Category Archives: Blog

Cystoscopy vs Ureteroscopy for Your Urinary Tract Symptoms

Two common procedures, cystoscopy and ureteroscopy, are used to diagnose and treat bladder, urethra, kidney, and ureter issues. In this article, we’ll explore the similarities and differences between the two methods to help make an informed decision about your medical needs when experiencing urinary tract difficulties.

Cystoscopy 

A cystoscopy is a medical device with a long thin tube containing a light and lens for viewing. This tube is inserted into the urethra and bladder to see any anomalies. 

Rigid and flexible cystoscopes are available depending on the issue you are having. Flexible cystoscopes are generally used to spot troublesome areas. A rigid cystoscope is slightly wider and can accommodate small surgical instruments inserted into the tube for biopsies or treatment. You will be awake during a flexible cystoscopy procedure, but general anesthesia or the numbing of the lower half of your body may be applied for a rigid cystoscopy procedure.  

Common symptoms requiring a cystoscopy are blood in the urine, frequent urinary tract infections, urinating problems, and chronic pelvic pain. Common conditions diagnosed and treated with cystoscopy are:

  • Bladder infections and UTIs 
  • Bladder stones 
  • Hematuria (blood in urine) 

The advantage of getting a cystoscopy is that it can find early signs of cancer, infections, narrowing, blockage, or bleeding in the urethra and bladder. The disadvantage is that biopsies and treatments can’t be done during a flexible cystoscope procedure if the surgeon sees an abnormality. A rigid cystoscope procedure would have to be scheduled to follow.

Ureteroscopy 

A ureteroscopy is functionally the same as a cystoscope, being equipped with a lens and a light. The difference is that the ureteroscope is longer, allowing a surgeon to insert the instrument into the urethra, through the bladder, and into the ureter leading to the kidney. When having a ureteroscopy procedure, general anesthesia is necessary.

You might need a ureteroscopy if you have the following symptoms:

  • Severe pain in your back or side
  • Blood in the urine
  • Burning when urinating

These symptoms can be indicative of common conditions that are diagnosed and treated with a ureteroscopy, such as:

  • Kidney stones 
  • Ureteral strictures 
  • Ureteral tumors 

The advantage of a ureteroscopy is that a doctor can see kidney stones located in the ureter and kidney and remove the stones instantaneously. The disadvantage is that the surgeon will have to place a stent in the ureter to facilitate the drainage of urine to the bladder. The surgeon will then need to remove the stent at a later date.

Similarities between Cystoscopy and Ureteroscopy

Both of these procedures are done as outpatient procedures in most cases. However, if you were under general anesthesia during these processes, you’ll need someone to drive you home when you’re released.

Differences between Cystoscopy and Ureteroscopy 

Because the diagnostic and treatment target areas are different for each procedure, the risks and complications will be specific to those target areas. A ureteroscopy can cause infection or injury to the ureter or kidneys, while it’s most likely the bladder and urethra will be affected by complications and risks after a cystoscopy.

Treatment Plans Following Cystoscopy and Ureteroscopy 

After both a cystoscopy and a ureteroscopy, the doctor may prescribe an antibiotic to prevent infection. A cystoscopy will cause belly pain, blood in the urine, and pain when urinating for up to 48 hours. Drink several glasses of water a day to flush out the bladder and take over-the-counter pain relievers to ease the pain. 

A ureteroscopy may cause more pain which prescribed pain medication may ease. You may feel pain in your bladder and burning when you urinate. If the kidney stone the surgeon treated was large, you may have to pass stone fragments still present in the days following the procedure. Follow your doctor’s diet and medication recommendations to prevent future stone formation.

Cystoscopy and Ureteroscopy Procedures in Middle Tennessee

There are similarities and differences between cystoscopy and ureteroscopy procedures, but both are important in the early diagnosis and treatment of urological conditions. Because these procedures target different issues in the urinary tract, it’s important to consult with a healthcare professional for personalized advice. At the Incontinence Institute, we specialize in urinary tract diagnostic and treatment options. Contact our team to find out if a cystoscopy or ureteroscopy is the right option for you.

Understanding Interstitial Cystitis Diagnosis and Treatment

Interstitial Cystitis (IC), also known as painful bladder syndrome, is a stressful condition. The disease is not contagious and does not spread or worsen over time. However, you may experience various issues affecting your social life and sleep.

IC is difficult to diagnose, and there is no cure, but treatments are available to help ease the illness. The first step toward managing your symptoms is understanding the basic facts about this condition.

Understanding Interstitial Cystitis

If you’re experiencing urinary pain that lasts for over six weeks and is not due to a kidney condition or infection, then it may be IC. You may be experiencing a chronic bladder condition that results from bladder wall inflammation. IC causes the bladder to harden, reducing the amount of pee it can comfortably store. In some cases, you may need to pee as many as 40 to 60 times per day.

IC often affects people of all ages. However, it can appear in your mid-40s. This condition is a widespread problem that affects approximately 1.2 million Americans, primarily women. Women are five times more likely than men to have IC.

