Urogynecology Expert Forum
Urge incontinence
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Questions in the Urogynecology forum are answered by Bruce Crawford, MD, J. Kyle Mathews, MD, and other medical professionals and experts. Topics covered include overactive bladders, bladder pain, fallen/drooping bladder, bowel urgency, bowel prolapse, cystitis, incontinence, pain with intercourse, rectal prolapse, surgery, urinary urgency, and uterine prolapse.

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Urge incontinence

I am 50 years old, have had 3 children. I had an hysterectomy at 40 for cystocele and rectocele, at that time I also had a bladder repair. I was OK for a while. A few years ago I developed urge incontinence. I went to a urologist who told me the vaginal sling (gynecort) would help me. I clearly told him that stress incontinence was not a big problem for me like it had been in the past. I had the sling surgery, and almost immediately my incontinence came back. It has gradually gotten worse. That was 3 years ago. I have since found out that the sling is for stress incontinence. Needless to say I changed Drs. I now am taking Sanctura after trying almost all the drugs for incontinence. I take it twice a day. I usually get up during the night once and many times don't even make it to the bathroom even after taking the Sanctura at bedtime. Usually what happens is, I am OK one minute  and suddenly have pain/spasm and there is no holding back. It is extremely distressing. A lot of times I don't even have the urge to urinate when it hits. It seems to be the worst when I go from standing to sitting or vice versa. Also, I have been on different hormone therapies since my hysterectomy including oral and patch estrogens, testosterone, bioidentical hormones, etc. I am now only on progesterone cream. I have occasional hot flashes but just mostly stay hot a lot and generally  don't feel that great. I have gained quite a bit of weight over the past few years. That probably puts pressure on the bladder I am sure, but I would like to go about my daily routine without worrying about accidents happening. I now have an   appt. with another Dr. who is well known for urogynecology. Do  you have any thoughts on my situation?
One Dr. told me the sling often makes urge incontinence worse. Is this true? Thank you very much.
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242593_tn?1313867921
The sling can make urge incontinence worse, but that usually improves over time.
Get an evaluation of your bladder voiding function. Have your doctor check your postvoid residual (the amount left in your bladder after you void). If this is elevated (Like 200 cc or more) , it may be that your sling may be on the tight side and needs to be released, (or your bladder muscle is too supressed by the sanctura dose).

As I understand your comments, you never had stress incontinence to begin with... And you are right. The sling is for Stress incontinence.

Yes, please follow up with a TRAINED urogynecologist. Ask to see evidence of their training.
2 Comments
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I have dyslexia and cerebral palsy that only infect my balance and larning.  Can that also effect my bladder i  wet the bed at nights.  and my doctor has no clue to do with it. he tired med. no luck.   I been  wearing adult diaper at night because of it
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1344197_tn?1392822771
J. Kyle Mathews, MD, DVMBlank
Plano Urogynecology Associates
Plano, TX
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