The Continence Clinic

The Continence Clinic at Baptist Medical Center seeks to improve the quality of life for men and women suffering from urinary incontinence (the uncontrolled loss of urine) and other urological disorders. Many people who experience urinary incontinence do not seek medical help because of embarrassment or lack of awareness that treatment is available. Over 25 million Americans suffer from incontinence; however, with treatment, symptoms can be improved or alleviated.

Baptist is the first hospital in the Jackson metro area to provide a wide-range of services specifically focusing on continence. The Continence Clinic offers minimally invasive diagnostic testing, patient education services, and non-invasive or minimally invasive outpatient procedures. A dedicated team of nurse practitioners, nurse specialists, wound, ostomy, continence nurses, and urology technicians assist the urologists in developing and implementing an individualized plan of care. In addition, the comprehensive medical staff at Baptist is available to assist with any other medical needs during the urological work-up and treatment process

Diagnosing Urinary Incontinence

Since there are different types, degrees and combinations of incontinence, your physician must consider the severity of the leakage, the patient's age, tolerance of treatment and lifestyle. All of these factors go into the decision regarding evaluation and treatment. First patients undergo a thorough history and physical examination plus urinalysis.

Many patients require some form of urodynamic evaluation, which might include a cystometrogram, urethral pressure profile, electromyography, and voiding flow rate.

Diagnostic Services

State-of-the-art diagnostic services performed at the Continence Clinic include Urodynamics and Cystoscopy. Urodynamics are a series of tests that provide a detailed look at the function of the bladder and urethra.

The following are descriptions of common urodynamic tests that are performed:

Uroflowmetry

This test measures the amount and speed of urine you void from your bladder. You will be asked to urinate into a funnel attached to a computer that records your urine flow.

Cystometry/videourodynamics 

This test evaluates how much the bladder can hold, how strong the bladder muscle is, and how well the signals work that tell you when your bladder is full. A thin tube ( catheter) is inserted into the urethra and bladder, and filled with water or contrast dye. X-rays may also be taken with this test. You will be asked to report any sensations you feel and you may be asked to cough or bear down during this test to check for urine loss.

Pressure Flow Study 

This test measures the pressure and flow of urine out of your bladder. You are asked to urinate while a catheter in the urethra measures the pressure within the bladder.

Video cystourethrography (VCUG) 

The bladder is filled with contrast dye through a catheter, then video x-rays are taken while the dye is urinated through the urinary tract.

Retrogradeurethrography (RUG)

This test takes x-rays of the urethra to check for scarring. Contrast dye is injected into the urethra to visualize narrowing or scarring.

Cystoscopy 

This test provides direct visualization of the urinary organs. A small tube called a cystoscope, attached to a light source and camera, is inserted through the urethral opening, allowing the doctor to look inside your urethra and bladder.

These procedures are often painless and do not require a hospital stay or extensive preparation. Information collected during these tests is reviewed with you and will help determine a diagnosis and treatment plan.

Treatment Options

Once the diagnostic tests are completed, your physician can plan a course of treatment. These include exercises, medication, external devices, catheterization, behavior techniques and surgery. There are many conservative treatments that are available before considering surgery for most patients. These include:

  • Kegel exercises, tightening and relaxing of pelvic muscles to improve urinary control.
  • Biofeedback, a simple technique to help you learn pelvic floor muscle exercises and measure strength of those muscles. Biofeedback can strengthen weak muscles or relax tense muscles. After evaluating a patient and performing a biofeedback assessment, a home exercise program (HEP) may be started.
  • Medication: There are many types of drugs that can help control bladder function. Some patients benefit from estrogen replacement therapy, which increases the thickness of tissues and might help prevent leakage.
  • Surgery is a treatment option for some patients who have tried other conservative treatments.

Minimally invasive treatments available at the Continence Clinic include

Bulking agent injections 

Agents such as collagen, Coaptite, Deflux or Durasphere, are injected into the urethra at the urinary sphincter to help control urine from leaking out.

Urolume stent 

A mesh tube or stent is placed inside the male urethra which allows urine to pass through without obstruction. This is done as a treatment for prostate enlargement, urethral narrowing or scarring from injury or previous surgery.

Neuromodulation 

There are two types of neuromodulation offered in the clinic. The first treatment is called Interstim. It is the stimulation of the nerves that affect bladder function to correct over-activity or under-activity of the bladder. This treatment requires a trial testing period of 5-7 days with stimulation of the sacral nerves (in the tailbone) and is used for treating uncontrollable urinary urgency, frequency, or retention (inability to urinate). Final treatment consists of implantation of a stimulating electrode and battery pack, much like a pacemaker, to provide constant stimulation of the bladder nerves. Another neuromodulation treatment offered at the clinic, Urgent PC, stimulates a nerve located in the ankle which carries an impulse to the nerves that control bladder function. The sessions are 30 minutes, once a week for 12 weeks with results typically seen in 6 weeks..

Transobturator sling (TOT)

For women, the sling procedure corrects stress incontinence by supporting the bladder neck and urethra in their correct position. The sling is laced through an incision in the thigh and vagina. The procedure may require an overnight stay in the hospital.

To learn more about continence services at Baptist, talk with a professional at the Baptist Health Line at 601-948-6262 or 800-948-6262. To send a question online, use Contact Us.

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