Common therapies for bladder and pelvic disorders include:

• Rehabilitation
• Medication
• Surgery

Rehabilitation
Holland Hospital's Pelvic Health Rehabilitation program offers effective solutions for a variety of male and female pelvic concerns.  Experienced physical therapists with advanced pelvic care training work in cooperation with the multidisciplinary team from Bladder and Pelvic Health services to treat female bladder problems, pelvic pain, abdominal weakness, how back pain, per-partum needs, bowel dysfunction and more.  For men, we offer expert care for incontinence, testicular and prostate pain, pre/post prostatectomy care, bowel dysfunction and other concerns.

Our experts work closely with you referring doctor or specialist to assure continuity of care.  As the patient, you are the center of our treatment program.  Your needs and wishes shape the treatment plan and goals.  Sometimes having a partner involved can have a very positive impact on recovery and we encourage their involvement.

Medications
Very often, medications such as estrogen creams and other drugs can be effective treatment for problems such as leaking (incontinence), too frequent urination, feelings of urgency and other urinary conditions.

Estrogen strengthens the urethra and other tissues in the urinary tract. During perimenopause and menopause, estrogen levels taper off. As estrogen levels fall, those tissues sometimes weaken to the point of causing bladder problems. A physical examination can determine how strong your urinary tissues are.

Medication is often very effective in strengthening those tissues. Estrogen replacement cream can be applied to the tissues near the opening of the urethra. It increases the blood supply to the area and thickens the mucus that lines the urinary tract. This often provides considerable relief for bladder control problems.

Unlike hormone replacement therapies that were prescribed often during menopause, estrogen replacement cream is a targeted, topical treatment that delivers estrogen only to the treated tissues and surrounding areas. Accordingly, it is considered safe for long-term use and does not have the same risks as more general hormone replacement therapies.

Other medications can also improve the symptoms of incontinence by increasing muscle tone in the area surrounding the urethra. Between 20 and 60 percent of women see improvement in their symptoms after starting these medications.

Surgical Options
Most women we treat have good outcomes with medication and/or exercise therapy. However, if these less invasive alternatives do not produce satisfactory results, surgery may be needed to correct bladder control disorders.

The most common types of procedures involve slings, injections or implants.

• Placement of a sling made of special mesh can be used to reposition and support your bladder. This procedure has been shown to achieve long-term (five-year) success rates greater than 86 percent.
• A collagen injection at the neck of the bladder can help control urine leakage caused by weak pelvic muscles. Multiple treatment sessions are typically required for successful results.
• A neurostimulator implant can correct the communication problems between the brain and the nerves that control the bladder. An external neurostimulator can be used during a trial period, and if successful, it can be implanted internally for long-term use.