UAB Synopsis, Vol. 28, No. 18, May 11, 2009

The UAB Continence Center is an interdisciplinary program for the treatment of pelvic urinary and fecal incontinence and pelvic organ prolapse. Urinary incontinence affects 1 in 3 women and 1 in 6 men during a lifetime. Fecal incontinence affects 1 in 12 older men and women and is not uncommon in women after childbirth. About 3% of women experience pelvic organ prolapse, and during a woman’s lifetime she has an 11% chance of undergoing surgery for incontinence or prolapse.

“Incontinence and pelvic organ prolapse can have a devastating impact on quality of life,” says UAB urogynecologist Holly E. Richter, PhD, MD. “Treatment delay is unfortunate, since a proactive approach can prevent or lessen symptom severity. Many new and effective treatment options are available.”

“Nonsurgical approaches for the treatment of urinary and fecal incontinence can be very successful for many patients and are our preferred first-line treatment modalities,” says UAB geriatrician Patricia S. Goode, MD. The UAB Continence Center offers pelvic floor muscle training, bladder control strategies and techniques, fluid and diet management, trigger point massage or injections, biofeedback, and electrical stimulation. Medications are prescribed when necessary. Pelvic organ prolapse also can be treated nonsurgically, using pessaries.

When surgery is indicated, the full range of treatments is available, from new minimally invasive surgeries to more traditional open procedures. Botox injections and sacral nerve stimulation for overactive bladder also are options.

Research studies are ongoing at the center and are offered to patients who qualify. The main clinic is on the first floor of The Kirklin Clinic^®.

Available diagnostic studies include urodynamics, anorectal manometry, and pelvic floor imaging with ultrasound. Comprehensive individualized evaluation helps assure treatment success. For patients’ convenience, continence evaluation and treatment is available at UAB Highlands in the Urology Clinic and at the UAB Senior Clinic at Fair Haven Retirement Center.

The multidisciplinary team at the UAB Continence Center includes nurse practitioners Jeannine McCormick, CRNP, and Lisa Pair, CRNP; Dr. Richter, director of the Division of Women’s Pelvic Medicine and Reconstructive Surgery; urogynecologists Robert E. Varner, MD, and Robert L. Holley, MD; urologists Tracey Wilson, MD, and L. Keith Lloyd, MD; colorectal surgeons Ernesto R. Drelichman, MD, and Jamie A. Cannon, MD; geriatricians Alayne D. Markland, DO, MSc, and Dr. Goode; and behavioral psychologist Kathryn L. Burgio, PhD, research director of the Continence Center.

“With behavioral, pharmacological, and, when needed, surgical interventions, we can improve quality of life for men and women suffering with urinary and fecal incontinence and women with pelvic organ prolapse,” Dr. Markland says.

For appointments, call 205.934.9999 or 1.800.822.8816.