Urinary complications of menopause.
Stress incontinence: leaking.
1.One nonsurgical intervention is an intravaginal pessary help give support to the bladder neck.
2.Surgical options: Mesh (the size of scotch tape) can form a hammock to keep the urethra upright. The mesh is the best treatment that urogynecologists have. The media does not like mesh and attorneys seem to love it
Overactive bladder: urge to urinate.
- First steps: voiding diary. 24-hour diary (writing down how much she drinks and how much she urinates at every bathroom trip) as this gives insight as how well the bladder is functioning.
- 2. Pelvic floor muscle strength. This is assessed during a pelvic exam.
- 3. Common medications are in the family of anticholinergics. The medication limits bladder contractility which is good, but can also cause dry mouth and constipation.
- Other nonmedication treatments: PTNS percutaneous tibial (which is on the leg) nerve stimulation. This is a treatment that can be done multiple times in a urology office.
- Intravesical botox. Botox is inserted into the bladder at your urology office. This helps relax the bladder.
- Spinal stimulation with implantable pulse generator can also give long-lasting relief.
Urinary tract infections: UTIs are more frequent after menopause.
1.The role of estrogen in the urologic system is to help to maintain a beneficial vaginal flora to help decrease infections. Use of estrogen helps decrease UTIs by half. Estrogen can be in the vaginal in the form of cream, pill, or ring.