Overactive bladder and incontinence part 9

Surgery
There are several types of surgical procedures to help individuals with an overactive bladder. Surgery is usually the last resort after the individual has failed lifestyle changes and drug treatment. Surgery should never be the first choice as the results are not that good. In fact, most individuals remain dis-satisfied with results of surgery.

Surgery is essentially done to improve the bladder’s storing ability and relax the muscles.

Surgical interventions include:

Stimulation of pelvic nerves. The nerves running from the spinal cord to the bladder (sacral nerves) are the target. The activity of these nerves is altered with the use of an electrical device. A very thin wire is placed near your tailbone and connected to a small pacemaker placed underneath your skin. The device is programmed to deliver very low current that relaxes the bladder. Like any electrical device, there are a number of technical problems and it often fails to work.

Enlarging the bladder (Augmentation cystoplasty). Some surgeons can increase capacity of the bladder by using a piece of bowel. This is a major undertaking. Because bowel does not have strong muscles, one constantly retains urine and thus, life long use of a catheter is a must. Enlargement of the bladder is a surgical procedure with a lot of risks and complications; it is only done when everything else has failed. The decision to undergo such surgery should not be undertaken lightly. Incontinence can be a difficult disorder to live with, but some of the complications from augmentation cystoplasty can make things a lot worse.

Detrusor Myectomy: There is another procedure that can thin or remove part of the muscle surrounding the bladder. This helps to strengthen the bladder and also avoids recurrent muscle contractions. The procedure is still in its infancy and results are not guaranteed.

Laser has also been used to relax or destroy the muscles around the hyperactive bladder. Laser is not a a magic bullet for overflow incontinence and often fails to work. The treatment is painful and the results are only temporary. Laser is also expensive.

Final Note

For those who are affected with an overactive bladder, there are many national and local organizations that provide support to other members. These support organizations offer the latest advice, coping methods and help improve self-esteem. These local chapters can be found on the internet under "incontinence support."

The other problem with incontinence is that most of the lay public and even many health care professionals remain clueless about this devastating disorder. Educating these individuals can help improve understanding and alleviate embarrassment.