Treating Incontinence (part 3 of 3)

Written by Dr. Jeremy Lieb Thursday, 17 May 2012 14:52

When treating incontinence, it is important to remember that each patient has different needs and responses to treatment. All diagnoses and treatment plans are only prescribed after a thorough patient evaluation. Wehave found great success with some of the treatment options listed below.

Bladder Sling
For patients whose incontinence is a result of stress being placed on the bladder (stress incontinence) this 15- to 30-minute minimally invasive procedure is highly effective. A mesh sling, made of the same material as thesutures used in surgery, is placed underneath the bladder restoring its height and removing pressure.

Interstim®Therapy
In patients who suffer from an overactive bladder (urge incontinence), this 30-minute minimally invasive treatment can solve the problem. Bodily functions such as urination require communication between the brain and body in order to assess when it is time for a trip to the restroom,which occurs naturally through electrical impulses between the body and brain via the sacral nerve system located at the base of the spine. When electrical impulses are not received by the brain or organs, the body does not communicate properly and accidents result.

Interstim therapy restores communication between the bodyand brain by delivering soothing electrical pulses to the sacral nerve system.To accomplish this, a urologist inserts a small device the size of a silver dollar under the skin of the lower back. This is an outpatient procedure done in the hospital under local anesthesia and IV sedation.

Medication
Patients suffering from urge incontinence may find great relief through prescription medication that relaxes bladder muscles and reduces bladder contractions.

Botox Injections
Placing Botox injections in the bladder blocks the release of chemicals that cause muscle spasms and incontinence issues, providing a minimally invasive option offering fast results.

There are many ways to treat incontinence, so you don’t need to suffer needlessly. We work hard to stay up-to-date on the latest procedures and treatment options in order to provide the most convenient, minimally invasive solutions to your urological issues. To learn more about how we can help, call our offices to make an appointment with our experienced board certified urologists.

Diagnosing Incontinence (part 2 of 3)

Written by Dr. Jeremy Lieb Tuesday, 17 April 2012 22:53

The first step in treating incontinence is a diagnosis. There are two main types of incontinence which require different methods of treatment: stress incontinence and urgency incontinence. Patients may have one type of incontinence, but it is also common to have both, depending on medical circumstances.

Stress Incontinence: Urinary incontinence occurs after the bladder experiences involuntary pressure during activities such as laughing, sneezing, lifting, straining or coughing.

This type of incontinence is common in women who have experienced childbirth, and is highly treatable. The stress that pregnancy can place on the vagina, pelvic floor muscles and ligaments holding the bladder can cause the bladder to lower and place additional pressure on the urinary system, resulting in stress incontinence.

Urgency Incontinence: Urinary incontinence occurs unexpectedly, and is triggered by surroundings or circumstances, accompanied with the frequent urge to urinate regardless of how full or empty the bladder may be.

Examples of urge incontinence triggers are feeling the uncontrollable urge to urinate upon hearing running water or drinking a small amount of water. Those with urge incontinence may also suffer from loss of bladder control while sleeping. Inappropriate bladder contractions are a common cause of urge incontinence, which can be triggered by abnormal nerve signals in the body.

Damage to the nervous system (spinal cord and brain) as well as nerve or muscle damage to the bladder affects urinary control. This damage can occur as a result of surgical treatment, Multiple Sclerosis, Parkinson's disease, Alzheimer's disease and stroke. Medical conditions such as hyperthyroidism and uncontrolled diabetes may also cause urge incontinence.

For information on additional incontinence types such as Overactive Bladder, Functional Incontinence and Overflow Incontinence, visit Kinds of Urinary Incontinence.

Check back soon for the final piece of this three part series...

Understanding Incontinence (part 1 of 3)

Written by Dr. Jeremy Lieb Friday, 16 March 2012 17:56

Does an unexpected sneeze or cough cause an even more unexpected problem – leakage? Do normal activities like rolling out of bed, hitting a golf ball or laughing cause urinary loss? Does the urge to urinate come seemingly out of nowhere and cause an uncontrollable need to flee for the nearest restroom?

We understand that experiencing this problem can cause frustration and anxiety. Incontinence is very common, but it is often a problem that people suffer through in silence. Sadly, many people may defer treatment because they feel embarrassed or ashamed to address the issue.

But incontinence sufferers are not alone. According to the National Association for Continence, there are more than 200 million people worldwide with incontinence. The majority of those diagnosed are women, with research showing that “one in four women over the age of 18 experience episodes of leaking urine involuntarily.”

The question we hear most from patients suffering with incontinence is “Why does this happen?” Our patients are accustomed to living independent, activity-filled lives, and this unexpected loss of control makes them feel betrayed by their bodies.

The causes of incontinence vary from patient to patient. Some patients are predisposed due to genetic makeup while others experience incontinence after prostate cancer treatment, stroke, Parkinson’s diagnosis, or neurological trauma.

Many women experience incontinence issues after pregnancy, childbirth or menopause. For others, age has affected the communication strength between their brain and urinary system. Patients may also experience incontinence as a response to certain foods, drinks and medications.

The good news is that regardless of the cause, at Pacific Urology we can prescribe a course of treatment that will restore control and comfort to your daily life.

Check back soon for Part two of this three part series...

PSA Screening in Men Less than 50 years old

Written by Dr. Jeremy Lieb Thursday, 02 June 2011 17:22

We've got it backwards. Recent studies have found that we focus a good deal of attention on screening for prostate cancer in men in their 70's-80's, but not enough attention on men in their 40's.

The PSA blood test is an excellent marker for prostate problems, including prostate cancer. This is a routine yearly blood test. The problem is that many men in their 40's and 50's don’t see a doctor on a regular basis. Too many of us wait until we’re older and start having medical problems.

A recent study showed that a single PSA blood test obtained from men in their 40's can predict risk for dying of prostate cancer. Men between the ages of 45-49 with a PSA value above 1.5 will account for almost half of the prostate cancer deaths over the next 30 years. The message? Don't wait too long. Get your first PSA test now!

Coffee Intake Reduces Prostate Cancer

Written by Dr. Jeremy Lieb Thursday, 26 May 2011 17:20

Okay, I have to admit it. The first time I read this report, I concluded that somehow in our polluted society a famous national coffee company had convinced the world that we need to drink more coffee. Then I started to think about the information the study presented.

The findings showed that people who drink six or more cups of coffee a day have a reduced risk of prostate cancer. (I wonder how many of these caffeine fiends had a heart attack during the time needed to complete this study?)

Coffee definitely has some medicinal value. It’s a well-known anti-oxidant and may have anti-cancer effects. It has been associated with a reduced risk for Diabetes and helps regulate insulin levels. This is an important point, since insulin intolerance and obesity has been associated with a higher risk for prostate cancer.

Perhaps the sequence of events is coffee=better insulin regulation=less prostate cancer. My strongest recommendation for reducing prostate cancer risk continues to be healthy diet and exercise. I will continue to drink my regular 1-2 cups of coffee in the morning, and won't be increasing my daily intake more than six cups a day. Now I’m waiting for the study which shows that drinking more than six beers a day increases risk for prostate cancer, because it reduces insulin regulation and increases body weight.