Stephan L. Werner, MD FACS
Total Incontinence Is the continuous total loss of urinary control. The patient is continually wet.
Causes of total incontinence are neurological, post surgical, after childbirth or due to pelvic disease. Damage to the nerves controlling the bladder may occur from spinal deformities such as spina bifida or scoliosis, trauma to the spinal cord, diseases such as multiple sclerosis or Lou Gehrig's disease or pelvic surgery. Pelvic trauma due to surgery for many pelvic conditions, accidents, radiation treatments or damage due to childbirth may result in total incontinence as a result of nerve damage, formation of scar tissue around the urethra, or leaks, (fistulas), between the bladder or ureters and the vagina or the skin or rectum. In females the most common cause is repeated surgery for stress incontinence, with complete scarring of the urethra. In males it is most commonly seen after radical prostatectomies for prostate cancer.
Treatment of total incontinence depends upon the cause. If a leak or fistula is present, surgery to close the fistula is appropriate. If it cannot be closed, diversion of the urinary tract may be needed. For females with total incontinence due to scarring of the urethra a sling procedure may be helpful. For some patients an artificial sphincter may be implanted or a new sphincter may be created from a muscle transplant. In some patients the only choice is urinary diversion. The treatment must be tailored to each patients needs and results are not uniformly successful.
MidAtlantic Urology Associates LLC
Formerly Werner-Francis Urology Associates LLC
Greenbelt - Bowie - Laurel Maryland
(301) 477-2000 Fax (301) 474-2389
7500 Greenway Center Drive Eigth Floor Greenbelt, MD 20770
A Patient Care Center of Mid Atlantic Urology Associates, LLC