There are many causes of urinary incontinence, so Individualized treatment is the best way to go. Doctor Miklos and Doctor Moore are world renowned urogynecologists and can find out the real reason for your problem and fix your problem based on your issues so you can live a worry-free life. Treating this is a top priority for Doctors Miklos and Moore.

Female urinary incontinence (urinary leakage) refers to the involuntary loss of urine from the bladder. Bladder control problems affect about 17 million people in the United States. It can be a cause of anxiety, social embarrassment and may limit ones social and daily activities. Fortunately, most of these conditions can be treated, however the first step to curing this condition is acknowledging the problem and then deciding to see a physician who has been properly trained in treating the condition of incontinence.

Many patients have a combination of incontinence types. The two main types of include:
1. Urgency (overactive bladder) – is when you have difficulty maintaining your urine on the way to the restroom. Urgency incontinence is usually treated with medication.
2. Stress Urinary Incontinence (activity related) – loss of urine during coughing, sneezing, laughing or with other physical activities such as exercise, jumping, running, etc.

Stress urinary incontinence occurs almost exclusively in women and is thought to be due to “pelvic (vaginal) relaxation” from childbirth or aging. Excessive weight can also be a contributing factor. Urinary leakage can be a major quality of life concern and one that women do not like to talk about. There are excellent minimally invasive treatment options available to women.

Laparoscopic Burch Procedure
The Burch procedure is an incontinence surgery that has stood the test of time and is currently considered one most curative operations for the treatment of bladder leakage. The Burch procedure has remained one of the top 2 surgeries in the treatment of stress urinary incontinence since the 1960’s. In 2008 and 2011 the FDA issued warnings on the use of transvaginal meshes (which excludes TVT, TOT and mini slings). We have seen an increase in patients who request the Burch procedure. The patients who are asking for the Burch procedure are doing so specifically because they fear the potential complications associated with mesh slings.

Tension-Free Vaginal Tape (TVT) Sling
Normally, the urethra, when properly supported by strong pelvic floor muscles and healthy connective tissue maintains a tight seal to prevent involuntary loss of urine. The TVT ‘s support for incontinence primarily consists of a mesh-like tape that is surgically inserted through the vagina to support the bladder neck and urethra.

The TVT sling procedure is appropriate for many types of patients, including overweight women and patients who have previously undergone other operations for incontinence. However, experience on the part of the surgeon is especially necessary if the patient has undergone other operations in the past for incontinence. The passage of the TVT sling device can be much more difficult in patients with previous incontinence surgery due to the severe amount of scarring which occurs after such type of incontinence surgery.

Transobturator (TOT) Sling
Making its debut in France in 2001, the transobturator sling procedure (TOT sling) was considered to be the second generation of mesh sling procedures. This device, like the TVT device, is also placed through a vaginal incision but exits the pelvis through small groin incisions. Though this technique showed promise with cure rates equivalent to the TVT sling and the Burch procedure, Drs. Miklos & Moore no longer offer this technique except for in very rare and unique patients.

The rare risks involved with this technique including groin and leg pain can be devastating. When leg pain is this severe, the sling should be removed immediately. Over the last 10 years Drs. Miklos & Moore have removed dozens of these slings form the groin and they consider this type of removal, to be one of the hardest operations they perform. Their opinion is that the TOT sling should be reserved for the unique and rare patients.

Mini Sling
The Single Incision Sling (SIS) is a smaller sling delivered through a single incision site via the vagina. Unlike the TVT and TOT slings that require three incisions, the SIS requires just one small ¾ inch incision. The mini sling was produced in an attempt to maintain cure rates yet minimize pain, blood loss, and voiding dysfunction post operatively.

Doctors Miklos and Moore are experts in the field of urogynecology and treating urinary incontinence in women. If you’re suffering, contact us today for more information!