Patient presentation by Caldera Medical on dealing with and treatment options for stress urinary incontinence

1. RESTORE YOUR CONFIDENCE
Presented By:
Stress Urinary Incontinence (SUI)

2. Discussion Points
 You Are Not Alone
 What is SUI?
 Causes of SUI
 Incontinence Impacts
 Types of Incontinence
 What to Expect at your Doctor Visit
 What Are My Treatment Options
 Summary
 Q&A
Stress Urinary Incontinence (SUI)

3. You Are Not Alone
T Chronic Conditions in the US (in millions)
op
40
35
30
25
20
15
10
5
0
1. Adapted from: National Center for Health Statistics. Vital Health Stat.10;1994.
2. Adapted from: Fantl JA et al. Managing Acute and Chronic Urinary Incontinence. Clinical Practice Guideline. No. 2, 1996 Update. Rockville, MD: Agency for Health Care
Policy and
Related Research; January 1996. AHCPR publication 96-0686.
Stress Urinary Incontinence (SUI)

4. You Are Not Alone
 Stress Urinary Incontinence (SUI)
 The involuntary leakage of urine with physical stress, such as
coughing, sneezing, laughing, bending and exercise.
 Prevalence
 Over 15 million Americans experience SUI, mostly women.
 SUI can occur at any age – it is the most
common type of urinary incontinence US Female Population
in women. 80+
 While more common in older women, 70-74
Est. 15 million adult
SUI is NOT inevitable with age and SUI is women suffer SUI
# of Years
60-64
NOT a normal part of aging. 50-54
 With new and minimally invasive 40-44
techniques available, you no longer 30-34
0 2,000 4,000 6,000 8,000 10,000 12,000
need to live with SUI. Population (in millions)
Stress Urinary Incontinence (SUI)

5. What is Stress Urinary Incontinence?
SUI in women usually occurs because the pelvic
muscles that help to hold or release urine have been
weakened.
 If coughing, sneezing, exercising, laughing or
doing other activities that put pressure on your
bladder causes urine to leak, you may have Stress
Urinary Incontinence.
Image source: NIDDK Image Library
Stress Urinary Incontinence (SUI)

6. Basic Anatomy
Normal Pelvic Anatomy Female with SUI
In the diagram above the
urethra is no longer
supported in the correct
position.
Stress Urinary Incontinence (SUI)

7. What Causes SUI?
 Stress Urinary Incontinence is the most frequently diagnosed
form of incontinence and can be caused by many different
medical problems, including diabetes and weak pelvic muscles.
 Pelvic muscles and connective tissue are often weakened by:
 Pregnancy  Previous Pelvic Surgery
 Child Birth  Obesity
 Menopause  Smoking
Stress Urinary Incontinence (SUI)

8. Mild to Severe SUI
 Many women leak small amounts of urine during
physical activity such as coughing or laughing.
 Mild leakage effects most women at some time in their
lives.
 Severe SUI occurs most frequently in women
between the ages of 30-60 years and in women who
have had previous pelvic surgery.
 Women with severe SUI may require 6-8 pads per day or
more and may avoid activities outside of the home.
Stress Urinary Incontinence (SUI)

9. Incontinence Impacts
 Embarrassment / lack of awareness of treatment keep women
from seeking SUI treatment
 62% wait a year or longer before discussing with physician1
 17% wait 5 or more years1
1. The 2001 Gallup Study of Incontinent Women
2.Waetjen, L. Elaine, et al. “Stress Urinary Incontinence Surgery in the United States,”Obstetrics & Gynecology. Vol. 101, N0. 4, April 2003, p671-676. Stefanakos, Victoria Scanlan.
“Hold It! (If You Can),”Working Mother, p25-26.
3.Wilson, Leslie, et al. “Annual Direct Cost of Urinary Incontinence,”Obstetrics & Gynecology. Vol. 98, No. 3, September 2001, p400.
Stress Urinary Incontinence (SUI)

10. 3 Types of Urinary Incontinence
Stress Urinary Incontinence (SUI)

11. What to Expect
 Your doctor will ask about your symptoms
and medical history
 A physical examination will be performed
 Bladder Diary
 To record when you void and what liquids you consume
Stress Urinary Incontinence (SUI)

12. Bladder Diary
Fluid intake
Leakage episodes
Pad count/day
Night time voids
Daytime voids
Voided amounts
Stress Urinary Incontinence (SUI)

13. Bladder Irritants
 Caffeinated beverages
 Coffee, tea, soda
 Alcohol
 Tobacco
 Citric fruits & drinks
 Chocolate
 Spicy, tomato foods
Stress Urinary Incontinence (SUI)

14. Non-Surgical Treatment Options
Depending on the severity of your SUI you and your doctor may
first consider non-surgical options:
 Kegel Exercises
 Consists of a series of pelvic exercises to help increase the strength of the pelvic
floor.
 Kegel exercises may reduce or cure mild cases of stress leakage.
 Bulking Agents
 Consist of a collagen or a biocompatible substance injected around the urethra to
reinforce the surrounding tissues.
 The effects of bulking agents are usually temporary and the cure rates are lower
compared to surgery.
 A Pessary
 A stiff ring that is inserted into the vagina. The pessary presses against the wall
of the vagina and the nearby urethra, which helps reposition the urethra leading
to less stress leakage.
Stress Urinary Incontinence (SUI)

15. Surgical Treatment Options
For patients whose lives are adversely effected by SUI, surgery
may be suggested.
 A sling procedure is used to help rebuild and restore support under the
urethra.
 Slings have the highest rate of success of all
treatment options.
 A sling is a synthetic, knitted polypropylene mesh which has been proven
to effectively treat SUI.
 The procedure is usually performed as an outpatient and takes about 30
minutes. ®
Caldera Desara Sling
Stress Urinary Incontinence (SUI)

16. Sling Placement
 Placement depends on your condition
and doctor preference. Typically the
sling is placed through two small
incisions.
 The sling is placed under the skin,
resting just below the urethra creating
a hammock to support the urethra so
you can maintain bladder control.
 The sling is not visible and your own
tissue will quickly grow into the sling
material. This tissue ingrowth will help
you regain continence. Supported urethra using sling
Stress Urinary Incontinence (SUI)

17. Your Recovery
 Generally patients are able to go home the same day of surgery.
 Resuming Activities
 Many women are able to return to their daily activities within several
days.
 You will want to avoid sexual intercourse, heavy straining and lifting for
about six weeks.
 Pain Management
 Pain from the procedure is usually mild and well managed with
medication.
 Catheter
 A catheter may be inserted to drain urine from your bladder. Depending
on the progress of your recovery your doctor will decide on the length of
time it will be needed.
 Results
 In most cases women see results immediately after the procedure with
little pain or discomfort.
 Risks
 Serious complications are rare.
Stress Urinary Incontinence (SUI)

18. Summary
 Urinary incontinence is
common in women
 Incontinence can be treated at
any age
 Thousands of women have
been successfully treated with
the Desara® Sling System
 Get Your Life Back; there is
no reason to live with
incontinence
Stress Urinary Incontinence (SUI)

19. Q&A
Stress Urinary Incontinence (SUI) LT037 Rev. A 7-10 CM