Stress Incontinence and Urodynamics
Stress incontinence, which is the loss of urine with increased intra-abdominal pressure (such as straining or coughing), is most commonly found in women who have had more than one child because they may have lost muscular support at the bladder outlet.
Symptoms. Symptoms include loss of urine when coughing, sneezing, bending over, or lifting or when participating in sports or other active exercise.
Diagnosis. Diagnosis involves a history and physical examination (including pelvic examination), and, in most cases, urodynamic studies.
Treatment. Treatment options include pelvic muscle exercise, medication, bladder training, vaginal pessaries, electrical stimulation, biofeedback, and surgery.
Slings are created by placing a piece of tissue around the weakened area of the urethra to strengthen the sphincter muscles that are responsible for holding the urine back when straining.
In some instances, material is injected directly into the urinary sphincter to attempt to strengthen the sphincter muscle.
The artificial urinary sphincter, or AUS, is an implantable medical device that provides the best surgical option for control of urinary stress incontinence, especially following prostate surgery. The surgery to place an artificial urinary sphincter takes approximately an hour and a half. An overnight hospital stay is required to administer intravenous antibiotics. The majority of patients are discharged the morning after surgery.