Cystoscopy and ureteroscopy are common procedures performed by urologists to take a closer look at the urinary tract. These procedures are helpful for diagnosing and treating issues related to the bladder, urethra, kidneys, and ureters.

What is a cystoscopy? 

A cystoscopy involves using a small tube, called a cystoscope to examine the urethra and bladder. The procedure is quick, usually lasting between 5 to 30 minutes, depending on whether sedation or anesthesia is used. 

What is a ureteroscopy?

A ureteroscopy uses a ureteroscope to look inside the ureters and kidneys. This procedure typically lasts between 30 minutes and a couple of hours. However, if additional treatment is required, the procedure may require an overnight hospital stay.  

When is a cystoscopy needed?

Urologists may recommend a cystoscopy to investigate the cause of incontinence or other urinary issues, such as: 

• Frequent urinary tract infections 
• Blood in the urine (hematuria)
• Urinary retention
• Difficulty urinating or pain during urination 
• Finding abnormal cells in urine samples 

During the cystoscopy procedure, the urologist can spot stones, any abnormal tissue or tutors, stricture, and other abnormalities. They can also treat certain conditions by:

• Removing a bladder or urethral stone 
• Remove or treat abnormal tissue and tumors
• Treat urinary leakage or prevent vesicoureteral reflux
• Gather urine samples from the ureters

Cystoscopy for incontinence 

For patients dealing with incontinence, a cystoscopy can help doctors examine the bladder and urethra more clearly. This allows them to identify potential causes, such as bladder stones, tumors, or an enlarged prostate. Urologists are also able to treat the bladder wall and remove any abnormal tissue.

When is a ureteroscopy necessary?

Urologists perform ureteroscopy to investigate urine blockages in the ureters, or to look for other issues in the ureters or kidneys. During the procedure, they can:

• Spot stones or abnormal tissue 
• Remove stones from the ureters or kidneys 
• Treat abnormal tissue 
• Take samples of the ureter or kidney tissue 

Recovering after a cystoscopy and ureteroscopy 

Most patients can go home on the same day as the procedure, depending on the type of anesthesia used. Before you leave, your medical team will ask you to use the restroom to ensure you can urinate comfortably. They will also provide guidance on rest, driving, and which physical activities to avoid while recovering.

After the procedure, you might experience some mild symptoms, which can include: 

• A slight burning sensation when urinating
• Small amounts of blood in your urine 
• Mild discomfort around the bladder or kidney area
• Increased urgency or frequency of urination

These symptoms typically subside within 24 hours. However, if you experience severe bleeding, pain, or if symptoms persist beyond a day, reach out to your healthcare provider right away.

Post-procedure Care Tips 

Your healthcare provider might recommend a few simple steps to help you feel more comfortable after your procedure. They may recommend to:

• Drink water regularly for the first few hours 
• Take a warm bath to soothe any burning sensations 
• Use a warm, damp washcloth on the urethral opening if you’re feeling discomfort
• Consider over-the-counter pain relief if needed

Find Relief with Incontinence Institute

Cystoscopy and ureteroscopy are valuable procedures that help urologists diagnose and treat a variety of urinary tract issues. While the procedures are generally quick and straightforward, it’s important to understand what to expect during recovery and how to manage any discomfort. If you’re experiencing symptoms of incontinence and want to explore these procedures, don’t hesitate to contact our team.

Pelvic floor dysfunction occurs when a person has difficulty controlling the muscles within their pelvic floor. A person with pelvic floor dysfunction will experience problems with urination, bowel movements, and sexual intercourse. 

Where is the Pelvic Floor?

The pelvic floor is a set of muscles and ligaments that support many of our organs. These muscles support the bladder, urethra, prostate (men), vagina and uterus (women), anus, and rectum. The pelvic floor also offers general support to the intra-abdominal contents.

Symptoms of Pelvic Floor Dysfunction

There are many symptoms associated with pelvic floor dysfunction. They include:

• Difficult urination: pain or delay in urinary stream
• Urinary incontinence: uncontrolled urine leakage 
• Fecal incontinence: uncontrolled bowel movements
• Long term constipation
• Lower back pain: unexplained chronic pain not caused by injury or illness
• Pelvic pain or chronic pain lasting more than 3-6 months

What Causes Pelvic Floor Dysfunction?

