Urinary urgency incontinence is leakage of urine due to inability to control the urge to urinate. Patients simply cannot get to the bathroom soon enough. It differs from stress incontinence, which is the spontaneous loss of urine occurring with activities that increase abdominal pressure, such as coughing or laughing. Urgency incontinence increases with age, is more common in women than in men, and often reflects a weakness in abdominal musculature.
Involuntary loss of urine is a very unpleasant problem, causing embarrassment, avoidance of social activities and therefore isolation, impaired sexual pleasure, anxiety and depression. Kegel exercises to strengthen abdominal muscles are helpful if correctly employed, but most people require instruction in performing these properly.
Medications that reduce bladder contractions are often beneficial, but have significant side effects, including dry mouth, constipation, blurred vision and confusion. They may also cause urinary retention with increased risk of infection, especially in men.
A new, non-drug therapy is available, providing at least a 50% improvement of symptoms in 60-80% of patients. It is simple and virtually painless.
A fine, sterile needle, like an acupuncture needle, is inserted just above and behind the inside of the ankle. It is stimulated with an electrical impulse powered by a battery, to create a sensation of tingling on the bottom of the foot. The impulses will travel through the tibial nerve and then to the nerves controlling bladder function. The patient sits comfortably in a chair with the leg elevated. Stimulation continues for 30 minutes, after which the needle is removed and the patient goes home. Treatment is repeated once a week for twelve weeks and, if effective, continued once a month for several months. Most patients feel relief after 5-7 treatments.
Medicare and some other medical insurances may pay for the therapy. To be eligible, patients must first fail treatment with medication, or have undesirable side effects.
The patient who informed me of the treatment had suffered for years with incontinence, and was elated when this nerve stimulation approach was effective.
To inquire about this treatment, call our office and schedule an appointment with one of our doctors.