Research programs are underway at the California Institute for Continence at Tower Urology to find more effective treatments to correct urinary incontinence (loss of bladder control) especially in women. These research programs have been formally approved by an institutional review board and follow strict guidelines as to how the research is performed.
Urethrin Injection Study
This study focuses on a "non-invasive" treatment for women who have severe leakage when they cough, laugh, sneeze, or change position (i.e., severe "stress" incontinence). The study is designed to compare the results of two different materials that are injected into the urethra to help "strengthen" the sphincter or valve muscle.
These two materials are collagen from beef (called Contigen which has been available for about three years) and Urethrin (which is a synthetic material). The injection is performed in the office with local anesthesia in about 15 minutes. Repeat injections may be required and patients in the study are followed to compare the results obtained with the two different injected materials.
New Method of Performing "Sling" Procedure
When a women with severe incontinence fails injection therapy, is not a candidate for injection therapy, or elects to undergo a surgical repair to correct her urinary leakage, the sling procedure is the procedure of choice with the best long-term outcome. The sling procedure is a one-hour operation done in the hospital.
The procedure involves placing a strip of material beneath the urethra (the tube that carries the urine from the bladder to the outside) to help close and support the urethra, thus eliminating the incontinence. This study uses specially processed, sterile cadaveric fascia (strong material from the leg) to restore bladder control without having to harvest the patient's own fascia, thus avoiding a significant amount of postoperative pain and shortening the recovery process. Patients undergoing this type of sling procedure will be followed to determine the outcomes after surgery.
Inflow Device to Empty the Bladder
An overactive bladder is a rare cause of incontinence - where the bladder never empties completely and "overflows". Most commonly this problem is seen with nerve problems affecting the bladder such as multiple sclerosis and spinal cord injury. Thus far, the most effective treatment to empty the bladder is to perform intermittent catheterization 34 times throughout the day. We are currently investigating a new device produced in Israel (called the Inflow device) that sits in the urethra and allows the bladder to empty with a unique "pump"design activated by an external controller without having to catheterize. The early results with this device are quite encouraging in well selected patients. This study involves placement of the inflow device in the urethra (performed in the office) with visits to change the device on a scheduled regular basis.
New medication for "Overactive Bladder"
Studies are beginning on a new oral medication to help control the symptoms of urgency (having to rush to get to the bathroom), frequency (urinating very often), and urge incontinence (losing control of the urine). This medication, called Tolterodine, helps to relax the bladder and thus control the urgent need to urinate. This study is designed to check the results and side effects associated with this new oral medication. Preliminary results have suggested that the side effects (i.e., dry mouth, etc.) associated with Tolterodine may occur less often than with other commonly used medications to relax the bladder.
Additional resources on incontinence are available from MayoClinic.com: