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Suggest Treatment For Urge Incontinence

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Posted on Thu, 19 Feb 2015
Question: Hello -- I wanted to update you on my situation and ask some more advise. I saw the surgeon last week. He decided to not do a Ductoscopy, saying the duct or ducts would need to be removed anyway. My surgery is scheduled for next Tuesday. I'm anxious to get it done and over with and hopefully the biopsies will come back ok. My question is this -- I've been having lots of problems with urge incontinence. This is an ongoing problem for the past couple of years that I take Oxybutynin for. This past week, the situation has become much worse with frequency as much as every 30-45 minutes and absolutely no warning. All of a sudden, I have an incredibly painful and burning urge to go and then the urine just comes out. There is no time to get to the bathroom. I'm using heavy duty pads and always sitting on a towel but it's still quite a problem and very embarrassing to leave the house. I took a urine specimen to my doctors office last week and it was OK with no infection. Obviously this is something that needs to be dealt with if it continues. However I'm scared that I won't be able to control it during next week's surgery. Should I ask to have a catheter inserted preoperative? And finally, what should I do about the incontinence. I think this is related to the neuromuscular disease process that has yet to be identified (I had a muscle biopsy done in December but won't see my neurologist again until March). Any advise will be appreciated. Thanks so much.
doctor
Answered by Dr. Aarti Abraham (3 hours later)
Brief Answer:
Need to see a Urologist for the urge incontinence.

Detailed Answer:
Hello again.
Thank you for the update.
Well, if there is no ductoscopy done , how does the surgeon decide WHICH duct / ducts have to be removed ?
Maybe he would do it just pre - operatively or peri - operatively , because ductoscopy is imperative.
ANyways, it is his domain and I am sure he is competent enough.
Do keep me updated with the biopsies, am sure they would be fine.
Now, regarding the urge incontinence.
Yes it is an entirely different and important issue.
Causes are varied and treatment depends on the cause.
A comprehensive workup is needed in the form of a detailed urinanalysis, ultrasounds, cystoscopy, urodynamic studies etc.
Treatment involves myriad options - medication, lifestyle modification, biofeedback, and ultimately - surgery if everything else fails.
You need to see a Urologist for this issue separately and follow up with it.
If you think you would not be able to control it during next week's surgery, you could request a catheter, or wear a heavy duty pad which should suffice.
Neuromuscular disease could be one of the causes, but others need to be ruled out by a Urologist, so please consult one, once you are done with the issue of your duct surgery.
WIsh you so much of luck with both the things, am sure you would come out on top of it all.
Take care.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
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Answered by
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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Suggest Treatment For Urge Incontinence

Brief Answer: Need to see a Urologist for the urge incontinence. Detailed Answer: Hello again. Thank you for the update. Well, if there is no ductoscopy done , how does the surgeon decide WHICH duct / ducts have to be removed ? Maybe he would do it just pre - operatively or peri - operatively , because ductoscopy is imperative. ANyways, it is his domain and I am sure he is competent enough. Do keep me updated with the biopsies, am sure they would be fine. Now, regarding the urge incontinence. Yes it is an entirely different and important issue. Causes are varied and treatment depends on the cause. A comprehensive workup is needed in the form of a detailed urinanalysis, ultrasounds, cystoscopy, urodynamic studies etc. Treatment involves myriad options - medication, lifestyle modification, biofeedback, and ultimately - surgery if everything else fails. You need to see a Urologist for this issue separately and follow up with it. If you think you would not be able to control it during next week's surgery, you could request a catheter, or wear a heavy duty pad which should suffice. Neuromuscular disease could be one of the causes, but others need to be ruled out by a Urologist, so please consult one, once you are done with the issue of your duct surgery. WIsh you so much of luck with both the things, am sure you would come out on top of it all. Take care.