I am a 35 year old woman in the UK, who has had urge incontinence
since the birth of my second child, by Ceasarean section.
I have had a urodynamics test, the results of which suggested an unstable detrusor. My gynaecologist has tried drugs and bladder training to try to resolve the problem, without any success, and has now referred me to a urologist. The urologist is planning to do a cystoscopy to identify whether I have a motor or sensory problem, and at the same time has suggested a urethral stretch.
I have been looking for information about the urethral stretch (dilation), but can find very little in relation to urge incontinence, only as a cure for a stricture. The little I have found suggests that this procedure is old and has fallen out of favour with most urologists.
I have a few questions that I hope you can answer -
1. Do urologists in the US still use urethral dilation as a cure for urge incontinence?
2. If not, why has it fallen out of favour? Is it ineffective or does it lead to other problems and are there any better procedures now?
3. If it does not cure the urges, I am concerned that the stretching will leave me unable to control the urges as well as I can at present, and also, whether it cures the urges or not, that it may weaken the sphincter muscles leading to loss of control and leakage either now or in later life. Has this been seen before?
I hope you are able to answer some of these questions.
To directly answer your question, yes, urethral dilitation is still used by urologists in the US. The procedure is quite controversial in the urology community as to whether it really has a measurable effect (I don
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