Wide array of non-surgical and surgical treatments available

A revolutionary treatment for bladder control problems was performed at Sutter Maternity and Surgery Center for the first time in February.

Santa Cruz Medical Clinic urologists Elizabeth Newsom, M.D., and Steven Roberts, M.D., worked as a team to implant a “bladder pacemaker” using a technique called Interstim® Therapy that was approved for use in the United States in January.

This therapy is a treatment option for men and women experiencing urge incontinence, urgent and/or frequent urination, or urinary retention (see Types & Symptoms of Incontinence). It involves placing an electrode in the lower back that sends mild electrical pulses to the sacral nerve, which controls the bladder and surrounding muscles that manage urinary function.
It is the newest in an arsenal of therapies for incontinence (the inability to control urine leakage), a condition that affects millions of Americans. According to Dr. Newsom, over 50 per cent of women may experience some form of incontinence, either stress incontinence or overactive bladder or both. Up to eight per cent of women with severe urinary incontinence may also suffer from an inability to control gas and/or bowel movements as well.

Most men experience prostate problems at some time in their lives such as benign enlargement that can cause frequent/urgent urination and leakage.

“Incontinence is a quality of life issue,” Dr. Newsom said. “It can drastically affect your lifestyle, robbing you of sleep and limiting social interaction, physical activity and travel for fear of having accidents. Some people with severe bladder control problems can’t even work.

“Fortunately, incontinence is treatable and often curable in many cases,” said Dr. Newsom, who specializes in female urology and is one of about 300 women urologists in the United States.
“Many people don’t seek help because they feel embarrassed or fear surgery, but surgery is no longer the only option and we’re here to help.”

Non-surgical therapies for men and women include medications that calm an overactive bladder, restore the lining of the bladder or treat infection; hormone therapy; dietary changes to remove foods that irritate the bladder; and modifying the way you drink fluids.

Other conservative solutions for women include wearing a pessary internally to support a prolapsed bladder, doing Kegel exercises, making behavioral modifications, and retraining the bladder and pelvic floor muscles through biofeedback.

In addition to the Interstim® Therapy, a number of surgical alternatives exist for both men and women. These include prostate surgery such as the TUNA procedure for men, urethral sling procedures and collagen injection treatments for men and women with stress incontinence, and pelvic reconstructive surgery for women with severe prolapse.

For men, Dr. Newsom and Dr. Roberts perform the minimally invasive TUNA procedure (which sends radio frequency energy to the prostate gland through a needle and scope) in their office. This procedure warms the gland so that as it heals over several weeks, it becomes spongy enough to allow urine to flow better through the urethra.
“There is minimal risk of bleeding, which makes TUNA ideal for men who have to be on blood thinners or aspirin. Their recovery is quicker,” she said. “It’s done under local anesthesia and men can usually return to their regular activities within a week.”

For treatment of stress incontinence, one choice is minimally invasive collagen injection therapy, a short outpatient procedure with rapid recovery. This therapy requires periodic re-treatment, usually once or twice a year, to maintain the effect. Sling surgery for stress incontinence is a permanent, effective solution for significant leakage and can be performed in both men and women.

For women with severe prolapse problems, Dr. Newsom often teams with gynecologists Janna Doherty, M.D., Howard Salvay, M.D., Susan Schaefer, M.D., and Marsha Muir, M.D. to perform pelvic reconstructive surgery. Dr. Newsom said, “We can perform even the most complex surgical techniques for the worst pelvic prolapse conditions with great success, right here in Santa Cruz, with our team approach.”
In addition to treating people with incontinence, pelvic organ prolapse and with neurological disorders that affect bladder control, Dr. Newsom and Dr. Roberts provide care for a wide variety of urological conditions in adults and children including intersticial cystitis, chronic prostatitis, testicle and penis problems, infections, cancers and kidney stones. Dr. Newsom and Dr. Roberts are both board certified in urology.



TYPES & SYMPTOMS OF INCONTINENCE
It is possible to have one or more types

People with Urge Incontinence/Overactive Bladder