The exact causes of pelvic floor dysfunction continue to be researched. Though not well understood by the medical community, there are known conditions and events that weaken the pelvic muscles and/or tear connective tissue. These events include:

• Pregnancy and childbirth
• Traumatic injury to the pelvic region
• Overusing pelvic muscles
• Pelvic surgery
• Nerve damage 
• Aging 
• Diagnosing pelvic floor dysfunction 

Your medical provider will review your medical history, observe your symptoms, and perform a physical exam. Doctors may perform an internal exam, or use electrodes on your perineum, to check for pelvic muscle control and pelvic muscle contractions. 

Treatments for Pelvic Floor Dysfunction

There are many ways to help treat pelvic floor dysfunction. Some people find relief with relaxation techniques like meditation, warm baths, and yoga. Physical therapy, medication, and trigger point injections are also great treatment options to relax pelvic floor muscles. Another common treatment is biofeedback therapy. 

What is Biofeedback Therapy?

Biofeedback therapy is the most common treatment for pelvic floor dysfunction, usually used in tandem with physical therapy. During biofeedback therapy, special sensors monitor and track muscle activity. A trained nurse or physical therapist inserts a probe into the patient’s anal sphincter and places sticky pads on the abdomen. They will ask the patient to contract and relax the pelvic floor muscles. The physical therapist will also lead the patient through breathing and muscle-strengthening exercises, as well as relaxation techniques. 

The muscle movements are converted into visual and auditory signals, and displayed on a screen in real-time. The nurse or physiotherapist is able to clearly demonstrate how well the patient is performing each exercise. With the feedback, the healthcare provider will be able to create a customized program based on the muscle strength of the patient.

The goal of biofeedback therapy is to provide the patient with the skills to improve and retrain pelvic floor muscle coordination and control. The physical therapist may also discuss changes to the diet including increasing water and fiber intake, positioning techniques like using a squatty potty, or massaging the abdomen to stimulate the gut. 

Biofeedback therapy is painless, but it is important to be consistent with frequent sessions and practice your pelvic floor exercises at home.

Biofeedback Therapy at the Incontinence Institute 

If you experience incontinence and are interested in biofeedback treatment, contact our team today. We are committed to finding a long-term solution to treat your incontinence symptoms.

Urinary and bowel incontinence is a serious problem that affects many older adults. It can also be an issue for people with multiple sclerosis (MS). MS damages the nerves, which send messages to your bladder or bowel muscles. As a result, it becomes harder to control them.

Sacral neuromodulation (SNM) therapy involves implanting a device that sends electrical pulses to your nerves. They help restore communication between your nerves and your brain. This helps control bladder and bowel movement.

Exploring SNM therapy nuances can help you understand whether this treatment is suitable for your condition.

What Is Sacral Neuromodulation Therapy?

The sacral nerves transmit sensory information from your pelvic organs to the brain and back. They help regulate bladder and bowel function, including storage and elimination of waste. When the sacral nerves sustain damage due to multiple sclerosis, they stop working properly.

Sacral neuromodulation therapy involves implanting a special device that adjusts impulses in sacral nerves. The implant consists of three parts:

• A pulse generator: a device similar to a pacemaker, which is implanted under your skin in the upper buttocks or lower back area.
• Leads: thin wires that carry electrical impulses from the pulse generator to the sacral nerves.
• Remote: a small remote you can use to adjust how much stimulation the pulse generator is providing.

Before undergoing sacral neuromodulation therapy, you would have to go through a trial period. During this period, the surgeon inserts a temporary lead to check whether the treatment works for you. If the trial is successful, you can install a permanent sacral neuromodulation implant.

Sacral modulation therapy has a high success rate for people who live with MS. Studies demonstrate that 80% of the patients experience significant improvements.

However, not all MS patients with incontinence are suitable candidates for the procedure. You need to consult your healthcare provider to find out if this option is right for you.