Interstitial cystitis affects people differently. Some people may only have slight discomfort, while others may experience severe pain and urgent, frequent needs to pee. This may result in life problems such as:

  • Emotional issues due to lack of sleep
  • Lack of social life and exercise as a result of isolation and withdrawal
  • Anxiety and despair

Recognizing Symptoms and Seeking Diagnosis

Some people might confuse IC for a urinary disease because of similar symptoms. Thus, it is essential to remember that IC symptoms are caused by bladder irritation and last for more than six weeks, whereas other urinary issues are caused by bacterial infection.

Some of the common symptoms of IC include:

  • Frequent and urgent urination
  • Pain during sex
  • Pressure and discomfort in the bladder, genital area, and pelvic area
  • Bleeding and ulceration
  • Glomerulations on the bladder wall
  • Irritated, scarred, or inflexible bladder wall

The signs and symptoms of IC differ from one person to another, and are often confused with a urinary tract infection. If you’re experiencing the above symptoms, ensure that you consult a healthcare provider for a diagnosis, which may include the following:

  • Examining your medical history: The doctor may request that you keep track of your symptoms by monitoring the amount of fluids you drink and the amount of urine you pass.
  • Conducting a physical exam: It includes examining your pelvic or genital area.
  • Urine testing: The doctor can also collect your urine sample to look for symptoms of a urinary tract infection.
  • Urine cytology: Your physician may collect a urine sample and examine the cells to aid in cancer diagnosis.
  • Cystoscopy: This is the process of inserting a thin tube with a tiny lens or cystoscope through your urethra to view the inner wall of your bladder. They may also take a biopsy for further examination under a microscope.

Treatment Approaches for Interstitial Cystitis

IC has no cure, but there are treatments to alleviate its symptoms. These include:

  • Lifestyle changes: For instance, you can train your bladder to store more urine to avoid urinating more frequently. Wearing loose clothing and engaging in low-impact exercises can also be beneficial.
  • Medications: Non-steroidal anti-inflammatory medicines like ibuprofen can assist in alleviating discomfort and thus help you improve your IC signs and symptoms.
  • Physical therapy: You can work with a physical therapist to relieve pelvic pain caused by muscular soreness and tight ligaments in your pelvic floor.
  • Surgery: Some doctors may suggest minimally invasive methods to treat bladder ulcers. However, this is only a choice if other treatments are ineffective.

Find the Right Doctor for Interstitial Cystitis

Understanding the symptoms and diagnosis of interstitial cystitis is important to get the right treatment option. If you’ve been experiencing pressure and discomfort in your bladder for more than six weeks, it’s time to see a doctor.At the Incontinence Institute, we provide the best healthcare solutions to help you get healthier. Contact us today to learn more about our services and techniques for diagnosis.

Botox in the Bladder: Relieving Incontinence with Botox Treatment

According to the Illinois Department of Public Health, approximately 13 million people in the US suffer from incontinence, with 85% being women. The medical field has witnessed exciting advancements in treating various forms of incontinence, including using Botox as a potential treatment. 

People with incontinence may experience limitations in their daily activities, social interactions, and overall quality of life. While traditional treatment methods, such as pelvic floor exercises and medication for incontinence, have benefited many patients, they may not provide adequate relief for everyone. This innovative approach has shown promising results in relieving individuals struggling with this debilitating condition.

How Botox Helps Treat Incontinence

Incontinence, the involuntary loss of bladder or bowel control, can occur in anybody, but it’s more prevalent in older adults. Botox works by inhibiting the release of acetylcholine, a neurotransmitter responsible for muscle contraction.

When injected into the targeted muscles involved with bladder control, Botox temporarily blocks the hyperactive contractions that lead to urgent and uncontrollable contractions. This relaxation effect helps increase the bladder’s storage capacity, allowing it to hold more urine before feeling the urge to urinate. 

The effectiveness of Botox in managing different types of incontinence

Botox has shown success in managing various types of incontinence, including:

  • Overactive bladder – Clinical studies have shown that Botox can significantly reduce urgent and frequent incontinence episodes. The effects of Botox injection last for several months, requiring repeat treatment to sustain the benefits. 
  • Neurogenic bladder – This condition causes bladder dysfunction due to nerve damage or neurological conditions such as multiple sclerosis or spinal cord injuries. Botox can relax the overactive muscles, reducing involuntary contractions. 

Consult with a healthcare professional before deciding to use Botox as a treatment option for incontinence. Consider factors like medical history, individual circumstances, and potential risks. 

The Botox Procedure for the Bladder

The first step is scheduling a consultation with a urologist or a urogynecologist. During this visit, they will review your medical history and conduct various physical examinations to determine if Botox is an appropriate option. They may also require comprehensive evaluations and diagnoses like urodynamic testing to determine the underlying cause of incontinence. 

A thorough evaluation ensures the treatment plan is tailored to your needs to maximize its effects. If Botox is deemed appropriate, the healthcare provider will continue with the treatment plan. 

