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What are the treatment options?
These are some of the options: |
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Behavior modification - Bladder training, timed
voiding, pelvic muscle exercises (Kegel's), biofeedback |
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Devices - Vaginal cones and pessaries |
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Medicines - Oxybutynin and imipramine usually for
urge incontinence only. For both urge and stress incontinence estrogen replacement can be given. |
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Surgical management: |
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Stress urinary incontinence - The medical literature indicates that abdominal
surgery has a better long-term cure than vaginal surgery. |
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Urge incontinence - When the bladder suddenly contracts and expels urine,
this may not be associated with a full bladder or any stress event. |
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Laparoscopic surgery - The primary procedure for incontinence is the BURCH
procedure. If pelvic prolapse is also associated with urinary incontinence,
then site-specific defect repair is performed along with the BURCH procedure. |
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Tension Free Vaginal Tape (TVT) - This a recent development in minimally
invasive surgery for incontinence. TVT is a 45-minute procedure with long-term
cure rates that are similar to those of the laparoscopic BURCH procedure. The
recovery is faster than after laparoscopy. TVT is ideal for a patient who has
stress urinary incontinence as a sole complaint with minimal prolapse of other
tissues.
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