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If you feel you have urinary incontinence, the first step in treatment is determining exactly what type of leakage you have. This is accomplished by your physician asking several questions about your leakage, performing a complete physical examination and performing a urodynamic evaluation called a cystometrogram (CMG).
A CMG is a painless test that evaluates bladder function. Most commonly it is offered to patients suffering from urinary incontinence and urinary frequency as well as other urinary symptoms.
Because the treatments for each type of urinary incontinence are significantly different, it is essential to differentiate between the various types. The CMG will help determine the type leakage therefore giving your physician the information needed to prescribe proper treatment. Urge incontinence is usually treated with medication and responds almost immediate. Complex incontinence may also be treated with medication.
Stress urinary incontinence is most often treated with some form of surgery. There are many new surgical procedures now available to treat stress incontinence, some of which are performed on an outpatient basis. Additionally, there are new forms of non-surgical therapies such as biofeedback and pelvic muscle stimulation that are useful in treating stress incontinence.
When a patient is given a CMG, she is first asked to empty her bladder. Then she is positioned as though she was having a pelvic examination or pap smear. A small sterile catheter is inserted into the bladder. The catheter is connected to a computer via a fiber optic transducer. The bladder is then slowly filled with sterile water through the catheter. The computer measures how the bladder muscle functions during filling. When the patient feels "full” she is asked to cough, strain, etc. in an effort to cause leakage. The computer measures the bladder pressures at which leakage occurs (if it occurs). The entire test requires approximately 15 minutes.
Studies tell us that millions of women suffer from the various forms of urinary incontinence needlessly because they are afraid to discuss it with their physician. If in reading this information you feel you need to discuss urinary incontinence further with us, please feel free to call our office during business hours for an appointment. Most insurance companies and Medicare cover the costs associated with evaluating and treating urinary incontinence.
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