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Urinary Incontinence

Alejandro Miranda-Sousa, M.D.

Urinary IncontinenceHaving an overactive bladder is nothing to be ashamed of. In fact, nearly 15 percent of women are dealing with it on a chronic basis. As you may suspect, it is more prominent in women due to pregnancies, menopause, and the unique structure of the female urinary tract.

Stress Urinary Incontinence (SUI) is a specific type of problem that is caused by movement or exertion. Certain movements can result in excess pressure on the bladder; which results in unintentional urine loss. In a healthy individual, the muscle surrounding the urethra, called a sphincter, is responsible for containing urine within the bladder. Our bladder walls are made up of muscles that must be relaxed for the bladder to expand. When incontinence occurs, it is because the muscles have been weakened and cannot maintain their normal function. Various events can lead to this condition; childbirth, trauma to the pelvic region, and even chronic coughing from smoking. Knowing the mechanics of urinary incontinence helps us to find a proper treatment.

The most troubling part of having an uncontrollable bladder is that it can happen at virtually any time, day or night. It can occur during laughing, sneezing, or working out. Anytime we experience strenuous physical activity could be the next embarrassing accident. As with most medical problems, being healthy can drastically reduce our risks. Being overweight can increase abdominal pressure making matters worse. A bad habit like smoking can induce coughing; which can weaken the abdominal muscles. There are different treatments available for this condition; ranging from Kegel exercises to surgery.

Kegel exercises are the clenching and unclenching of the pelvic muscles. It is accomplished by “bearing down” and releasing. Also, the use of Botox is an option. When we hear the word “Botox”, it is generally attributed to the removal of wrinkles. However, in this case Botox is used to treat and reduce daily bladder leakage.

Botox has been FDA approved for incontinence sufferers and has shown great success. It works by injecting the Botox into the bladder muscles; this allows them to relax and store more urine with less stress. Botox is not a permanent solution and needs to be re-injected every 9 to 12 months.

Durasphere injections are another option; they are bulking agents that consist of non-migratory and non-absorbable prolytic-coated graphite beads in a gel.  A mouthful to say, but it’s actually a quite simple procedure to help control uncontrollable bladder leakage.  The bulking agents are injected straight into the urethra to fill up the space that permits urine leakage. The injection actually thickens the bladder making it more easily retain a healthy amount of urine. The pyrolytic carbon has been used in the medical field for over 30 years in implantable medical devices and it is non-reactive to tissue. This treatment is a safe and effective, minimally invasive, outpatient procedure option for urinary incontinence.

When it comes to treating urinary incontinence, the InterStim device is the most technologically advanced. This product has been used for over 15 years with over 100,000 individuals undergoing the procedure. The small device is surgically placed underneath the skin to stimulate the sacral nerves, the nerves that control the bladder. It blocks communication between the brain and the bladder. About the size of a pacemaker, this device sends electrical pulses down to the nerves of the pelvic floor. This is a method to reduce the contractions of an overactive bladder.

Urinary incontinence is not something that will go away on its own. Proper treatment is the only way to alleviate the symptoms. If you have any questions regarding incontinence, you can contact Dr. Miranda-Sousa at (239) 226-2727.

Dr. Miranda-Sousa is a Diplomat of the American Board of Urology (ABU) with a Fellowship in Urodynamics and Neurourology. The American Board of Urology is to assure the public that an individual has; (a) received appropriate training, and (b) has a level of urologic knowledge to practice safe and effective urology.

He completed his urology training with a Fellowship at the University of South Florida in Tampa. He graduated from the prestigious Universidad Peruana Cayetano Heredia School of Medicine in Lima, Peru. After his training, he moved to Massachusetts, creating a very successful practice over the course of five years. He has strong working relationships with the Massachusetts General Hospital, Lahey Clinic, Mayo Clinic and the H. Lee Moffitt Cancer Center.

He has published many research and clinical studies in peer-reviewed journals. He has presented his work in many medical conferences, and has been an invited speaker to multiple national and international Urologic conferences. In 2007, he was recognized for having the best abstract at the American Urological Association’s annual meeting.

His areas of special interest and expertise include Urologic Oncology (Cancer Treatment), Minimally Invasive Surgery, Laparoscopic Surgery, Laser Surgery, Neuro-Urology, Urodynamics, Urinary Incontinence, Male Sexual Dysfunction, Non-Scalpel & Needle-Less Vasectomy, Treatment and Prevention of Stones, and Treatment of BPH (Benign Enlargement of the Prostate) and more.

He uses the most modern technologic advances and surgical techniques.

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