Sacral Neuromodulation Surgery 

If the trial phase of the SNM therapy is successful, you can undergo surgical implantation. The procedure is usually performed under general anesthesia. The steps include:

• Making a small incision in the upper buttocks or lower back area to implant the neuromodulation device
• Placing the lead wires next to the sacral nerves, which are located at the base of the spine

Once the device is implanted, the surgeon tests it to make sure it’s functioning properly. They also program the implant to deliver the appropriate level of stimulation.

The impanation surgery, which lasts around 30 minutes, is done on an outpatient basis. The majority of patients return to normal activities in a few days.

What Is Axonics Sacral Neuromodulation Therapy?

Axonics sacral neuromodulation therapy is a type of sacral neuromodulation therapy that involves implanting a pulse generator created by Axonics Modulation Technologies.

One of the notable features of the Axonics system is its long-lived rechargeable battery. This battery, which you need to recharge once a month, can last up to 15 years. This reduces the need for frequent replacement surgeries.

Another popular sacral neuromodulation implant is the InterStim implant. Unlike the Axonics implant, it doesn’t require recharging. However, you need to replace it every five years.

If you are a good candidate for sacral neuromodulation therapy, your healthcare provider can help you choose the most suitable implant for your needs.  

Battling Your Incontinence Problems with Sacral Neuromodulation Therapy 

If you live with MS and have urinary or fecal incontinence that doesn’t respond to conservative treatment, you might benefit from SNM therapy.

At Incontinence Institute, we have a team of surgeons and therapists with extensive experience in implanting different types of sacral neuromodulation devices. Our goal is to improve your quality of life.

To learn whether you are a good candidate for the procedure, schedule an appointment with our medical team today.

Urinary incontinence affects millions of men and women worldwide. Whether it begins after surgical treatment, with age, or due to a neurological disorder, this condition can decrease your quality of life tremendously. Since many urinary incontinence treatment options exist, it may be hard to choose the right one for your needs.

Before you schedule a consultation with a urologist, consider taking the time to explore the available choices. One of the most common treatment methods is an artificial urinary sphincter (AUS). Understanding how it works and comparing it to other options can help you make an educated decision.

Artificial Urinary Sphincters (AUS)

The artificial urinary sphincter mimics the natural function of the urinary sphincter muscle. It consists of three components:

• A cuff that encircles the urethra
• A pressure-regulating balloon placed in the abdomen
• Control pump in the scrotum or labia

When you need to urinate, you press the control pump to deflate the cuff so the urine can flow. After urination, the cuff automatically inflates to prevent leakage.

The surgical procedure for AUS implantation involves implanting the cuff and pressure-regulating balloon in the body. It’s performed under general anesthesia.

Around 80% of people who take advantage of AUS see a reduction in symptoms of urinary incontinence.

Other Urinary Incontinence Treatments

While AUS is an effective treatment option, you can also benefit from other approaches.  Some of them are:

Non-surgical Options 

• Lifestyle modifications – managing fluid intake, avoiding bladder irritants like caffeine and alcohol, and maintaining a healthy weight
• Medications – anticholinergic drugs and alpha blockers to relax the bladder muscles and hormones to improve the work of the urethral sphincter
• Behavioral therapies – bladder training, pelvic floor exercises, and urge suppression strategies

Surgical Alternatives

• Male sling procedures – placing a sling around the urethra to move it to another position
• Urethral bulking agents – injectable materials to strengthen tissues surrounding the urethra so it can closer better
• Other surgical interventions – bladder neck suspension, sacral nerve stimulation, posterior tibial nerve stimulation, or urinary diversion

Comparing Effectiveness and Patient Considerations 

AUS demonstrates high success rates in treating urinary incontinence, especially for patients with severe stress urinary incontinence and intrinsic sphincter deficiency. However, compared to non-surgical options, AUS implantation involves surgical risks such as infection and devise erosion.

While non-surgical treatments may provide symptom relief, the effectiveness of these options can vary depending on many factors. The main considerations include the cause of the condition, the age of the patient, and the severity of the incontinence.

