Q & A with Carlton Pearse, MD, Chief of Obstetrics and Gynecology, St. Luke's Hospital
What types of treatments are available for women with incontinence?
More than 50 percent of women age 55 and older suffer one or more of the problems caused by pelvic floor dysfunction including problems of urinary incontinence. Patients often live with these issues rather than seek treatment. Fortunately, physical therapy, medication and surgical options can be very effective in treating most bladder control issues.
Proper evaluation is the first step to treatment, especially in determining the type of incontinence. Urge incontinence and stress incontinence, the two primary types, each respond well to different treatment.
Pelvic ultrasound is a useful evaluation and treatment tool. Pelvic ultrasound assists physicians and physical therapists in providing surgical and non-surgical treatments. The test is a simple and painless ultrasound examination that takes images of the muscles and connective tissue of the pelvic floor and can show areas that are weakened or torn. St. Luke's recently began offering this technology to patients and it enhances the treatment plan, allowing the physician to see the pelvic floor condition to evaluate treatment options and also to see the results after treatment.
Conservative treatment approaches are often considered first before surgery. Pelvic floor therapy is often prescribed and is especially effective in treating urge incontinence, which is a muscular problem. St. Luke's Therapy Services offers a comprehensive program for pelvic incontinence and pain. At the root of many bladder control issues is the pelvic floor - a network of muscles, ligaments and other tissues that support the pelvic organs. Pelvic exercises prescribed by the therapist can often be effective in strengthening the pelvic floor muscles, helping to keep the bladder in place.
Surgery is the best treatment option in some cases, such as for stress incontinence, which is a problem caused by loss of support. One of the latest and most effective surgical treatments for stress incontinence is the tension-free tape procedure, or TVT or the TOT. It is less invasive than more conventional surgical treatments, can be done as an outpatient procedure requiring shorter recovery times, and is 90 percent effective.
For a referral to a physician specializing in pelvic floor issues, please call St. Luke's Physician Referral Service at 314-205-6060.
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