Urinary incontinence affects over 13 million Americans, 85 percent of whom are women.  With new urinary incontinence treatment options available at Northwest Hospital Center, women can now be restored to their active lifestyles and improve their overall enjoyment of life.

Urinary incontinence is the general term associated with the loss of voluntary control over bladder and urinary functions.  It may consist of the loss of a few drops of urine while coughing or laughing, or urine loss following a sudden urge to urinate.  Loss of urine may occur in large amounts necessitating the use of pads or even adult diapers. 

Urinary incontinence may be more accurately characterized as one of the following:

• Stress urinary incontinence occurs when there is a loss of urine due to physical forces such as coughing, laughing, sneezing or running.
• Urge incontinence involves a sudden, strong urge to urinate, combined with a sudden, uncontrollable leakage of urine.
• Overflow incontinence produces frequent or constant dribble or urine.
• Neurogenic incontinence is the inability to control bladder function due to nervous system injury or damage.
• Mixed incontinence, as the name implies, involves a combination of stress and urge incontinence issues.

Stress incontinence occurs when pelvic muscles are not strong enough to keep the opening of the bladder neck closed.  This happens because of weak pelvic floor muscles, pressure from other organs or shifting or weakening of the bladder neck region.  Signs of stress incontinence are leaking urine when laughing, coughing, lifting, exercising or increasing abdominal pressure in any other way.  Causes of stress incontinence include vaginal childbirth, aging, intrinsically weak pelvic floor muscles and previous pelvic surgery.

Treatments for Incontinence
While surgery is often needed to correct incontinence, it may not be the only useful treatment method. Behavior modification techniques, drug therapy and injectable bulking agents may be very helpful.  For a minority of individuals, catheters and absorbent products may be the best option to improve bladder control.

If surgery is needed, your doctor may recommend any of several procedures, depending upon the underlying cause of the incontinence.  Therapy is always individualized for best results.  One commonly performed procedure for the correction of stress urinary incontinence is the minimally invasive procedure known as the Trans-obturator tape suburethral sling procedure, or "TOT" as it is commonly known.

Trans-obturator Tape Suburethral Sling (TOT)
The TOT procedure is performed as a minimally invasive surgery technique and may provide long term control of stress incontinence.  The surgery involves the implantation of a synthetic mesh tape below the urethra.  Made from a permanent, biocompatible (polypropylene) material that promotes tissue ingrowth, the bladder neck and urethra are supported in their natural positions.  After the TOT procedure is completed, most women regain control of their bladder and no longer suffer from incontinence.

Minimally Invasive Surgery Option
Northwest Hospital offers patients a modern alternative to conventional surgery.  Known as Minimally Invasive Surgery, many of the disadvantages of tradition procedures are eliminated.

Minimally Invasive Surgery has a variety of patient benefits:

• Less pain
• Shorter hospital stay
• Faster recovery time
• Smaller scars

The TOT is one example of the many new and innovative minimally invasive surgical procedures Northwest Hospital has available to benefit patients.

The Facility
The highest standards of patient care and surgical excellence are practiced by the physicians and surgical team at Northwest Hospital Center.  The procedures performed at Northwest Hospital combine the clinical and surgical expertise of the surgeon, along with the professional attitude, experience and compassion of the highly skilled health care team.

Chief of the Division of Minimally Invasive Surgery
W. Peter Geis, M.D.
410-552-4202

Associate Chief of the Division of Minimally Invasive Surgery
David Zisow, M.D.
410-879-1139

Address:
Northwest Hospital Center
5401 Old Court Road
Randallstown, MD 21133
Phone: 410-521-2200