Still Struggling with Female Incontinence? A Urologist Explains Minimally Invasive Treatment Options. 

If female incontinence is decreasing your quality of life, it may be time to seek minimally invasive treatment. A Keck Medicine of USC urologist explains the options. 

Physical therapy and medication are both highly effective treatments for female incontinence, but they don’t work for everyone. For these patients, there is a wide range of safe and effective minimally invasive procedures to consider. 

“There are many safe, noninvasive and conservative treatment options available,” says Elodi Dielubanza, MD, a urologist specializing in pelvic floor conditions with USC Urology and the USC Urogynecology and Reconstructive Pelvic Surgery Program, both part of Keck Medicine of USC. 

Signs that it may be time for a minimally invasive procedure 

Dr. Dielubanza says the decision to seek other treatments is a personal one. For instance, she says, “When and if to have minimally invasive surgery for incontinence really has a lot to do with how disruptive your symptoms are. If you are bothered, then surgery is a very reasonable option, even as a first approach.” 

“Our goal is to improve your quality of life, so we want patients to take an honest look at their degree of impairment,” she adds. 

Do you: 

• Avoid certain activities because of incontinence concerns? 
• Avoid social situations? 
• Adjust your daily schedule to help avoid leakage or accidents? 
• Have trouble being fully active in your job? 
• Avoid fully participating in your favorite exercise or workout routine? 
• Find yourself considering cutting back on work hours? 

If you answered yes to any of these questions, a minimally invasive treatment could be right for you. 

The most common minimally invasive procedures for female incontinence 

For urge incontinence (sudden loss of urine with urge), minimally invasive options include botulinum toxin injections into the bladder, office-based nerve-stimulation therapy or a nerve-stimulation implant.  

For stress incontinence (leakage during certain activities like coughing, laughing or exercising), there are transvaginal supports that fit like a tampon or pessary. Once in place, they provide support for the urethra.  

A urethral-bulking procedure involves injection of special filler material into the walls of the urethra to help reinforce the connective tissue of the urethra. 

There’s also the sling procedure, an outpatient surgery where a sling made from mesh or the patient’s own fascia (connective tissue) is placed to reinforce the support tissue around the urethra. 

More conservative treatments are still available 

Patients who don’t yet feel ready for a minimally invasive procedure still have options.  

“Physical therapy is still considered the gold standard for all types of incontinence,” Dr. Dielubanza says. “There are specially trained pelvic floor physical therapists whose expertise is solely focused on helping patients with female incontinence. Additionally, oral medications can help some patients.” 

Care for every stage of life 

Dr. Dielubanza adds that younger patients often put off treatment, thinking they’re too young to ask for help, while older patients sometimes believe they’ve aged out of treatment options. This is simply not true. 

“Female incontinence can impact patients at any age,” Dr. Dielubanza says. “But there are many safe and effective options that can be tailored to your needs at different times of life.” 

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Kate Faye

Kate Faye is a writer and editor for Keck Medicine of USC.

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