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Urge urinary incontinence due to neurological or non neurological causes

Χωρίς κατηγορία 1021

Treatment without pills. The type of incontinence that is characterized by a sudden urinating desire, that cannot be controled by the patient and is called urge incontinence, is a tormenting feeling and creates a severe social problem, as well as hygiene problems. Also, the cost of incontinence diapers is by no means inconsiderable. This kind of incontinence can be due to certain diseases. These diseases can be neurological or diseases of the bladder wall, such as inflammations or tumours.

However, in the majority of cases there is no known cause for this type of incontinence and thus it is called idiopathic. In order to exclude the presence of serious diseases, some simple medical tests, such as the ultrasound of the urinary tract, the urine test and, sometimes, the cystoscopy, must be performed.

Ένεση της βουτυλινικής τοξίνης στη κύστη.The urodynamic test is a relatively simple examination that records the spasms of the bladder and the increase of pressure in the bladder, at the spasm phase. In the case of incontinence which is due to neurological reasons, the increase of pressure in the bladder due to the highly intense spasm causes, apart from incontinence, a reflux of the urine to the kidneys, which results to their rapid destruction and to a renal failure. The urge incontinence is treated mainly with medicines. Newer medicines, that have even less side effects compared to the older oxybutynin – that causes intense dry mouth, constipation and tachycardia -, are added to the therapeutical arsenal of the urologist. However, the newer medicines are not totally free of side effects, and they are not always effective or tolerable. A new alternative therapeutical method for an overactive urinary bladder is the administration of botulinum toxin, with injections directly in the urinary bladder with the aid of a cystoscope. This medicine has the characteristic that it temporarily relaxes the muscular wall of the urinary bladder and can, thus, improve and, at most times, fully stop this type of incontinence.

P41The injection is applied with local anesthesia and there is no need of hospitalization of the patient. The final result can be observed up to one week after the injections. This treatment result can last up to six months. After this period, the administration of the medicine can be repeated. This treatment is safe, without any considerable side effects, when the instructions and indications that regard its applications are properly observed, although the patients should be informed that, in a small percentage of cases, intermittent catheterization may be temporarily needed. The great advantage of this treatment is the fact that it is minimally invasive, cheap, safe, very effective, that the patient avoids possible problems caused by medication and a possible surgical operation – when drugs are not effective -, while patients with neurological diseases ensure, without any operation, apart from the improvement or even the elimination of their incontinence, the protection of their kidneys against the high pressures that are developed due to the uncontrollable spasms of the bladder.