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What is Urinary Incontinence?

The simple definition of urinary incontinence is the loss of bladder control, but it can be more than just something that is embarrassing or inconvenient. The truth is, urinary incontinence can be a serious issue, or even something that indicates an underlying health problem, although most women merely view it as a symptom of age and not something they need to discuss with their doctor. At Urogynecology Center NoVa, Dr. Maria Canter understands that urinary incontinence can affect your self-confidence as well as your relationships, neither of which you should just have to “live with.” Dr. Canter is passionate about helping her patients live their best life, free from the burden of whatever type of incontinence you suffer from, including:

  • Stress incontinence – Leaking urine when you laugh, sneeze or cough, as well as when exercising or during physical activity, stress incontinence is typically prevalent in women who have given birth one or more times.
  • Urge incontinence – The sudden, strong urge to urinate, including leaking urine. This type of incontinence is often due to age or overactive bladder syndrome.
  • Overflow incontinence – Frequent or constant urine leakage due to the inability to completely empty your bladder.
  • Mixed incontinence – A combination of symptoms from more than one type of urinary incontinence.

If you have urinary incontinence of any kind, Dr. Canter offers several treatment options – all you have to do is come in to Urogynecology Center NoVa for a consultation and decide which one is right for you.

InterStim Therapy

Bladder control issues can be traced to the roots of the sacral nerves, which are located just above the tailbone. Sacral nerves control the impulses of the muscles responsible for expanding and contracting the bladder. When these nerves aren’t firing properly, your bladder muscles don’t work properly, and urinary incontinence is the result. Problems with the nerves can cause urge incontinence, frequent urination and the inability to empty your bladder completely.

An InterStim procedure involves the implantation of a small device through an incision just above your hip, with a soft wire extending near your tailbone. The device is a neurostimulator, which sends mild electrical pulses to your sacral nerves, regulating and reducing the overactive signals given off by your nerves. This regulation, similar to that of a pacemaker for your heart, can help control symptoms of urinary incontinence that are caused by the miscommunication between your brain and your sacral nerves.

FDA-approved since 1997, InterStim therapy is typically recommended for patients who have not responded to other urge urinary incontinence treatments. Once you and Dr. Canter have decided to try InterStim therapy, you may choose to try out the device before getting it implanted. This is accomplished by wearing the neurostimulator on your waistband, right at the area where it would be implanted. You are able to control the device with a handheld remote, turning the stimulation impulses up or down as needed. If you and Dr. Canter see progress using this therapy, the next step is to implant the device during a minimally invasive outpatient procedure. Even if you get the neurostimulator implanted, you can discontinue or reverse treatment at any time. As with any treatment, there are risks of complications, as well as the chance that the treatment may not be successful. Dr. Canter will discuss the pros and cons of InterStim therapy with you to help determine if it is the correct treatment for your needs and goals.


Most everyone has heard of Botox and its ability to smooth your forehead and eliminate wrinkles. However, most women aren’t aware that Botox can also help reduce symptoms of urinary incontinence. Botox is derived from Botulinum toxin A, a neurotoxin that targets the nervous system, and in the case of urinary incontinence, it works by blocking the signaling process of the neurons (known as neurotransmitters) that control your bladder. By blocking these signals, Botox reduces the contractions of the bladder, which can lead to less urine leakage, less pressure in your bladder and more bladder capacity.

When you decide to undergo Botox to treat urinary incontinence, Dr. Canter will numb your bladder and inject the Botox into the muscles of your bladder. After your injection, you will need to wait about 30 minutes in the office to ensure that you tolerated the injection well, and you will also need to urinate to make sure that the numbing agent has worn off. It does take time for Botox to work, so you won’t see immediate results, though most people notice a difference within about two weeks of treatment.

Similar to InterStim therapy, Botox is typically used if other avenues of treatment for urinary incontinence are unsuccessful or not well tolerated by the patient. It is a temporary treatment, lasting up to eight months, though it can be repeated as often as needed to maintain results. It is FDA-approved, and while it is a safe option for treatment, it does come with the risk of side effects such as increased urinary tract infections.

If you have tried other treatments for your urinary incontinence issues with little to no success, it might be time to try InterStim therapy or Botox to relieve your symptoms.

Call Urogynecology Center NoVa today to schedule a consultation, and reclaim your freedom from urinary incontinence.703-293-5239