The administration of Botox injections in the bladder

The procedure occurs in the outpatient setting, reducing the need for anesthesia or sedation.  You will lie down with support to your legs, and the healthcare provider will sterilize the area around the bladder to reduce the risk of infection. Injections to the bladder are performed using either:

  • Cystoscopy – It involves the insertion of a thin, flexible tube with a camera through the urethra to the bladder. The healthcare professional will accurately guide the needle injecting Botox into specific areas.
  • Ultrasound guidance – Ultrasound imaging can also guide the needle into the bladder. It provides real time visualization, helping the accurate administration of the injections. 

Botox administration takes around 15 – 30 minutes. However, the pre-procedure preparations, discussions, and post-procedure monitoring may affect the overall duration. 

Side Effects of Using Botox for Incontinence

Like any medical procedure, Botox may present some side effects and potential risks, including;

These side effects are not a major cause for concern. Less common but serious side effects include;

  • Allergic reactions like itching, skin rashes, breathing difficulty, and swollen face, lips, and throat
  • Systemic spread of toxins, causing muscle weakness, breathing difficulty, and swallowing problems

Before considering Botox for incontinence, thoroughly discuss with a healthcare provider for an informed decision and personalized treatment plan.

Determining if Botox is Right for You

A healthcare provider will determine factors such as your medical history, the type of incontinence, and previous incontinence treatment outcomes. Botox is not recommended for;

  • Pregnant or breastfeeding women
  • Individuals with active UTI
  • People with neurological conditions or muscle disorders
  • People with known sensitivity or allergy to Botox

Only a qualified healthcare provider can offer evaluation, such as urodynamic testing and treatment recommendations regarding Botox for incontinence. 

Regain Your Quality of Life With the Incontinence Institute

The Incontinence Institute supports individuals with incontinence with the best treatment options available. Our team of healthcare providers understands the mental and physical trials this condition can cause. Our Tennessee urologists are ready to provide you with the best treatment option to help you enjoy your life again. Contact our medical concierge to start your healing journey. 

Incontinence After Back Surgery: Practical Guidance for Patients

Dura mater is one of three membranes that are woven around the length of your spine and continue up and around your skull. It is the outermost of three layers and responsible for protecting your central nervous system (CNS). During back surgeries, there is some risk of nerves getting damaged and interrupting the CNS. This means your brain may have a hard time communicating with your bowels and bladder, causing urinary incontinence

Back Surgery and its Effects on the Bladder

Back pain is a common medical problem that has a range of symptoms and causes. It can be the result of sudden trauma, like a car accident; occur as we age due to bone and tissue degeneration; or be a side effect of other medical conditions like arthritis. Regardless of how it started, back pain can cause debilitating discomfort.

Types of back surgery

Your doctor will do a physical exam, take x-rays, and evaluate your medical history and symptoms before determining a diagnosis. Additionally, they may suggest doing exercises, stretches, or prescribe other medical treatments like epidural injections to relieve the pain. If the pain persists, surgery may be the next viable option.

  • Spinal fusion involves the use of devices such as metal plates and screws to connect two vertebrae together.  Over time they will fuse together, acting as one bone. This will intentionally limit the mobility of the vertebrae that’s causing pain when it’s in use.
  • Laminectomy is the removal of vertebrae or bone spurs to relieve pressure on the nerves.
  • Discectomy is the removal of the parts of the disc that are causing pain to relieve pressure on the nerves.
  • Foraminotomy is where the surgeon enlarges the hole in the bone where the nerve root opening is, relieving pressure on the nerves caused by the narrowing of the spine.

Potential Bladder Issues After Spinal Surgery

As long as the neural pathways along your spine still exist, recovery is possible, but it doesn’t hurt to understand the characteristics and different types of post-surgical incontinence.

  • Stress incontinence happens when pressure is put on the bladder. Symptoms might include leaking urine when you make sudden or harsh movements, sneeze, cough, or lift something heavy.
  • Urge incontinence is an involuntary squeeze or spasm of the bladder that causes an immediate urge to urinate. Sometimes it’s a feeling of having to go or actual leakage may occur.
  • Mixed incontinence both the feeling of an overactive bladder and stress factors may be experienced by the patient.

Prevalence and Risk Factors for Post-Surgical Incontinence

Spinal surgery is related to lower urinary tract dysfunction in 38%–60% of patients. The nerves along your spinal cord may get impinged or damaged and can hinder your body’s neuronal circuit. Your neuronal circuit is essentially the network of nerves that communicate with your brain to deliver functions to the body, i.e., your bladder and urethra.

Risk factors include but are not limited to:

  • Body Mass Index
  • Age
  • The type of surgery performed
  • Overall health
  • Medical history
  • Management of symptoms post-surgery

Post-surgical incontinence can be a disheartening experience. It’s uncomfortable and leaves patients feeling embarrassed and vulnerable. Fortunately, there are options for relieving symptoms and regaining control. The first step is to take a quick assessment and seek professional help.

Management and Treatment Options

After consulting with a doctor and determining which type of incontinence you have, they may take additional steps to help formulate a treatment plan. This includes a urinalysis to check for infection, bladder journal to identify patterns and amount of incontinence episodes, and other urine tests to check for any obstructions.

