Incontinence
About Incontinence
Urinary incontinence happens when urine leaks from the bladder unexpectedly. It may happen when you do physical activities (stress incontinence), or you may fell a very sudden, strong need to urinate (urgency incontinence). In some people, urinary incontinence is caused by an inability to fully empty the bladder (urinary retention).
Incontinence at Paradigm Urology is managed by Dr. Tony Makris, an experienced urologist with a special interest in female and male incontinence.
How is incontinence diagnosed?
If you suffer from incontinence, you’ll usually notice the symptoms on your own. Your doctor can help identify a cause and an appropriate course of treatment using a series of tests. These can include:
Lifestyle and medical history
Your doctor will ask you questions about how much you eat and drink, how often you urinate, how often you leak urine, and any other medical conditions you have. Keeping a bladder diary for a few days can help you answer these questions accurately.
Urinalysis
A sample of your urine may be analysed for signs of infection. In some cases, it may also be tested for chemical markers which could indicate other conditions.
Urodynamics studies
These tests assess the flow rate of urine, your bladder capacity, and the pressure of the bladder (detrusor) muscle. Dr Tony Makris holds a subspecialty in this area.
How is incontinence treated?
The goal of treating urinary incontinence is to manage the impact that it has on your daily life. This may be done by controlling the symptoms themselves, or by addressing an underlying contributor. Plausible treatments may include:
Bladder/pelvic floor training
You may be given a specialised set of exercises to help strengthen the muscles in your bladder and/or pelvic floor. This can help improve  incontinence. Paradigm Urology has a pelvic physiotherapist, Miss Shani Clark, who works along side Dr Makris.
Absorbent garments
If other symptoms aren’t bothering you, incontinence can be managed using clothes or pads which absorb urine as it leaves the body, preventing it from smelling or staining your clothes.
Intermittent catheterisation
If incontinence is due to poor emptying, catheterisation can be used to fully drain the bladder and prevent leakage. Your urologist will teach you how to do this at home.
Bulking agents
These are gel-like agents which are injected into your urethra (waterrpipe) and help reduce and cure incontinence.
Sling surgery
A small ‘sling’ is made of body-safe synthetic mesh or fascia (a piece of very dense tissue covering your abdominal muscle). It is placed inside your body, compressing the urethra slightly and changing its position. This helps many regain urinary continence.
Artificial urinary sphincter (AUS)
This is an implantable device which can only be installed by a urologic surgeon. It has three parts: a cuff which goes around the urethra, a fluid reservoir which rests in the abdomen, and a pump which rests in the scrotum. You control whether or not urine can pass through by squeezing on the pump.
Urinary incontinence procedures
Paradigm Urology offers a range of urinary incontinence procedures including:
- Autologous sling procedure for stress urinary incontinence (SUI)
- Intravesical botox
- Colposuspension for SUI
- Insertion of an artificial urinary sphincter in men and women
- Removal of mesh sling
- Sacral nerve stimulator
- Synthetic mesh sling for menÂ
- Treatments for OAB
- Urethral bulking
- Vaginal fistula repair (abdominal and vaginal)