Bladder leakage must rank as one of the most frustrating of problems. The gradual worsening and escalation from panty liners to pads to diapers feels like a most unwelcome sign of the body breaking down.
Paying attention to the nearest bathroom at all times becomes exhausting. And waking up during the night because the bladder needs attention means a distinct drop in quality of life.
I’ve shared before that many doctors are unaware of the most effective treatment for incontinence. Instead, their patients get recommendations to manage fluids, practice pelvic floor exercises, take daily medications, or undergo surgical procedures like the bladder sling. But what happens when it fails?
The bladder sling is a procedure recommended to many women. While there are a number of variations, each technique involves surgically placing a strip of material, sometimes synthetic mesh or biological graft tissue, under the urethra in the area of the bladder neck to support the anatomy and stop leakage, especially the kind that occurs when you cough or sneeze.
It is often advertised as a more permanent solution, but the reality is that many people resume having bladder leakage once again at some point after the sling procedure. And I know from meeting many such individuals that most of them are thinking, what now?
The answer is usually a lot simpler than one might think. Although not nearly as well known, and far less taught in surgical training programs, sacral neuromodulation is a less invasive treatment that has significantly higher success rates than other treatments, including the surgical sling procedures, daily medications, or exercise therapies.
It is similar to pacemaker technology, in that the doctor places a fine, specialized lead wire using some local anesthetic, and then uses a computer to provide gentle stimulation to the nerves and muscles.
The difference is that here, instead of correcting the heart muscles to beat once again in proper rhythm, this pacemaker restores the nerve and muscle activity of the pelvic floor and bladder sphincters. After a few minutes of programming the device, you walk out with a pair of small Band-aids and restored bladder control.
And there is an interesting bonus that the other treatments do not offer. Neuromodulation treatment also resolves bowel leakage, something that over 20% of people with bladder leakage experience — and another condition that is often privately managed in shame and silence.
With major advancements in the technology over the last 20 years, sacral neuromodulation is highly effective after a failed bladder sling procedure. In fact, many continence centers that treat bladder leakage regularly find that nearly half of their patients have already had a failed bladder sling procedure, and the results of sacral neuromodulation are still outstanding.
If only more people knew that over 90% success is achieved with the less invasive sacral neuromodulation! While it requires some effort to find the specialists with the required expertise, the benefits of a 25-minute procedure that does not require general anesthesia or daily medications are well worth it.
It was FDA approved nearly 20 years ago and has been dramatically improved over the years, but here is the best part: The device itself has become miniaturized while the battery life now exceeds a whopping 15 years.
Raising awareness about the prevalence of incontinence and the treatments that make a meaningful difference is the first step to ensuring that people understand their options. Managing incontinence is frustrating and can be embarrassing, and failed treatments only add insult to injury.
The truth is, incontinence can be effectively resolved. And no one should be resigned to accepting bladder leakage because one treatment failed. Today, more effective, and less invasive treatments exist.
What methods have you used to stop bladder leakage? What is your experience with each of them? With an issue that is kept so private, how did you learn of each method? Please share with our community.