Non-surgical approaches to manage incontinence after back surgery

  • Pelvic floor exercises and physical therapy will help strengthen the muscles around your bladder.
  • Lifestyle modifications such as quitting tobacco, exercising more, and avoiding liquids that have more trouble being processed by your bladder.
  • Planning scheduled times to use the restroom so your bladder doesn’t get too full.
  • Dietary modification such as eating a diet rich in fiber so as to prevent getting constipated and having bowels press against your bladder.

Medical interventions for incontinence

  • Supplements and herbs will help fight off infection and give your body the nutrients it needs, specifically for urge and stress incontinence.
  • Nerve stimulation techniques such as sacral neuromodulation involves devices that are implanted below the skin and above the muscle in your back. It delivers electric impulses to the nerves that control the muscles around the pelvic floor.

Surgical options for incontinence after back surgery

  • Sling procedures treat stress incontinence by surgically connecting a sling to your abdominal wall and lifting the urethra to it’s normal position.

Post-Surgical Incontinence Relief in Middle Tennessee

At the Incontinence Institute, we understand the indignity that urinary incontinence brings to both men and women. Our mission is to help patients understand what it is, decide on a treatment plan through a variety of methods, and to be a resource for the 33 million American adults who suffer from incontinence. Contact us today to get started!

The Link Between UTIs and Urge Incontinence

Urinary tract infections (UTIs) and urge incontinence are two separate but potentially interconnected conditions. Is there a link between them? Let’s look at both and explore the possibility of one leading to the other as well as resources for patients who suffer from these conditions.

Definition, symptoms, and treatment of a UTI

UTIs are infections that occur in any part of the urinary system, which can include the urethra, bladder, ureters, or kidneys. The most common UTIs are caused by bacteria, like Escherichia coli (E. coli), which can be found in the gastrointestinal tract. When bacteria enter the urinary tract and multiply, an infection can develop, which leads to symptoms like frequent and urgent urination, burning sensation during urination, and cloudy or bloody urine. There may also be a smell, fever, and/or pain associated with a UTI. Treatment for a UTI is generally around of antibiotics prescribed by a healthcare provider.

Definition, symptoms, and treatment of urge incontinence

Urge incontinence, also known as overactive bladder (OAB), is a type of urinary incontinence characterized by a sudden and intense urge to urinate, often resulting in an involuntary loss of urine. People with urge incontinence may experience urinary urgency even when their bladder is not full. The first line of treatment includes lifestyle changes such as keeping a voiding dairy, dietary modifications, and avoiding bladder irritants like caffeine and smoking. Strengthening the pelvic floor can also help.

Can a UTI cause incontinence?

The link between UTIs and incontinence can be caused by several different factors. In some cases, a UTI can trigger or worsen symptoms of urge incontinence. The inflammation and irritation caused by the infection can lead to bladder spasms and increase the urgency to urinate. These spasms may cause involuntary urine leakage, resulting in urge incontinence episodes.

Chronic or recurrent UTIs can contribute to bladder dysfunction, which may present as urge incontinence. Repeated infections can damage the bladder lining, affect the nerves that control bladder function, or lead to changes in the bladder’s muscle tone. These alterations can disrupt normal bladder contractions and increase the frequency and urgency of urination, leading to urge incontinence.

Coping with the psychological effects of UTIs and urge incontinence

Urge incontinence can have an emotional and psychological impact as well. Shame and insecurity are often the results of uncontrolled loss of bladder functions. Over time, this leads to the avoidance of social interactions and possibly to depression and isolation. Also, there can be increased anxiety with incontinence that can affect an individual’s sex life. One study has shown that many women feel anxious that they may experience incontinence during sex, and try to avoid the act altogether. This can lead to psychological trauma between couples due to a lack of intimacy.

Also, it can lead to less activity, which can lead to other health complications associated with a sedentary lifestyle. Skin infections are common among those who experience frequent incontinence because of excessive moisture contact. When skin continuously comes into contact with bacteria from waste products, it can easily result in incontinence dermatitis (also known as diaper rash) and bacterial or fungal infections.

Fortunately, there are resources available. The National Association of Continence has many resources and educational material on its website. Sufferers can sign up for their newsletter or share experiences with others on their message boards. 

Find Relief at the Incontinence Institute in Middle Tennessee

While UTIs may contribute to the development or exacerbation of urge incontinence, not all cases of urge incontinence are caused by UTIs. Other factors, like age, hormonal changes, neurological conditions, certain medications, and bladder muscle abnormalities can also play a role in the development of urge incontinence.If you are experiencing symptoms of UTIs or urge incontinence, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Here at the Incontinence Institute, we can help you navigate the challenges associated with incontinence.  Contact us today for more information.

InterStim Therapy: What to Expect from Stage 1 and Stage 2

There are over 25 million Americans living with bladder incontinence. The InterStim implant is manufactured by Medtronic for patients with urinary incontinence, which is the result of a disconnect between the brain and the bladder. It provides a type of sacral neuromodulation, or sacral stimulation, therapy to help patients get that connection back.

