<p>My 78 year old mom has had an incontinence issue ever since she had her hip replaced. I didn’t like her primary care doctor’s response “your old and that’s what happens when you get old”, so I got her in to see a geriatric specialist who referred her to a Urologist.</p>
<p>The Urologist tells her that she suffers from Stress Urinary Incontinence.</p>
<p>The options he told her about:
- do nothing- unless she feels her quality of life is decreased
- Coaptite injectable implant - done under a local anesthetic at the hospital
- Create a “sling” for her bladder. Very very invasive and the complications can be great.</p>
<p>The Urologist is telling her that the least invasive procedure is the Coaptite Injectable Implant. He would not recommend the sling surgery since he has never done one on a person mom’s age and the complications could be worse than the incontinence.</p>
<p>Mom is ok with leaving things as they are but she is thinking about the implant. She feels guilty that we have to buy her boxes of depends just so she can have a social life. I don’t mind buying these things for her, just want her to be happy.</p>
<p>Does anyone have any experience with this procedure?</p>
<p>Chuckledoodle: Can your mom’s internist write an Rx for her to have PT? There are PTs who specialize in incontinence issues in our area, and I hear they can be very helpful, particularly with stress incontinence. (And, what might be just “inconvenient” incontinence now could end up getting worse, and might keep her from qualifying from some assisted living situations in the future.)</p>
<p>Avoid the sling surgery at all costs. Result vary enormously and the correction frequently fails within the first 3 years. (At least according to my OB/GYN. Also according to a family friend who’s a urologist.)</p>
<p>Second the rec for PT; however finding a PT who handles incontinence issues can difficult unless you live in at least a mid-size town. (There are exactly 3 in my city of 500,000 people.)</p>
<p>Be aware that the PT doesn’t work for everyone and requires a daily/several times a week maintenance exercise regime. Unless your mom is capable and willing to do maintenance exercises, PT will be a waste of time and money.</p>
<p>Kegel exercises, which she can do on her own at home. They involve loosening and tightening the muscles of micturition and others in the groin and pelvic area. Here is one link and you can google for many more.</p>
<p>[Kegel</a> Exercises For Women](<a href=“Vaginal Weights | Kegel Weights | Vaginal Cones - Vagacare”>http://www.kegelexercisesforwomen.com/)</p>
<p>Has her Dr. discussed the option of a trans vaginal tape (TVT) procedure. It is relatively non invasive, and when done by a proficient and experienced practitioner has a good result rate. </p>
<p>If you google info on TVT you will quickly come across several sites which discuss class action lawsuits and severe problems with this procedure. From what I can tell, the early problems are related to a particular tape material which caused erosion issues. </p>
<p>Consider having your mom evaluated by a uro gynocologist. As the name suggests, this specialist is knowledgeable in both systems and one often causes problems in the other. They will most likely have her undergo a series of uro dynamic testing to see if the problem is muscular or nervous system related. Although the symptom is the same - leakage - the underlying causes can be very varied and needs to be identified before a treatment is recommended.</p>
<p>OP here. Mom has done the PT for kegel and it hasn’t worked. Her Urologist says its because of her age. She is going in next month for the Urodynamic test which is the precursor for the Coaptite. 10 days after the test, she has a followup appt with the doctor to go over the results and have further discussion.</p>
<p>I will ask her Doctor about the trans vaginal tape (TVT) procedure. He seems very informed and has already said he advises against the sling, so that option is off the table.</p>
<p>Thank you for the information about the incontinence and possible assisted living problems. Mom is still able to get around and not requiring any assistance (so far), although I can see it coming in the future. Hubby and I have been discussing future plans on what to do “when…if…” happens and looking into resources that may be able to help depending on mom’s quality of life.</p>
<p>I know a PT who works in this field, and depending on the degree of prolapse, she recommends a pessary as a way to avoid surgery. She states you need to find the right gyn, who will work with you to find the right pessary, which is no more difficult to use than a diaphragm. However getting one that works can be a process. Some, if not most, physicians tend to recommend surgery for this problem, rather than working on alternatives.</p>