At Lahey Hospital & Medical Center’s Continence Center, we offer a wide variety of surgical and nonsurgical treatments for urinary incontinence and conditions affecting continence. Here is a look at some of them.
Treatments for Urinary Incontinence
The purpose of this procedure is to create a “hammock” to support the urethra and prevent it from opening when you cough, sneeze or laugh. This procedure is minimally invasive and performed in an outpatient setting. At Lahey’s Continence Center, we have achieved excellent results with this pubovaginal sling.
Bulking substances, which are specially formulated artificial materials, may be injected in the urethra to provide bulk and support in order to reduce the effects of stress urinary incontinence. The injection procedures are performed in the office setting under local anesthesia.
This procedure involves implanting an electrical stimulator into the body that sends impulses to the sacral nerve, which controls the bladder. This helps target the communication problem between the brain and the nerves that control the bladder.
In this procedure, similar to sacral neuromodulation, electrical stimulation is delivered to the tibial nerve and travels to the sacral nerve, which controls the bladder.
OnabotulinumtoxinA (Botox) is an FDA-approved therapy for certain patients with overactive bladder. Botox is injected into the bladder muscle through the urethra either in the office or under conscious sedation in the operating room.
This is a reconstruction procedure to reduce the bladder’s internal pressures and increase its capacity. It is performed for patients whose incontinence has resulted from conditions such as spina bifida, spinal cord injury, multiple sclerosis, radiation cystitis or congenital (inherited) conditions.
Complete removal of the prostate through surgery may cause urine leakage in some men. For men with significant leakage, the urethral sling procedure may be an option. It involved placing a small piece of material to gently compress the urethra and increase its resistance.
Men with moderate to severe urinary incontinence after prostate cancer surgery may require an artificial urinary sphincter. This device is placed internally, with a pump that controls the flow of urine from the body.
Treatments for Conditions Affecting Continence
Urologists at Lahey’s Continence Center are highly experienced in performing innovative procedures to treat conditions that affect continence. Here are some examples.
For pelvic organ prolapse:
- Vaginal repair (non-mesh-based)
- Sacrocolpopexy (open or robotic-assisted)
For vesicovaginal fistula:
- Vaginal corrective repair
- Abdominal corrective repair
For interstitial cystitis:
- Diagnostic cystoscopy and hydrodistension
- Guidance for bladder instillation protocols