InterStim Stage 1

Stage 1 of InterStim therapy allows for a trial period evaluation. The patient will have a wearable, external version of the InterStim device for two weeks to see how he/she responds and if the treatment will be an effective path for the patient.

The InterStim implant will be put under the buttock area skin and connected to a wire that comes out of the skin. There will be a battery that is worn on the belt. Both of these in tandem allow sacrum nerves to be stimulated and can be altered to stimulate, or quiet, the bladder. After this stage is complete, patients will have a follow-up to see if this has improved symptoms. If improvement is shown, a physician may recommend moving toward stage 2 of the procedure.

Stage 1 limitations typically include limited physical activity, no sexual activity, no heavy housework or twisting, no bending of the waist, no heavy lifting, no hard exercise, and no “sliding” of the body across beds, couches, etc. At-home care recommends keeping the dressing dry and in place, and not using the shower or bathtub. Patients are otherwise encouraged to continue their normal routine with regard to any medications taken and their existing diet.

InterStim Stage 2

Stage 2 of the InterStim procedure allows for the actual surgical treatment of the device. If Stage 1 results were positive, surgery is scheduled and the device will be implanted by the sacral nerves in the lower back area.  After surgery, a doctor will program the electrical signals in the device based on the results obtained in Stage 1.

After a couple of weeks of promising Stage 1 results, Stage 2 can be performed. It is an outpatient procedure where the pacemaker device is implanted under the skin and no wires will show outside the body. Patients are often given IV sedation during this procedure. There are two incisions made and the side that will be chosen for the implant will be determined by the side that had the best response during Stage 1..  There may be vibration, tingling, pulsing, pulling, or tapping sensations during the stimulation.  After surgery, the device is programmed and patients are given instructions on how to turn the neurostimulator on and off, change the settings, or increase/decrease the stimulation amount.

After implantation, patients undergo 5-6 weeks of restricted activity to allow for the incisions to have time to heal and to prevent the lead wire from moving out of proper positioning. After 48 hours, patients may shower. About a month following Stage 2, patients will receive an implant ID card from Medtronic.

What’s the Difference Between Stages 1 and 2?

Stage 1 of InterStim therapy sets the test period to see if the device has viability as a treatment option for the patient prior to implantation surgery, or Stage 2. Both stages offer an operating system that provides patients with the freedom to control the stimulation or the quieting of bladder signals. There is more downtime with Stage 2 because of the actual implantation of the neurostimulator under the skin, while the Stage 1 trial is limited to an external device.

Contact the Incontinence Institute

The InterStim procedure gives many patients a chance to return to normalcy which allows for a higher quality of life. If you’re experiencing urinary incontinence, and have tried other treatment options, don’t wait any longer to seek treatment. Our team of medical professionals at the Incontinence Institute is ready to help. Contact us today to schedule an appointment and learn more about our services. Together, we can help you regain control of your body and your life.

Bladder Sling Surgery: What to Expect and How to Prepare

Both men and women who suffer from stress incontinence, or bladder leaks that occur when performing certain actions like sneezing, coughing, laughing, or lifting, may consider bladder sling surgery. In most cases, those who receive bladder sling surgery experience less severe, or an end to, stress bladder leaks.

This article will discuss what happens during a bladder sling procedure and how patients can prepare. We will also look at recovery and risks associated with the procedure, and when to talk to your doctor about whether this treatment is right for you.

What is Bladder Sling Surgery? 

Bladder sling surgery, or urethral sling surgery, is a procedure where a surgeon uses a mesh or a sling made of human tissue to support the tube that allows urine to pass the urethra. Bladder sling surgery is used to treat stress incontinence

Procedural Overview

  • Your doctor will be able to assess your situation to determine what type of urethral sling surgery will work best for you. A sling made of either mesh or human tissue will be fitted to your abdominal wall to lift the urethra. Pressure will then be placed on the urethra to allow the bladder to retain urine more easily.

Why Might a Patient Consider Bladder Sling Surgery?

  • A patient may consider urethral sling surgery if other measures to treat urinary incontinence have failed to provide complete relief. 

Types of Bladder Slings 

  • A bladder sling can be made from ligaments, muscle tissue, or synthetic mesh.

Expected Outcomes

  • A patient is expected to make a full recovery within 4-6 weeks and to have significant relief from the symptoms of stress urinary incontinence.

Preparing for Bladder Sling Surgery 

If you feel urethral sling surgery could help improve your quality of life, your physician will perform a consultation and determine if this procedure is right for you. Before your surgery, you will have a preoperative evaluation which will help the surgeon decide on the best means of creating and attaching your urethral sling. At this point, the physician will also offer specific instructions about how to prepare for your procedure.

Before the Surgery 

Always follow your doctor’s specific directions before surgery. In general, you may be asked to:

  • Shower before arriving at the hospital
  • Avoid eating for at least 12 hours before the procedure
  • Empty your bowels
  • Make arrangements for after the surgery

After the Surgery

Make your arrangements for after your surgery. These may include:

  • Arranging transportation to return home
  • Preparing your home and meals so you do not need to exert yourself for 2-4 weeks following the surgery.

