Stop Planning Your Day Bathroom To Bathroom
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. Urgency or urge urinary incontinence is not typically associated with exertion but occurs in response to the filling of the bladder with urine.
Dr. Zipper Explains Urgency Incontinence
Do I Have Urgency Incontinence?
Do you sometimes leak urine while getting out of the car in your driveway or while you’re trying to unlock your front door? Do you need to hurry to the bathroom because you might not make it there in time or do you lose urine while trying to get your pants off? If you’ve answered yes to any of the previous questions, you probably have Urgency Incontinence.
How Did I Get Urgency Incontinence?
Although Urgency Incontinence can occur with severe diseases such as Parkinson’s disease or multiple sclerosis and can occur following a back injury or a stroke, the vast majority of women who suffer from Urgency Incontinence have no identifiable cause.
Bladder emptying is predominately controlled by a spinal reflex. As young children undergoing potty training, we are taught to allow the brain to control this reflex. As we age the brain becomes less capable of controlling the bladder reflex. Additionally, microscopic injury to the pelvic nerves often occur at time of childbirth, hysterectomy, and other pelvic surgeries. The combination of aging and prior injury eventually leads to impaired control of the bladder emptying reflex. The result is uncontrollable bladder contractions perceived as urgency of urination and resulting in urinary incontinence.
Urgency Urinary Incontinence can really take the urge out of your life. Unlike Stress Urinary Incontinence, which is easily related to certain activities, Urgency Incontinence can be very unpredictable. Secondary to this, you might find yourself curtailing your fluid intake, limiting your time in the car, and eventually avoiding social activities. We don’t want you to stop drinking your coffee or seeing your friends! Our goal is to get you driving to Starbucks on your way to visit your out of town family and friends. Most of the time we are able to accomplish this without any surgery.
Not only do we offer every treatment for Urgency Incontinence, we offer treatments that are not available anywhere else in the southeast.
Did you know that Dr. Zipper was recently recognized as the number one urogynecologist for Interstim® in the world? Did you know that Zipper Urogynecology has one of the world’s largest databases on bladder Botox® therapy?
It doesn’t end there; the Zipper Urogyn team invented and holds the patent for Painless Laser Therapy™ for overactive bladder disease. We are certainly not the only place in the southeast capable of treating your Urgency Incontinence, but we do have a special level of experience and expertise.
Certain medications decease the bladder spasms responsible for urgency, frequency, and urgency incontinence. The majority of these medications fall into the class of Anticholinergics. While these medications are generally effective treatments for incontinence, they target Acetylcholine, the main neurotransmitter also responsible for a multitude of other body functions. This often results in unwanted side effects. Possible side effects include dry mouth, dry eyes, constipation, blurry vision, fatigue, and memory loss. A newer medication, Myrbetriq, is not an anticholinergic and is not associated with many of these side effects. It is our experience that approximately 50 percent of patients are happy with the results of drug therapy.
Bladder retraining is a mental game or exercise in which we help you retrain your brain to be in better control of the bladder reflex. Your brain has more to do with bladder control than you might think. Bladder Retraining has the ability to successfully treat mild to moderate symptoms of Urgency Incontinence and Overactive Bladder Disorder. During the Bladder Retraining process, you will record a diary to determine just how often you go to the bathroom to urinate. Following very specific rules, you are forced to increase the time between bathroom visits every three to five days by fifteen-minute intervals. Your compliance with the rules will have an enormous impact on the success of this treatment method. Though many patients significantly improve through Bladder Retraining, the time considerations and limited effectiveness of this treatment make it unattractive to many women.
Pelvic Floor 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.
InterStim, also referred to as sacral nerve stimulation or neuromodulation, is a tiny pacemaker-like device placed deep beneath the fatty tissue of the upper buttock. This little pacemaker sends gentle calming impulses to the nerves of the overactive bladder. Approximately 80% of women are successfully treated with the InterStim device.
A great quality of this treatment option is that you are able to try a temporary one before you commit to the implant procedure. You will wear a temporary gentle nerve stimulator on your waist for two days. If the two-day test results in drastic improvement in your symptoms, we will then proceed to place the Interstim device with great confidence. The implantation procedure is completed in approximately fifteen minutes under gentle sedation. As noted above, our team is among the most experienced InterStim implant teams in the world and our entire staff is trained in InterStim management.
We all know that Botox can make your face look younger, right? But did you know that Botox could make your bladder feel younger? Botox reduces the wrinkles in your face by weakening the muscles beneath the skin responsible for frowning. By weakening the muscles in the wall of the bladder, Botox decreases the bladder contractions responsible for Urgency Incontinence. Unfortunately, sometimes this effect is too strong and can lead to a temporary inability to urinate. Within our practice, we have found that 3-5% of women may need to temporarily catheterize.
We have also found that 5-10% of our patients will develop recurrent urinary tract infections following Botox injection. The good news is that the majority of our patients will experience three to five months of significant improvement in their Urgency Incontinence without any significant side effects. The Botox injection is performed through a cystoscope in a five-minute procedure. You will be able to drive yourself home, as there is no recovery period.
Painless Laser Therapy™
This is a form of low-level laser therapy. That means that there is no significant heat or pain associated with treatment. A small probe is placed into the vagina for a series of five-minute treatments performed over several weeks. The Painless Laser Therapy method and laser were developed and patented by Dr. Zipper and his colleagues.
Painless Laser Therapy is still considered experimental and offered under our ongoing IRB approved clinical trial. We have performed this therapy over the last 4 years without any side effects or complications.
Other therapies include Tibial Nerve Stimulation, Drug Therapy, and Bladder Retraining.