100 North Eagle Creek
Lexington, KY 40509
@andrewmtoddmd
Urge Incontinence
Urge incontinence is a type of urinary incontinence that causes an urgent, uncontrollable need to pee several times during the day and night. You may leak pee before you get to the bathroom. An overactive bladder causes urge incontinence. Treatments include, lifestyle modifications, chronic oral medications (Gemtesa, Myrbetriq, Ditropan, Trospium, Detrol, etc.), and therapies like botulinum toxin (Botox) and nerve stimulation (Interstim, Axonics)
Stress Incontinence
Stress incontinence is the most common type of urinary incontinence. It causes you to leak urine during physical exertion. It can happen during exercise, coughing, laughing and sneezing. Pelvic floor exercises (Kegels) can strengthen muscles and reduce symptoms. Surgical treatments include bulking agents (Bulkamid) and bladder slings.
Bladder Botox
The Botox procedure for OAB is performed primarily in the clinic setting, but may also be performed in an ambulatory surgical center with or without mild sedation.
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It takes about 5 minutes to complete. Doctor Todd performs a cystoscopy and partially fill the bladder with saline. 5-10 injections are performed with 100 units Botox. This usually provides relief for 6 months (2 injections per year). Studies show that 30% of patients experience complete dryness, and 70% of patients experience >50% reduction. Risks are UTI and <5% chance of urinary retention.
Sacral Neuromodulation (Interstim, Axonics)
Sacral neuromodulation (SNM), also known as sacral nerve stimulation (SNS), is a therapy used to treat overactive bladder, bowel dysfunction, and some pelvic pain conditions by modulating nerve signals between the brain and the bladder or bowel. It involves a two-stage procedure: a trial phase with an external device and, if successful, a permanent implant
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SNM involves implanting a small, battery-powered device under the skin, usually near the buttocks, connected to a wire (lead) placed near the sacral nerves. The device sends mild electrical pulses to the sacral nerves, which help regulate bladder and bowel function by improving communication between these organs and the brain.
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It is incredibly helpful for individuals with overactive bladder symptoms like urgency, frequency, and urge incontinence, as well as those experiencing urinary retention or bowel dysfunction. It is a great option for patients who don't want or have failed medications or botox.
Bulkamid
Bulkamid is a urethral bulking agent used to treat stress urinary incontinence (SUI) in women. It works by injecting a hydrogel (Bulkamid) into the urethra to add bulk and help it close more effectively during activities that cause leakage, such as coughing or sneezing. The procedure is minimally invasive and can be performed under local anesthesia or sedation, with most patients returning to normal activities within 24 hours. Studies show that it lasts 5-7 years, and can be reapplied at any time.
Mid-Urethral Sling
(MUS) is a surgical option for women with stress urinary incontinence (SUI). SUI is the involuntary loss of urine during physical exertion, such as coughing, sneezing, or exerci​se.
A small strip of synthetic mesh (usually polypropylene) is placed under the mid-portion of the urethra to provide support and help prevent urine leakage during activity. It acts like a "hammock" to lift or support the urethra and bladder neck. It's a minimally invasive surgery performed through a small vaginal incision. Dr. Todd ​performs the retropubic (TVT) approach. The surgery is typically done as an outpatient under general anesthesia. A catheter is inserted during the procedure and left in for 1 day with packing.