The Bladder Sling Surgery Procedure 

Bladder sling surgery is normally an outpatient procedure. After arriving and checking in, expect:

Anesthesia and Incision 

  • Your doctor will administer either general or spinal anesthesia, then the doctor will make either one or two small cuts near the location in your abdomen where the sling will be attached.

Bladder Sling Placement

  • The surgeon will then carefully place the sling in the correct location and tighten it to create pressure that will keep the urethra in a more functional place inside your body.

Suture and Closure 

  • The surgeon will use sutures or skin glue to keep the sling in place and will close up after surgery.

Duration of the Procedure

  • Bladder sling surgery is generally expected to take around 30 minutes.

Bladder Sling Surgery Recovery

Postoperative Care 

Postoperative care usually includes a brief stay in the facility recovery room and management of a catheter. Patients are then typically advised on the following:

  • Pain management
  • Restrictions on activity 
  • Follow-up care and appointments

Bladder Sling Surgery Risks & Complications

Potential Complications Include:

Minimize Risks of Complications By:

  • Following the doctor’s directions about weight and activity restrictions
  • Keeping all of your follow-up appointments
  • Discussing any discomfort or concerns you have right away with your provider

When to Contact a Healthcare Provider

If you have any concerns, unusual or persisting pain after your urethral sling surgery, contact your healthcare provider. If you are unable to urinate comfortably, contact your doctor right away to correct the situation as quickly as possible.

Improve Your Quality of Life

Bladder sling surgery is a useful procedure that can help bring relief to those suffering from stress urinary incontinence. Discuss your condition with your healthcare provider. If you have any questions specific to treatment for stress incontinence, or other treatment options,  please contact us today to schedule an appointment and learn more about our services. We can help you get in touch with a medical professional skilled at answering questions and treating patients with dignity and compassion.

Pelvic Floor Disorder vs Pelvic Organ Prolapse: Know the Difference

Pelvic floor disorders (PFD) refer to a broad range of conditions related to the functions of the pelvic organs. One of these conditions is pelvic organ prolapse (POP), in which one or more pelvic organs sag due to weak pelvic muscles. While these disorders may appear identical, it’s important to remember that they have subtle differences that matter greatly when your physician offers treatment options. This article will cover the main differences between pelvic organ prolapse and pelvic floor disorders.

What is a Pelvic Floor Disorder?

Pelvic floor disorders can develop when the pelvic area muscles or connective tissues are injured or weakened. Some common PFD types are pelvic organ prolapse, urinary incontinence, and fecal incontinence. These disorders are widespread in older women, and if you have PFD, you will exhibit symptoms like:

  • Constipation
  • Pain in your lower back
  • Pelvis muscle spasms
  • Pain during sexual intercourse
  • Painful urination due to urinary issues
  • Rectum or pelvic pain
  • Discomfort in the rectum or pelvic area

What is Pelvic Organ Prolapse?

Pelvic organ prolapse occurs when your pelvic floors, such as the ligaments and muscles, become too fragile to support your pelvic organs. Pelvic floor muscles are vital slings that support the rectum, vagina, bladder, and uterus. Any damage or injury to pelvic muscles moves these organs out of position.

Depending on the affected organ and the weak spot in your pelvic floor, you can experience anterior vaginal wall prolapse or posterior vaginal wall prolapse. You may or may not notice symptoms of pelvic organ prolapse, but if you do, they can be in the form of:

  • Discomfort during intercourse
  • Spotting from the vagina
  • Urinary issues like a persistent urge to urinate
  • Pain in the lower back
  • Abnormal bowel movements

Differences between Pelvic Floor Disorders and Pelvic Organ Prolapse

Pelvic floor disorders occur when pelvic muscles, tissues, or ligaments are weakened or injured. Pelvic organ prolapse is a type of PFD that mainly affects organs such as the vagina, uterus, and rectum.

The two conditions also have different causes. PFD is linked to trauma, childbirth, obesity, nerve damage, and pelvic surgery, whereas POP is related to aging, vaginal childbirth, long-term abdominal cavity pressure, and family background.

Several approaches to treating pelvic floor disorders exist, depending on the individual symptoms. For instance, your doctor may suggest a lifestyle change, physical therapy, medication, or surgery. When it comes to pelvic organ prolapse, you may need surgical or behavioral treatment based on the severity of your symptoms.

Similarities between Pelvic Floor Disorders and Pelvic Organ Prolapse

Pelvic floor disorders and pelvic organs do share similarities. For instance, risk factors such as difficulties during childbirth, obesity or overweight, irregular bowel movements, aging, family history, and surgical treatment increase your chances of developing these conditions. Moreover, pelvic organ prolapse is a type of pelvic floor dysfunction that develops when the pelvic muscles or ligaments are weak or injured and cannot hold the rectum or bladder.

Pelvic floor muscles are, therefore, essential since they support the bowel and the uterus. Besides that, they guard against bowel and bladder prolapse and are crucial for sexual function.