Another important factor to think about is treatment costs. For example, AUS implantation may involve higher initial costs but could lead to long-term savings on ongoing symptom management.

Surgical treatments usually provide faster relief than non-surgical alternatives do. While recovery time is involved, they allow you to return to daily activities with confidence. Non-surgical options often involve lifestyle modifications that may not always be suitable.

Patient Selection and Suitability

While each treatment option has its pros and cons, the final decision is up to the urologist and the patient. Your doctor will evaluate all the factors, including:

• Medical history
• The severity of the condition
• Your lifestyle preferences

The key to achieving success with urinary continence treatment is a personalized approach to each patient. What works well for one person may not fix the problem for another, and vice versa.

Find Incontinence Treatment in Middle Tennessee 

Artificial urinary sphincters have a high success rate. However, other surgical and non-surgical options can prove to be viable alternatives. To find the best treatment for your needs, you need a personalized approach from a qualified medical professional.

At Incontinence Institute, we have a team of experienced urologists who have helped hundreds of patients with urinary incontinence improve their quality of life. To take advantage of their expertise, get in touch with our medical concierge today.

When you undergo prostate surgery, one of the potential side effects is urinary incontinence. The prostate’s proximity to the bladder and urethra requires the surgeon to practice extreme precision. Slight damage to the nerves and muscles of the bladder, urethra, or urethral sphincter during the procedure could cause urinary incontinence.

For the majority of men, incontinence after prostate surgery is temporary. It goes away within the first year. For others, it may continue for a longer period. Exploring effective solutions to this problem can help you improve your quality of life.

Non-Invasive Incontinence Solutions

To speed up recovery from prostate surgery, your doctor may recommend several non-invasive solutions, including:

• Pelvic floor exercises – pelvic muscle floor training (PMFT) can improve urinary control and reduce leakage. The most well-known PMFT type is Kegel exercises.
• Dietary modifications – to keep your bladder under control, you may have to avoid such irritants as caffeine and alcohol.
• Bladder training techniques – such techniques as scheduled voiding or delayed urination can “train” the bladder to hold urine for longer periods to prevent leakage episodes.

The key to ensuring the success of these solutions is implementing them regularly according to the doctor’s recommendations.  

External Incontinence Solutions

External solutions are also a non-invasive approach to incontinence after prostate surgery. They are:

• Penile clamps – these external clamps put pressure on the urethra and compensate for the improper work of the urethral sphincter.
• External catheters – also known as condom catheters, these devices collect urine through a sheath placed over the penis.
• Absorbent pads and diapers – these products protect against unexpected leaks, especially for people with severe forms of incontinence.

While external devices aren’t always convenient, they can make your everyday life easier. Your doctor will help you choose the most suitable option for your needs.

Medications for Incontinence

Some medications may be highly effective in managing incontinence after prostate surgery. They include:

• Anticholinergic drugs – this medication helps relax the bladder muscles to reduce the feeling of urgency and help the bladder hold more urine.
• Alpha-blockers – these drugs relax the smooth muscle of the bladder neck and make it easier to urinate.
• Hormonal therapy – serotonin/norepinephrine reuptake inhibitors can decrease the symptoms of incontinence by improving the work of the urethral sphincter.

Hormonal therapy is a temporary solution. Before taking advantage of it, you need to discuss the pros and cons with your doctor.

Surgical Treatments for Incontinence

If non-invasive solutions and medications don’t yield the desired results, your doctor may recommend surgical treatment options for incontinence. Some of them may be:

• Artificial urinary sphincter (AUS) – this device placed around the urethra to control urine flow allows for manual control over urinary function.
• Urethral sling procedures – the surgeon puts a supportive mesh-like sling around the urethral bulb to compress and move the urethra into another position.
• Urethral bulking agents – a bulking agent is injected into the wall of the urethra to strengthen its sides and help it seal tightly.

Each one of these procedures has counterindications. That’s why professional medical evaluation is necessary.

