Urinary frequency, urgency, and urge incontinence are usually caused by an overactive bladder.  The bladder is supposed to function as a passive reservoir, like a balloon, between episodes of urination.  In some patients, however, the bladder contracts before the bladder is actually full.  Those unwanted bladder contractions define bladder overactivity.

The urinary bladder is quite strong.  So much so that it is often difficult to hold the urine back when one has an unwanted, or involuntary, bladder contraction. Leakage of urine from involuntary bladder contraction is often termed urge incontinence.  There are several treatment options for this condition. Initially, medications are tried.  They unfortunately have a high failure rate.  On our practice, most patients have already tried and failed medications (eg. Oxybutinin, Trospium, Vesicare, Detrol, etc.) before seeking consultation.  

The work-up for medication unresponsive bladder overactivity usually begins with urodynamic testing. This procedure which takes a couple hours in the office can usually determine the location and severity of the condition.  At the same consultation, Dr. Milam will discuss with you the various treatment options.  For urge incontinence this usually includes Interstim Neuromodulation and Botox injection.