New Treatment for Incontinence Could be the Answer
When you have to go, you have to go. But how often should that be? And
what if you can’t seem to make it to the bathroom in time? Whether
it’s just leaking a few drops when you laugh or having an urge to
urinate that is so sudden and strong you leak a large amount, urinary
incontinence is a common problem among women. But now there is a relatively
new procedure that can help called tibial nerve stimulation.
“There are two primary types of urinary incontinence for women,”
explained Dr. Alison Slack, MD, a local gynecologist with Washington Township
Medical Foundation and member of the Washington Hospital medical staff.
“One is called stress incontinence, where you might leak a little
urine when you cough, sneeze, or lift something heavy. The other is called
urge incontinence or overactive bladder, and that is when the bladder
muscle contracts when it’s not supposed to causing an overwhelming
urge to urinate. The newer procedure can effectively treat urge incontinence
for many women, without side-effects.”
Stress incontinence generally happens as women age and the muscles that
hold up the bladder weaken over time. Pregnancy, child birth, and some
surgeries can contribute to it, according to Dr. Slack. Childbirth can
stretch or damage the pelvic floor muscles and nerves.
Urge incontinence is caused by abnormal bladder contractions, she explained.
Urine is stored in the bladder and then leaves the body through a tube
called the urethra. Muscles in the wall of the bladder contract to force
urine out through the urethra. At the same time, sphincter muscles around
the urethra relax to let urine pass through it. With urge incontinence,
the muscles of the overactive bladder contract with enough force to override
the sphincter muscles and urine is able to pass through the urethra.
“It can happen at any age, but it’s more common as we get older,”
Dr. Slack said. “Muscles and nerves become more unstable as we age.
But there doesn’t seem to be any common cause for it.”
There are several treatment options available, but they are not always
effective and most are either invasive or have side-effects, according
to Dr. Slack. For example, Kegel exercises can help to strengthen the
pelvic floor muscles, which hold in the urine. Bladder retraining is another
option, which entails going to the bathroom at set times before you have
the urge to urinate. But these are not always effective for some women.
Surgery is another option, but it is invasive.
“The primary way we have treated urge incontinence up until recently
is through medication,” Dr. Slack said. “But many patients
are not compliant. The medication has side-effects like dry mouth, dry
eyes, and constipation. However, tibial nerve stimulation can be very
effective, is not invasive, and has no known side-effects.”
The tibial nerve goes from the lower back, down the leg and into the foot.
Stimulation of this nerve in the foot can stimulate the pelvic nerve roots,
which also control the bladder, she explained.
“When we stimulate that nerve, over time it can reprogram the bladder,”
Dr. Slack added. “Studies show that most people see significant
improvement of bladder symptoms over time.”
Patients undergo weekly 30-minute sessions for 12 weeks. An acupuncture
needle is inserted near the ankle and it is attached to an electric stimulator.
A small electrical current stimulates the nerve.
“It doesn’t hurt, and for many of my patients, it’s very
meditative,” Dr. Slack said. “Patients lie down and we turn
off the lights. They lay there and relax as the electric current stimulates
the nerve. Most patients see a noticeable improvement after eight to 10
weeks. There is a significant benefit with really no risks or side-effects.
It won’t make you feel bad and you don’t have to take a pill
every day. There is an initial time commitment, but the results are impressive.”
For more information about other programs or services at Washington Hospital
that can improve your health, visit www.whhs.com.