Comparing Effectiveness and Further Considerations

To choose the right option for your needs, you have to consider such factors as possible side effects, risks, costs, and success rates.

During a consultation, you and your doctor will discuss the effects these solutions can have on your lifestyle. In many cases, the slight discomfort that some of these options bring is offset by the alleviation of the incontinence issues.

The benefits of each of these solutions can vary from person to person. Before recommending one of them, a medical professional has to consider several factors, including:

• Medical history
• Severity of incontinence
• Age

Your preferences play a major role in the selection of the solution. You would have to consider your lifestyle to make sure the chosen option doesn’t interfere with your daily activities.

Find Post-Prostate Surgery Incontinence Solutions in Middle Tennessee

If you are having incontinence issues after prostate surgery, many treatment options are available. Determining which one is the best for you requires a consultation with an experienced medical professional.

At the Incontinence Institute in Middle Tennessee, we have a team of certified urologists who have experience administering all treatment solutions. We’re focused on finding the most effective, personalized solution for each patient. To schedule a consultation, contact our team and learn more about the treatment options we offer.

Erectile dysfunction (ED) is a failure to achieve and maintain an erection. It is a highly common condition impacting more than 30 million men in the United States. Causes for ED vary from physical or psychological factors to a combination of both. They include hormonal imbalance, diabetes, obesity, depression, anxiety, and many more.

The psychological impact of erectile dysfunction is tremendous. When faced with ED, many men become depressed. They feel insecure, emasculated, and isolated. The stigma associated with the inability to achieve an erection often keeps men from seeking medical assistance.

Thankfully, many ways to address this condition exist, varying from lifestyle changes to surgery.

Common Treatment Options for Erectile Dysfunction

The most common options for treating ED are:

• Phosphodiesterase type-5 inhibitors (Viagra, Cialis, Levitra) in the oral form
• Testosterone therapy may be recommended when blood tests demonstrate low testosterone levels
• Penile injections or intraurethral medications that improve blood flow to the penis
• Vacuum erection devices (also called vacuum pumps or penis pumps)

If these methods don’t resolve the issue, your doctor may recommend a surgical approach, otherwise known as implementing a penial implant, or penile prosthesis.

What is a Penile Implant?

A penile implant, or prosthesis, is a surgically inserted device that allows a man to achieve an erection. There are two main types:

Inflatable Implants

Inflatable implants, the most common type of penile prostheses, require the surgical implementation of cylinders inside the penis and a fluid reservoir filled with salt water. Depending on the type of inflatable implant, the reservoir is located either in the abdominal wall (3-piece penile implant) or the scrotum (2-piece penile implant).

To achieve an erection, you can pump fluid from the reservoir into the cylinders inside the penis. Then you can drain the salt water back into the reservoir.

Semirigid Rod Implants

Semirigid rod implants are made of two bendable tubes made of silicone materials or coiled wires. Once they are placed inside the penis, you can bend it in the desired position and achieve an erection.

Assessing the Benefits and Risks of Penile Implants

Similar to other ED treatments, a penile prosthesis has several advantages and disadvantages.

Pros:

• Restores erectile function when other methods fail
• Improves sexual satisfaction
• Provides a long-term solution for erectile dysfunction
• Improves self-confidence

Cons:

• Surgical procedure required
• Risk of infection
• Potential for mechanical failures

Besides infection, such procedures could cause excessive bleeding, scarring, and post-surgical pain and discomfort.

The Surgical Procedure

Penile implant surgery can be done with local or general anesthesia. Once the surgeon administers the anesthesia, they make an incision in the lower abdomen, above the penis base, or the scrotum. The location of the incision depends on the type of implant you are getting.

The doctor will spread the tissue to make space for the implant and insert all of the pieces of the device into the penis. If you are getting an inflatable implant, the surgeon will place a fluid reservoir in the abdomen or the scrotum.

Once the prosthesis is in place, the surgeon will close the incisions using sutures or surgical staples. They may also apply dressings or bandages to aid in the healing process.

The recovery period following the surgery is fairly short. While many patients resume normal activities after one to two weeks, it’s not uncommon to expect to wait six weeks post-surgery to resume sexual activity. Your surgeon will be able to make a formal recommendation.

