Did you know that over 62% of women in the US suffer from urinary incontinence and 23% are affected by fecal incontinence? Unfortunately, many women bothered by their leakage remain untreated due to a lack of incontinence specialties and underutilization of therapies. We want to change that at SurgOne. Our female urologist is focused on eliminating the unnecessary stigma associated with these extremely prevalent medical conditions and helping women navigate to the treatments they need to live their best life not burdened by urinary or fecal incontinence.
While incontinence in women increases with age it by no means is a normal part of aging nor something you must “just live with.” There are many safe, conservative, and minimally invasive innovative therapies that can reduce or even eliminate urinary and fecal incontinence. Dr. Rogers is focused on offering a spectrum of options to assist patients in making the right decision to treat their condition. While most women remain silent for too long about frustrating leakage, Dr. Rogers wants to accelerate every patient’s journey to improving their incontinence with a variety of vetted therapies.
Types of Incontinence Treated
Our female urological expert focuses on providing excellent care for three most common types of leakage. Often undiscussed and undisclosed with health care professionals and regularly overlooked or dismissed, we want women to know that these conditions are not a normal part of aging, not something they need to simply live with and certainly not conditions that should reduce their quality of life.
We want to help with and specialize in improving:
Overactive bladder (OAB)
OAB is a syndrome comprised of the following possible symptoms:
Urge Urinary Incontinence (i.e., the inability to control your urine flow or stop it once it starts resulting in leakage) which occurs in 33% of women
Urgency (i.e., feeling you must go to the bathroom immediately with no warning)
Frequent Urination (i.e., going to the restroom too often)
Nocturia (i.e., getting up too often at night to use the restroom)
This condition affects 40% of women is caused uncontrollable bladder muscle contractions. Overactive bladder often progresses in severity and becomes more bothersome as women age. 75% of women with OAB remain unmanaged despite many therapy options being available which are often covered by insurance.
Conservative options for OAB include lifestyle changes, pelvic floor physical therapy, and medications, but many are not successful with these initial offerings for various reasons including lack of efficacy, intolerance, poor adherence and/or cost. There are several new and evolved therapies that are available to treat OAB:
Neuromodulation – These restorative therapies stimulate nerves which results in improved bladder control. Neuromodulation has no systemic side-effects unlike OAB medications. There are multiple ways to deliver neurostimulation – external application or internal implants.
Sacral Neuromodulation Implant Surgery – Sacral neuromodulation implants are available to treat OAB as well as fecal incontinence, urinary retention, and bladder pain. These implants are placed near a sacral nerve at the lower back. These implants can be placed through a minimally invasive surgery after a temporary testing phase to confirm improvement from the stimulation. Both Axonics F15 and Medtronic Interstim X SNM implants are offered by Dr. Rogers after shared decision making.
The eCoin tibial stimulator – This coin sized device is placed near the ankle with just local anesthesia. Once activated, the eCoin automatically delivers stimulation the tibial nerve twice a week for 30 minutes. This treatment results in reduced urge urinary incontinence in many.
Percutaneous Tibial Neuromodulation (PTNM) or Percutaneous Tibial Nerve Stimulation (PTNS) – Stimulation of the tibial nerve near the ankle can have a significant calming effect on the bladder over time. With this therapy, similar to acupuncture, a small needle is placed at the tibial nerve, and stimulation is provided for 30 minutes during these office sessions. If 12 weekly sessions provide meaningful improvement, the interval for these office sessions becomes monthly.
Botox Bladder Injections– Botox injections in the bladder muscle can be highly effective in alleviating OAB. This option is delivered using a small scope briefly inserted into the bladder though the urethra. Reinjection is required to maintain relief roughly every 6 months.
Stress Urinary Incontinence (SUI)
Stress urinary incontinence is the leakage of urine with exercise or activity, coughing, sneezing, jumping, heavy lifting or anything that puts pressure on the bladder. Over 40% of women suffer from stress urinary incontinence and it is commonly caused by weakening of the pelvic floor. There are several options ranging from conservative to more invasive to treat SUI.
Pelvic floor physical therapy may help reduce SUI but sometimes will not meet treatment goals. More recently, the Bulkamidurethral bulking procedure has offered a less invasive procedure compared to a Mesh urethral sling surgery which can be associated with long term complications not always easily managed. The Bulkamid bulking procedure is highly effective for improving SUI while having no long-term risk.
Fecal Incontinence (FI)
Trauma from vaginal delivery, uncontrolled diabetes, severe constipation, neurological disorders, and GI issues can all cause fecal incontinence. Nearly a quarter of women in the US suffer from fecal incontinence, yet 70% won’t ever discuss it with their doctor. We’d like people to know there are treatments available to reduce or even cure this distressing condition.
Sacral Neuromodulation (SNM) Implant Surgery – Like OAB, fecal incontinence is often due to sacral nerve dysfunction, so stimulating the sacral nerve is a highly effective treatment for fecal incontinence. These implants are placed near a sacral nerve at the lower back. These implants can be placed through a minimally invasive surgery after a temporary testing phase to confirm improvement from the stimulation. Both Axonics F15 and Medtronic Interstim X SNM implants are offered by Dr. Rogers after shared decision making.
The Eclipse System – This is a non-surgical option where a vaginal insert similar to a pessary is fitted in the office. It is deflated to allow for a bowel movement when necessary and reinflated to compress the rectum and prevent any stool leakage – most successfully fitted women feel this solution is comfortable and many can experience complete bowel continence.
We set and maintain the highest standards of competence, professionalism, and integrity. We provide expert advice and consultation on surgical matters and serve as exemplary resources for our community. We place the interests of our patients above all else.