Atlanta Center for Laparoscopic Urogynecology
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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
- Patient's age
- Patient's overall general health
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Incontinence Treatment