Dr. John Miklos & Dr. Robert Moore
Atlanta Center for Laparoscopic Urogynecology

* Atlanta Center for Laparoscopic Urogynecology promoting the highest standards for gynecology surgical care for women.     * Atlanta Center for Laparoscopic Urogynecology promoting the highest standards for gynecology surgical care for women*

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  (Cystocele)

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Atlanta Center for Laparoscopic Urogynecology
Dr. John R. Miklos
M.D.,F.A.C.O.G.,F.A.C.S.,F.I.C.S.

Dr. Robert D. Moore
D.O.,F.A.C.O.G.,F.I.C.S.

3400C Old Milton Parkway
Alpharetta (Atlanta)
GA 30005

Phone 770-475-4499
Fax 770-475-0875

www.tvtsling.com
www.anewvagina.com
www.mmedicalspa.com
Atlanta Center for Laparoscopic Urogynecology
Incontinence Treatment
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Incontinence Treatment >>

SANS UNIT - Percutaneous Ankle Nerve Stimulator

Incontinence Treatment
Incontinence Treatment  Figure: 1
Incontinence Treatment  Figure: 2

The FDA has recently approved a new minimally invasive method of peripheral nerve stimulation, which affects bladder control. The device works via a needle placed near the ankle about three fingerbreadths above the inside anklebone. The needle ties in with the tibial nerve, which ascends to the sacral (tailbone) nerve complex. The percutaneous Stoller Afferent Nerve Stimulation System (perQ SANS UNIT) is low-frequency electrical stimulation that is applied for 30 minutes once a week for approximately 12 weeks. After this initial trial of therapy, the patient's therapy is repeated from every week to every other or every third week, depending on the patient response.

Clinical trials have suggested success rates as high as 80%. Success was defined by study design as at least a 25% reduction from baseline in daytime or nighttime frequency. Side effects from the treatment were classified as transient and resulting from insertion of the very fine needle. No serious adverse results have been reported.

Incontinence Treatment
Incontinence Treatment  Figure: 3





SANS Unit
- An acupuncture needle is placed in the nerve behind the ankle and is stimulated to modulate nerve impulse going to the bladder from the sacral nerves.

Download a SANS Procedure brochure by Clicking here.

Overflow Incontinence Treatments

Overflow incontinence in men commonly occurs due to benign prostate hypertrophy (enlarged prostate). This condition causes obstruction to the urethra and inhibits complete emptying of the bladder. Women do not have a prostate but can have overflow incontinence because of:

Poor bladder contractility
Bladder neck obstruction due to uterine/vaginal prolapse
Bladder neck obstruction due to strictures (rare)
Bladder neck obstruction due to previous anti-incontinence surgery

Clean Intermittent Catheterization

For certain patients, the bladder has limited or no ability to contract to empty. These patients include those who may have neurological diseases as well as other diagnoses. Since the bladder muscle has weakened too much, it is important to empty the urine to prevent either infection or kidney damage as well as decrease the irritative voiding symptoms of frequency and urgency or urge incontinence. These patients learn to catheterize themselves on a schedule usually two to four times a day. They use a small, clear, flexible catheter that is much softer than catheters used in the hospital setting. The procedure is done with clean, not sterile, technique and is best learned by sense of touch and not by use of mirrors.

Vaginal Prolapse Treatment - Improving Bladder Neck Obstruction

Severe uterine and vaginal relaxation can cause a kinking of the urethra at the bladder neck. These patients will not be treated effectively by urethral dilation. The kinking of the urethra and bladder neck must be removed. This can be accomplished by using non-surgical management (i.e. pessary) or by surgical correction of the vaginal prolapse. The surgery procedure chosen is dependent upon:

Area specific for the prolapse
Desire to maintain fertility (maintain uterus)
Desire to maintain sexual function
Patients age
Patients overall general health


:: Incontinence Treatment ::  

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