Urinary Incontinence

Stress Urinary Incontinence
Are You Ready To Take Back Control?

Urinary Incontinence is even more common than high blood pressure, and is much more likely to ruin your day. There are two main categories of Urinary Incontinence; Stress Incontinence and Urgency Incontinence, and many women have both. Stress urinary incontinence does not mean you have urinary incontinence when life becomes stressful. Stress urinary incontinence is a type of urinary incontinence that occurs with exertion or physical stress on the pelvis.

Dr. Zipper Explains Stress Urinary Incontinence


Do I Have Stress Urinary Incontinence?

If you lose urine while participating in daily activities such as coughing, laughing, sneezing, walking briskly, running, or exercising, you likely have Stress Urinary Incontinence (SUI).

How Did I Get Stress Urinary Incontinence?

Stress Urinary Incontinence is not contagious or genetic, so you didn’t catch it from the lady sitting next to you on the plane, and you didn’t inherit it from your mother. You can thank your children for this, as they are typically the culprits. SUI is caused by damage or stretching to the pelvic floor and the most common cause of stretching is vaginal childbirth.

Other causes of damage to the pelvic floor that contribute to the onset of SUI include hysterectomy, vaginal surgery, obesity, and smoking. As you age, so do the supporting vaginal tissues. The more of these risk factors you have, the more likely you are to have Stress Urinary Incontinence.

 

Our Thoughts

Stress Urinary Incontinence can put you on the sideline. First, you start wearing pads. Then, you require heavier pads. The next thing you know, you are no longer participating in the daily activities that you enjoy. When SUI is left untreated, heavy pads may not cut it for long.

At Zipper Urogyn, we want to get you back in your dancing shoes, back on the tennis court, and back to laughing, and sneezing without crossing your legs. We can get you there, sometimes with just a five-minute office procedure. We encourage you to do your research before choosing your specialist, and always consider a second opinion before selecting a surgeon to operate on you.

 

Our Treatments

 

Our TreatmentsAs a national referral center for female pelvic medicine and reconstructive surgery, we offer every available SUI treatment. Our team has performed over five thousand sling surgeries, trained surgeons from around the globe, performed thousands of urethral injections, and even invented some of the devices and methods currently used worldwide.

 

Mid-Urethral Slings

If you watch TV , listen to the radio, or read the newspaper, you may find yourself wondering, “Is this that horrible vaginal mesh thing?” The answer is both yes and no. In 2011, the FDA issued what we believe to be a very appropriate warning with regard to the use of polypropylene mesh (PPM) in vaginal prolapse surgery. This warning was not for polypropylene mid-urethral slings. The polypropylene mesh sling remains the most common surgery used to treat stress urinary incontinence.

As noted above, synthetic slings are made out of polypropylene mesh. Therefore, all of the complications associated with transvaginal mesh can also occur with PPM slings. As a national referral center for complications of mesh surgery, we have gained unique experience with PPM. We have learned that many women with stress urinary incontinence are not candidates for transobturator PPM slings and some are not candidates for any type of PPM sling. We a have also developed methods for quickly and effectively treating PPM sling complications. In the hands of the right surgeon, cure rates may exceed 90% and complications rates can be less than 1%. However, remember that this is mesh and in the hands of the wrong surgeon, the complications can be common and serious.

This is a fifteen-minute outpatient surgery performed through a small vaginal incision and two fingernail sized incisions on the skin of the pubic area or vulva. You will need to avoid strenuous activity and intercourse for four weeks. You will be able to drive and partake in non-strenuous activities the day following your procedure.

Urethral Injections

Urethral injections are two-minute office procedures performed through a small cystoscope. The injected materials are typically synthetic and similar to those used on the face by plastic surgeons. We most commonly inject Coaptite® and Macroplastique®. Patients describe minimal discomfort.

Unlike the sling surgery, you will have no post-procedure restrictions. The procedure does not involve cuts or stitches. You can return to your desired activities immediately. When performed correctly, the injected material squeezes the walls of the urethra together just enough to prevent accidental loss of urine, but not enough to prevent urination, so it is essential that you select your urogynecologist carefully.
We recommend choosing a specialist who performs a minimum of 50 injections each year. This information may be available through manufacturers of the injection materials such as Boston Scientific and Uroplasty.

Physiotherapy

As many as 80% of women experiencing Stress Urinary Incontinence achieve significant improvement through pelvic floor physiotherapy. But did you know that as many as 80% of women doing Kegel exercises are actually doing them incorrectly?

Although there is no shortage of physical therapists simply dabbling in pelvic floor therapy, your interest is best served by seeking treatment by a full-time expert in pelvic floor physiotherapy. Dr. Sherri Lorraine, our director of pelvic floor physiotherapy, is central Florida's only dual doctorate pelvic floor physiotherapy. Dr. Lorraine will provide hands-on teaching that will enable you to perform numerous exercises to improve pelvic tone. For most women, this will lead to an improvement in bladder function, bowel function, and sometimes even sexual life.

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