from unknown causes. People with overactive bladder experience a sudden urine loss or urge to urinate due to bladder spasms of unknown origin.

Mixed incontinence, the most common form of the disorder, is a combination of stress and urge incontinence.
  

Overflow incontinence results in unwanted loss of urine associated with incomplete emptying of the bladder. Causes include obstruction of the bladder outlet in men due to prostate enlargement, pelvic floor disorders in women or neurogenic bladder caused by peripheral neuropathy, diabetes or spinal cord injury.

Transient incontinence is less common and can result from urinary tract infections, medications, urethritis or chronic incomplete emptying of the bladder. Normally, it can be resolved by diagnosis and treatment of the underlying cause.

Treatment Options

Our physicians begin treatment with the least invasive options:

• Kegel exercises
• Hormone therapy (Premarin® cream)
• Weight loss
• Behavioral modification
• Medication
• Urethral bulking with materials such as collagen
• InterStim® therapy

Kegel exercises are a program of pelvic-muscle training designed to decrease urine leakage by increasing the strength of the pelvic floor muscles, specifically the levator ani.

Medication is the first line of treatment for women who experience urgency, urge urinary incontinence and urinary frequency. New second-generation medications for overactive bladder are now available and producing excellent results. Medications include:

• Tolterodine tartrate (Detrol®)
• Oxybutynin (Ditropan®)
• Oxybutynin transdermal system (Oxytrol® patch)
• Trospium chloride (Sanctura®)
• Darifenacin (Enablex®)
• Solifenacin succinate (Vesicare®)
• Imipramine (Trofranil®)
• Alpha-andrenergic agonists (Ornade® and Sudafed®)

Bladder training and timed voiding may be as effective or more effective for some types of urinary incontinence than treatment with medication.

Bladder augmentation offers patients who have not responded to other treatments for urge incontinence a surgical option. Memorial Hermann-TMC offers minimally invasive robotic-assisted bladder augmentation for patients who qualify for the procedure.

Additional Services

We also offer the following treatment services:

• EMG biofeedback
• Pelvic floor rehabilitation therapy
• Incontinence education
• Self-catheterization instruction and support
• Referral for pelvic reconstructive surgery

For more information about bladder health, call the Memorial Hermann Urology and Continence Center at 713-704-2494.