Continence Treatments

A number of treatments are available, depending upon your individual circumstances. These include the following

Neuromodulation involves applying electrical impulses to stimulate fine nerve tracts in the sacral nerves, as this is where the nerve tracts and reflexes of the urinary tract come together. Fine electrodes are placed on the sacral nerves in the small pelvis either through the skin or laparoscopically and connected to a battery-powered stimulator. Stimulation is then applied in a test phase lasting a number of days and the success ascertained.

Bladder problems and involuntary leakage of urine can be treated effectively with medication. The correct selection and dosage of the agents together with an assessment of their risks and limits for each individual concerned are the prerequisite for successful, treatment without side-effects. This requires neurourological experience.

This involves the administration of liquid medicines into the bladder. A catheter is placed temporarily in the bladder, either by the patients themselves or someone assisting them or a catheter permanently positioned in the bladder is also suitable.

Instillation treatment of the urinary bladder

Unfortunately it is not possible to successfully treat incontinence and functional disorder of the urinary tract in every case, but most sufferers can control incontinence using suitable aids. The ability to maintain normal outward appearance helps to maintain a person's quality of life and self-confidence. The choice of aids stretches from urine flasks and incontinence pads through to various models of catheter, based on individual circumstances and needs.

Urinary incontinence surgery

Injection treatment with botulinum toxin (Botox)

Medication treatment

Continence Treatment Centres

Using the catheter the bladder is first emptied and then filled with the liquid containing the medicine, bringing it into contact with the internal wall (mucosa) of the bladder. This is generally pain-free; the patient feels merely a brief sensation of coldness. Bladder instillation is employed primarily in cases of overactive and painful bladder syndrome (interstitial cystitis).

Botulinum toxin has been used to treat bladder dysfunctions, including overactive bladder, for around 10 years.

Pelvic floor therapy

Training the pelvic floor muscles is a highly effective way of countering urinary incontinence without side-effects and biofeedback and electrical stimulation are seen as a complement to this.

If the makeup of the bladder and/or urethral sphincter mechanism is damaged, or conservative, or medication-based measures do not result in the desired success, surgery may be an effective option.

Neuromodulation and neurostimulation

Since stimulation has a modulating effect on the reflex pathways, it can be used to treat a series of different functional disorders of the bladder. Thus, the procedure is of equal help to patients with overactive and underactive bladders. If the patient benefits from the stimulation, a stimulation system can be fully implanted just like a pacemaker.

Incontinence advice and continence aids

First, the internal wall of the bladder is desensitised using a local anaesthetic. During a cystoscopy, the toxin is then injected into the bladder wall from inside. The agent takes effect after five to seven days, stabilising the overactive bladder muscle for up to twelve months. The injection may be repeated if the symptoms recur.

The simplest method is visualisation of the urethra in an ultrasound scan, showing the proper way to contract the muscles and how to correct this. Devices for biofeedback training use a probe in the vagina or the intestine to measure the activity of the pelvic floor muscles and show this on a chart. Some devices can also deliver electrical impulses that train the pelvic floor muscles by stimulating the vagina.

Specialist Treatments < Continence < Continence Treatments

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