Urinary Incontinence: Innovative Techniques for Treatment

Urinary incontinence is leakage of urine or loss of bladder control. In the United States, millions of women suffer from urinary incontinence, and its devastating and embarrassing side effects. Billions of dollars are spent on incontinence protection each year. The two most common types of urinary incontinence are stress urinary incontinence (SUI) and urge incontinence (overactive bladder).

Stress Incontinence.  SUI is caused by a weakening of the urethra, the tube that carries urine out of the body. Women with SUI commonly have urine leakage when they laugh, cough, sneeze, walk, pick up a heavy object or engage in exercise or sports activities.

Urge Incontinence.  Women with and overactive bladder often feel a strong need to go to the bathroom but an inability to get there in time. Other symptoms include urinary frequency and the need to urinate several times during the night. Some women with urge incontinence lose urine when they hear running water, change position, or put their key in the door. Overactive bladder is caused by unexpected contractions of the bladder muscle.

These two common types of urinary incontinence are treatable ailments, however they are treated differently. It is important to obtain an accurate diagnosis from an expert in the field in order to ensure the proper treatment. A complete evaluation involves a history and physical examination, and often, urodynamics testing.  

Expert Care in Evaluation and Treatment of Incontinence

Urogynecology is the evaluation and treatment of female incontinence and pelvic floor problems. Board-certified ob/gyn Dr. Craig McCoy is an expert in this field, and consults for several top medical companies that produce new technologies for treatment of female incontinence. Through his role as a consultant, Dr. McCoy enjoys training physicians across the country on these state-of-the-art procedures. With Dr. McCoy's leadership, we are proud to incorporate the most advanced technologies in the world to diagnose and treat many forms of female urinary incontinence allowing women who suffer these ailments to regain confidence and quality of life. 

Below are listed several minimally invasive procedures for treatment of female incontinence, most of which can be conveniently performed in our office. In addition to these procedures, Dr. McCoy is skilled in traditional surgical treatments, using either a vaginal or abdominal approach. A complete evaluation will aid in deciding which treatment is right for you.

Minimally Invasive and Non-invasive Treatments

The Lyrette System. A non-surgical approach to treat stress urinary incontinence (SUI). The Lyrette treatment involves a small probe, which a physician passes through the urethra. The treatment can be performed in the convenience of our office. There are no incisions, bandages or dressings required. Recovery is rapid and comfortable, with minimal post-procedure limitations. Lyrette uses radiofrequency energy to generate controlled heat at low temperatures in tissue targets within the lower urinary tract. The heat denatures collagen in the tissue at multiple small treatment sites. Upon healing, the treated tissue is firmer, increasing resistance to involuntary leakage at times of heightened intra-abdominal pressure, such as laughing, coughing or during exercise, thereby reducing or eliminating SUI episodes. Click here for more detailed information on The Lyrette System.

Urethral Bulking.  Another minimally invasive technique for treating SUI, urethral bulking, involves injecting a specialized insert substance into the tissues surrounding the urethra. The increased "bulk" allows the urethra to close more effectively and prevents urine from leaking. The procedure can be performed in our office in approximately 30 minutes time.  A small optical instrument (cystoscope), placed in the urethra, is used to allow the urethra and bladder to be visualized while injecting the substance into the surrounding urethral tissue. Only a local anesthetic is needed.  Click here for more information on urethral bulking. 

InterStim Therapy.  One possible cause of overactive bladder (urge incontinence) is miscommunication between the brain and the nerves that control the bladder (sacral nerves), which can cause bladder control problems such as leaks, sudden urge to go, or going too often. Interstim Therapy is a minimally invasive neuromodulation therapy that targets the communication problem between the brain and the sacral nerves. The theory behind InterStim Therapy is that stimulation of the sacral nerves with mild electrical pulses will reduce the signals to the nervous system, which may reduce symptoms. Interstim has proven to be an effective treatment for incontinence well as interstitial cystitis, a painful bladder disorder that causes frequent urination. Click here for more information on InterStim Therapy. 

PTNS (Percutaneous Tibial Nerve Stimulation).  This is a non-invasive, painless treatment for urge incontinence, or overactive bladder. It is particularly helpful for women who cannot tolerate medications used to treat urge incontinence.  PTNS involves inserting a very thin needle electrode just above the ankle, close to the tibial nerve, and stimulating the nerve with a mild electrical impulse for 30 minutes. The electrical impulse travels up to the pelvic nerves involved in bladder control. Patients will feel a tingling or buzzing sensation, no pain. Treatments are continued twice weekly for 6 weeks. Symptoms are eliminated or improved in 75-80% of cases.  Click here for more information on PTNS. 

Pelvic Floor Therapy (Biofeedback).  This non-surgical form of therapy is used to retrain the pelvic floor and/or bladder muscles. It can be useful for treating either stress or urge incontinence. Typically, pelvic floor therapy consists of weekly sessions for 3 weeks, then every 2 weeks for the next 3 weeks. Using biofeedback techniques, our pelvic therapy nurse will evaluate your pelvic muscle strength and instruct you on how to properly isolate and exercise these pelvic floor muscles. A computerized measurement of your pelvuc floor contractions will be used to guide you and monitor your progress. Our pelvic therapy nurse will educate you in these techniques so that you can continue the exercises at home. Click here to learn more about pelvic floor therapy.

InTone Home Pelvic Floor Therapy InTone is a medical device that can help stop bladder leakage without pills, without surgery and without pain. You can treat your bladder leakage safely and effectively in the comfort of your home. InTone provides a combination treatment: vaginal muscle stimulation that strengthens the pelvic floor and inhibition of bladder spasms.  InTone uses biofeedback to improve your response.  Biofeedback refers to any treatment that gives you sensory-based cues to help you control your body’s responses. InTone gives you verbal coaching using the same directions that a therapist would use during a clinic visit.  You will strengthen your pelvic floor muscles by contracting as coached by the handheld control unit in combination with the deep muscle stimulation, all in the privacy of your own home.