Make an Informed Decision: Consult the Experts

While a penile prosthesis may be an excellent solution for people who struggle with ED, it may not be the best solution for you. Deciding whether a penile implant can be beneficial for resolving your erectile dysfunction will require a consultation with a professional urologist. Together, you will consider factors like health status, age, personal preferences, and risk tolerance.

At the Incontinence Institute in Middle Tennessee, we have a network of experienced urologists who have helped many patients tackle ED. If you’re interested in learning more, consider visiting our resource on erectile dysfunction.  If you’re ready to take the first step toward resolution, contact our discreet medical concierge to discuss your case and the effective treatment options our team of urologists can provide.

While the exact number may vary based on definition, data suggests that roughly 13 million people experience urinary incontinence. This condition causes you to leak urine involuntarily and significantly impacts your life. 

Fortunately, urinary incontinence is not something you have to fight alone, as various treatment options can help address the condition. One such solution may be an Artificial Urinary Sphincter (AUS).

What Is an Artificial Urinary Sphincter (AUS)?

When it comes to controlling when and where you urinate, the body has a circular, muscular structure called the sphincter that regulates the release of urine from the bladder.

Designed to mimic the sphincter’s functionality, an AUS is a small implantable device that restores your control over the bladder. 

To effectively perform its functions, an artificial urinary sphincter has several components working in tandem. These components include a cuff, a pump, and a reservoir, all working together to replicate the sphincter’s function.

Benefits of Using an Artificial Urinary Sphincter

Beyond causing UTI infections and skin problems, urinary incontinence can have significant psychological and social impacts, leading to isolation, depression, and anxiety.

Fortunately, an AUS offers several benefits that help address these challenges:

• Effectiveness: Artificial urinary sphincters have high success rates in resolving incontinence issues, and the device typically lasts for many years.
• Improved Quality of Life: Choosing AUS can restore confidence, enhance comfort, reduce urinary accidents, and reduce reliance on pads.
• Adjustability: One of the unique advantages of AUS is its adjustability, allowing users to customize the device’s pressure for individual comfort and effectiveness.
• Safety Profile: There’s an established history of using the device, and continuous improvements have made the procedure safer and more reliable over time.

Risks and Potential Complications of AUS

However, like any medical procedure, AUS is not without its potential drawbacks and risks.

• Surgical Risks: The implantation of AUS involves surgery, which carries the possibility of infection, bleeding, and anesthesia complications.
• Device Malfunctions: While rare, AUS can experience mechanical failures over time.
• Erosion or Tissue Damage: There is a slight risk of the device causing wear and tear on surrounding tissues.
• Need for Revisions or Replacements: As with any medical device, there’s a lifespan to consider, which may lead to future surgeries for modifications or replacements.
• Cost and Insurance Considerations: Knowing the potential out-of-pocket costs and the variability in insurance coverage for AUS is important.

Who is a Candidate for AUS?

With as common as urinary incontinence is, and the number of treatment options available, getting an AUS may not be suitable for everyone. While an AUS device is often considered for individuals with severe urinary incontinence, you’ll want to discuss your candidacy with a physician to determine whether other treatment options would be more appropriate.

In understanding your current symptoms, severity, treatment history, and current health of the bladder, a healthcare professional will comprehensively evaluate your options.

Alternatives to AUS

Before settling on an AUS, it’s essential to consider if other treatment options may be more suitable for you. Such medical interventions to consider include:

• Other Surgical Options: There are alternative surgical procedures, such as bladder sling procedures and the use of bulking agents, that can address urinary incontinence.
• Non-Surgical Treatments: Non-surgical options include medications and pelvic floor exercises, which may suit some individuals.

Making the Right Choice 

Dealing with urinary incontinence is challenging and can significantly impact your life. We understand that finding a solution is at the top of your priority list. The Incontinence Institute in Middle Tennessee is here to guide you every step of the way. Contact our medical concierge to learn more about artificial urinary sphincters and schedule an appointment with a physician.