Involuntary incontinence, the loss of bladder control, can be due either to impaired function of the urinary bladder’s closing mechanism (stress incontinence) or due to an overactive bladder (urge incontinence). In some cases it’s a combination of both.
At the clinic all examinations and tests are performed which means minimal wait times and expedited test results.
Before your appointment at the clinic you will:
During your first outpatient visit you will meet with a urologist who is highly specialised in treating urinary incontinence. You will be asked to describe your ailments and we will walk you through your questionnaires and the result of your blood test.
After this the urologists will perform an exterior body exam, examination of the urinary flow and bladder control. In local anaesthesia, a cystourethroscopy, a procedure to look inside the bladder using a thin flexible endoscope, is performed.
If cystometry is required, you will be in a lying, seated or standing position. Under local anaesthetic, a catheter is inserted through your urethra. Another catheter is placed in your rectum. The catheters monitor the pressure in your bladder and your abdomen.
The testing is performed while awake in the Peritus Clinic’s urodynamic laboratory.
Based on the results of the examination your urologist and you will decide on an individual treatment plan.
Pelvic floor exercises strengthen the pelvic floor muscles and in many cases is an effective method to treat stress incontinence, with results normally within 3-6 months. To ensure that the exercises have effective results our urology nurses will guide you and monitor your progress. You can also use the app Tät®II, which you can download for free on AppStore or Google Play.
At Peritus Clinic you can receive support and guidance from our urology nurses, who are experts in assessment and treatment of urinary incontinence. They will help you try out and prescribe incontinence medical devices (sanitary pads, penile compression device, catheters and urinary bag)
The drug Duloxetin (Yentreve) increases the tension in the muscles of the urethra and thereby reduces stress incontinence.
Patients suffering from urge incontinence can benefit from pharmaceutical treatment that reduces bladder tension (Toviaz, Tolterodine, Betmiga, and more).
Botox injections in the bladder muscle may be effective in treating severe problems with stress incontinence where other treatments have been exhausted. The injections are performed at Peritus Clinic in local anaesthesia and take about 20 minutes. The effect lasts for up to 6-7 months and will then need to be repeated.
Surgery can be performed to treat severe problems with stress incontinence when other treatments have been exhausted.
The surgery is performed in full anaesthesia and normally takes 2 hours. After the surgery you will have a catheter overnight. The catheter is removed the following morning and you can normally leave the hospital the day after surgery.
Leave of absence is usually required for 2-4 weeks after surgery and after 5 weeks you will have a follow-up appointment with a nurse and the surgeon who performed the surgery.
At Peritus Clinic we use two types of surgical methods: sling surgery and artificial urinary sphincter performed by highly specialised urologists.
Sling surgery has been used for more than 10 years and is a minimally invasive surgery with speedy recovery.
The surgeon creates a “sling” out of mesh or human tissue. It is placed under the urethra. The sling is like a hammock that lifts and supports your urethra and the neck of your bladder (where your bladder connects to your urethra) to help prevent leaks. The sling remains permanently and needs no maintenance.
The best results are seen with light to moderate stress incontinence (less than 4 sanitary pads per day) and in men whose sphincter is intact (can stop urinary flow).
Most men experience a marked decrease of urinary incontinence and some are complete incontinence free following the surgery. An evaluation shows that 92 percent are satisfied with the result and 94 percent would recommend the surgical method to a friend.
The method is not appropriate for patients who are undergoing or will be undergoing radiation therapy targeting the pelvic area.
This surgical method has been used for more than 40 years and is considered “the golden standard” of surgery for stress incontinence. The artificial urinary sphincter (AUS) functions as a healthy sphincter and allows the patient to control urination.
The AUS acts as a natural sphincter and consists of three liquid containing soft silicon parts that are inserted in surgery. The patient must understand and be able to handle the system for the surgery to be successful.
AUS is appropriate for all types of stress incontinence including for those patients who are undergoing or will be undergoing radiation therapy targeting the pelvic area, or have a completely non-functioning sphincter.
The majority of patients experience a clear improvement and some are completely incontinence free after the surgery. An evaluation shows that 90 percent of patients are satisfied with the result, 92 percent would repeat surgery if necessary, and 96 percent would recommend the surgical method to a friend.