Prevention and Management

 Even though many PFD and POP causes are beyond your control, there are preventative measures you may take to reduce your likelihood of developing these conditions. Yoga or other pelvic floor exercises might help you relax and manage your pelvic muscles.

Always strive to keep a healthy body weight because it can strain your pelvic floor muscles. You can prevent PFD and POD by avoiding smoking, which often leads to prolonged coughing, straining your pelvic floor muscles, and putting unnecessary pressure on your abdomen. If you suspect that you may be experiencing symptoms of pelvic floor disorder or pelvic organ prolapse, don’t wait any longer to seek treatment. Our team of medical professionals at the Incontinence Institute is ready to help. Contact us today to schedule an appointment and learn more about our services. Together, we can help you regain control of your pelvic health and improve your quality of life.

Axonics Therapy: Your FAQs Answered

Axonics Therapy is a novel and innovative treatment option for patients with urinary and fecal incontinence, as well as urinary retention. It is a minimally invasive, long-term solution that involves the implantation of a small device that stimulates the nerves responsible for controlling the bladder and bowel. 

While Axonics Therapy is a relatively new treatment, it has already helped numerous patients regain control of their bladder and bowel function and improve their quality of life. However, many people may still have questions or concerns about the treatment. In this article, we will answer some frequently asked questions about Axonics Therapy to provide a better understanding of this promising treatment option.

What is Axonics Therapy?

Axonics treatment, or sacral neuromodulation, is a cutting-edge bladder and bowel control procedure intended to lessen the signs and symptoms of overactive bladder and bowel incontinence. It is also used to treat patients suffering from urinary retention. The Therapy provides a long-term solution by reestablishing regular contact between your brain, bladder, and bowel.

How does Axonics Therapy work?

Generally, Axonics Therapy works by stimulating the sacral nerves with tiny electrical pulses. The treatment works to better regulate the sacral nerve’s activity by restoring everyday communication in patients with fecal or urinary incontinence.

What conditions does the Axonics treat?

Axonics Therapy is a proven treatment to help patients who have lost control of their bowels and bladder. As a result, it is effective for treating bowel incontinence, urine retention, and overactive bladder symptoms such as urinary urgency incontinence.

How does the implant procedure work?

Minimally invasive surgery can be used to swiftly and safely implant Axonics. Although some physicians favor using general anesthesia, a local anesthetic is typically administered. The device is then positioned above the buttocks in the lower back. The surgical procedure typically takes around 20 to 30 minutes.

What are the benefits of Axonics Therapy?

Axonics Therapy offers many benefits, such as a longer-lasting solution than other treatment options. It’s also among the safest and most effective treatments for people with chronic illnesses. Axonics Therapy is also minimally invasive, offers lowered infection risk, and other unfavorable side effects.

What are the side effects of Axonics treatment?

Axonic Therapy is an FDA-approved surgical procedure. Aside from minor stimulation-related discomfort, it has few significant side effects. Patients may also suffer some temporary, localized swelling, which may be cause for concern. Some patients also report changes in their sense of touch, mainly in their feet and buttocks, due to the Axonics implants’ stimulation.

Can the device be removed?

Yes, an Axonics device can be removed. This is a procedure that can be performed in the unlikely case that the treatment is ineffective.

What is the cost of Axonics Therapy?

Cost may vary, but the majority of insurance plans cover Axonics Therapy. Patients are encouraged to consult their doctor to learn more about insurance coverage.

How long does the device last?

An Axonics device can last for approximately 15 years. Unlike other devices that may require biweekly charging, patients only need to charge the device once per month.

Is Axonics treatment an inpatient procedure?

Axonics treatment is typically an outpatient procedure. Patients can expect to go home the same day as their procedure.

How long does the recovery period last?

After receiving Axonics treatment, returning to your regular routine can take up to three weeks. But light activity may be possible a few days after the procedure.

Interested in Learning More About Axonics Therapy?

Our personalized approach ensures that you receive the guidance and support you need to make informed decisions about your health. Whether you prefer to speak with a medical concierge or fill out a self-assessment, we are here to help. Don’t let urinary or fecal incontinence hold you back from living a confident, healthy life. Contact us today to learn more about Axonics Therapy and take the first step toward a better quality of life.

Everything You Need to Know About Incontinence After Prostate Surgery

The male prostate is a gland found under the bladder and in front of the rectum. It has a significant role in the male reproductive system that creates fluids that carry your sperm. You might need surgery to partially or fully remove your prostate if you have prostate cancer, an enlarged prostate, or benign prostatic hyperplasia (BPH). Removing part or all of your prostate is called a prostatectomy. There are potential side effects to prostate surgery, such as prostate surgery incontinence.

What Is Prostate Surgery Incontinence?

Prostate surgery incontinence is when you involuntarily release urine from your bladder. It can affect men of any age, but it is not a normal part of aging. It commonly occurs after having prostate surgery and is generally temporary.

What Are the Causes of Incontinence after Prostate Surgery?

