Proper Diagnosis of Urinary Incontinence
Loss of urine is a very common problem of women. A recent survey found that 29% of women actually have some leakage of urine although very few offer it as a complaint. In fact, many women are extremely embarrassed by it and it has caused diminished the quality of life for far too many women. Many believe it is simply a fact of life that must be endured as they age. Many believe it only occurs in women after menopause. Neither of these could be further from the truth. Loss of urine, other as the result of coughing, sneezing, laughing, or exercise, may be related to anatomic problems but the causes can be quite varied. Many years ago, the only approach to treatment was surgical and quite extensive surgery at that. Today the therapeutic approach totally depends on the exact nature of the problem - Is the urethra too mobile? Is the bladder unstable? Is the sphincter of the urethra defective? Or is there some neurological component? Proper diagnosis is essential before assigning appropriate therapy. There is currently medication for unstable bladder; drugs to treat genuine stress incontinence are in phase III trials. Less invasive surgeries that may soon be no more involved than a colonoscopy done under conscious sedation, been developed and are being perfected. Special exercises, bladder retraining, and voiding strategies now exist. HOWEVER, IT ALL STARTS WITH PROPER DIAGNOSIS!
Our office is now performing multichannel urodynamic testing to make the correct diagnosis. This is a painless 10-minute procedure performed by a special nurse. The patient starts with a full bladder and voids into a special commode that measures volume and velocity of urine flow. Then a tiny catheter is inserted in the bladder. It is half the size of a traditional catheter used during surgery or after childbearing, and is painless. It can measure the pressure in the bladder and urethra. The bladder is then filled and the pressures measured. The patient is then asked to cough and bear down at various points during bladder filling. Urethral pressures are measured as well. Finally, the patient voids again. The urodynamics test is covered by all insurances including Medicare. If you have urinary issues, please bring them to Dr. Goldstein's attention. You so not have to merely "live with it".
The urodynamic test is covered by all insurances including Medicare. If you have urinary, issues please bring them to Dr. Goldstein's attention. You do not have to merely "live with it."
©2004 Steven R. Goldstein, M.D.
