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Overview

Urinary incontinence affects up to 65% of women and greatly affects their quality of life. Many women believe that this embarrassing condition is a normal part of aging and that nothing can be done, but this is not the case. There is actually a variety of effective treatment options available. Up to 90% of women who seek treatment report significant improvement. Dr. Nelken will evaluate your symptoms and may recommend additional bladder testing to determine which type of incontinence you have and which treatment is best for you.

STRESS URINARY INCONTINENCE
Stress urinary incontinence (SUI) is the involuntary leakage of urine associated with any physical activities that increase abdominal pressure. These activities most commonly include sneezing, coughing, laughing, and exercising. These symptoms often limit physical or social activities, and can have a serious impact on women’s quality of life.

URGE INCONTINENCE / OVERACTIVE BLADDER (OAB)
These are characterized by urinary urgency and frequency, along with waking at night to urinate. These symptoms may be accompanied by urgency incontinence (leakage of urine associated with a strong urge to urinate). Although these symptoms are common, they are not a normal part of aging, and there are a number of treatment options available.

OTHER URINARY CONDITIONS
Dr. Nelken also treats women who suffer from recurrent urinary tract infections and interstitial cystitis.

Treatments

  1. Stress Urinary Incontinence

    Non-surgical Treatments
    Pelvic floor strengthening exercises can help regain bladder control. Research shows that women who perform these exercises properly will enjoy better outcomes. Dr. Nelken will evaluate your pelvic floor strength and recommend an exercise regimen suited to your needs.

    Surgical Treatments
    Surgical treatment for stress urinary incontinence is a minimally invasive procedure performed in an outpatient setting. The procedure takes about 30 minutes, and patients may go home the same day. This procedure involves placing a permanent sling to support the urethra and prevent leakage during activities that cause increased abdominal pressure. Other surgical options are available as well. Please schedule an appointment to discuss which option would be best for you.

  2. Urge Incontinence / Overactive Bladder (OAB)

    Lifestyle & Behavior

    • Manage Fluid intake
      • Trust your body to tell you when its thirsty!
      • It is not necessary to walk around with a huge bottle of water
    • Avoid bladder irritants
      • Women with OAB may be more sensitive to the effects of certain irritants on their bladders. It may be helpful to reduce intake of caffeine, carbonation, and artificial sweeteners
    • Weight management
      • For overweight women, losing just 5-10% can significantly reduce incontinence episodes
    • Bladder retraining
      • Based on your voiding diary, Dr. Nelken will customize a program of timed voiding to help decrease daytime frequency
    • Pelvic floor muscle strengthening

    Medications
    If behavioral management is not successful, Dr. Nelken will prescribe oral medications to help improve symptoms of urgency, frequency, and urge incontinence.

    Botox Injections
    Botox is FDA-approved to treat overactive bladder, and is covered by most insurances. This procedure is performed in the office under local anesthesia, and the effects typically last 6-9  months.

    Read more about Botox for OAB here.

    Percutaneous Tibial Nerve Stimulation (PTNS)
    This is a series of weekly treatments performed in the office. It involves placement of a tiny needle behind the ankle to deliver electrical stimulation to the nerves that control your bladder.

    Sacral Nerve Stimulation
    This involves an initial test phase, and if symptoms improve, then a device can be implanted under the skin, like a pacemaker to directly stimulate the nerves to the bladder.

Call Dr. Nelken

(310) 652-0100

Make Appointment