You will typically have leaks when you sneeze, cough, or lift something heavy. These actions cause stress on the bladder, which can then allow leaks. You might also have urge incontinence, which is when you have a sudden urge to use the bathroom but leak before getting there.

Potential Side Effects of Prostate Surgery

Incontinence is just one potential side effect of prostate surgery. Some other side effects you might have to deal with include:

  • Erectile dysfunction
  • Changes in orgasm
  • Loss of fertility/decreased fertility
  • Lymphedema (This is rare)
  • Change in penis length
  • More likely to develop an inguinal/groin hernia

Types of Incontinence After Prostate Surgery

There are two main types of incontinence following prostate surgery.

Stress Incontinence

Stress incontinence occurs when stress is placed on your bladder. This can happen as you move around or sneeze, cough, or laugh. You might find that you just dribble a little urine, or you might fully leak urine.

Urge Incontinence

Urge incontinence, on the other hand, is not caused by any actions you do. Your bladder may randomly contract, causing you to suddenly feel like you need to use the bathroom. However, you will begin to leak before you can make it to the bathroom. Again, the amount you leak will vary from person to person.

Man in dark room with his head in his hand looking depressed

How Long Does Post-Surgery Incontinence Last?

The amount of time you might have to deal with incontinence varies by person but can be affected by things such as your age and weight. It can potentially last weeks, months, or even over a year. However, most people deal with it for around three months. There are treatments if you aren’t able to get it under control.

How to Stop Post-Surgery Incontinence

Your steps for stopping post-surgery incontinence depend on the type of incontinence you have.

Stress Incontinence

If you have stress incontinence, there are several things you can do to help.

Biofeedback

This mind-body therapy is an alternative medicine approach. It teaches people to change the way their bodies work and can help improve their mental and physical health. 

During biofeedback, a practitioner will use monitoring equipment and various instruments to measure how your body functions. They can then use that feedback to suggest how you can make physiological changes. Then, after some time practicing, you can do it without the equipment. 

Exercises

You can also do certain exercises to help control your bladder. Here are some examples:

  • Sitting Fast-Twitch Exercise
  • Sitting Slow-Twitch Exercise
  • Horizontal Kegel Exercise
  • Standing Kegel Exercise

Surgery

There are two main surgeries to help with your incontinence. First, you can get an artificial sphincter, which is a patient-controlled device. It is made of three parts, including a pressure-regulating balloon, a pump, and a cuff that encircles the urethra. The cuff prevents urine from leaking. The artificial sphincter generally improves around 70% to 80% of cases.

You can also get a bulbourethral sling. In certain situations, a sling can be helpful. It is a device that suspends and compresses the urethra. The sling can be made from the patient’s tissue or synthetic material. It creates the urethral compression that is needed to get bladder control.

Urge Incontinence

If you suffer from urge incontinence, there are multiple solutions to help you.

Double Voiding

Double voiding is a simple process that can help ensure you get all the urine out when using the restroom. Follow these steps.

  1. Sit on the toilet and lean slightly forward.
  2. Rest your hands on your knees or thighs.
  3. Urinate as normal and try to get everything out.
  4. Stay sitting on the toilet for another 20 to 30 seconds.
  5. Lean a little further forward and try urinating again.

Dietary Modification

You will want to implement these dietary changes to help with incontinence.

  • Watch the amount of water you drink. Don’t drink too much or too little.
  • Cut out alcohol to start, and then slowly reintroduce it to see what your bladder can handle.
  • Lower your caffeine intake.
  • Avoid spicy and acidic foods.
  • Stop drinking carbonated drinks.

Bladder Training

You can do certain things to train your bladder so that you don’t have to use the bathroom as often. Follow these steps.

  1. Create a journal of when you have the urge to use the bathroom and when you leak.
  2. Figure out when you’re feeling the urge to use the bathroom based on your journal entries. Then schedule a bathroom visit for that time plus 15 minutes. So, if you were going every hour, schedule a bathroom break for every hour and 15 minutes and try to go even if you think you don’t need to. Slowly increase the amount of time between visits to the bathroom.
  3. Every time you feel the need to urinate, try to hold it for five minutes. Slowly increase this time in ten-minute increments until you don’t need to use the bathroom for at least three or four hours.

Pelvic Floor Muscle Exercises

Kegel exercises are popular for helping with incontinence. Here’s how they work.

  1. Identify your pelvic floor muscles by stopping urination in midstream or by tightening the muscles that stop you from passing gas.
  2. Next, tighten these muscles, hold them for three seconds, and then relax the muscles for three seconds. Do it multiple times in a row.
  3. Make sure you only tighten your pelvic muscles and not muscles in your thighs, abdomen, or buttocks. Also, ensure you are freely breathing rather than holding your breath.
  4. Try to do at least three sets of 10 repetitions each day.

Get Relief from Incontinence after Prostate Surgery

Incontinence isn’t something anyone wants to deal with, but it’s an unfortunate reality for some people after prostate surgery. The good news is there is plenty you can do to help relieve your incontinence symptoms. Contact us today to get relief from your prostate surgery incontinence.

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.


Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

Contact Us

Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067

1.888.741.6403

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