Type of Surgery
Last updated: 11/24/2009
Incontinence significantly affects a patient's quality of life; thus patients usually consult a doctor when their urinary problems begin to cause difficulties in the workplace or on social occasions. A family care practitioner will usually refer the...
patient to a urologist for diagnosis of the cause(s) of the incontinence. Patients with urinary and fecal incontinence are evaluated carefully through the taking of a complete patient history and a physical examination. The doctor will use special techniques to assess the capacity of the bladder or rectum as well as the functioning of the urethral or anal sphincter in order to determine the cause or location of the incontinence. Cystoscopy, which is the examination of the full bladder with a scope attached to a small tube, allows the physician to rule out certain disorders as well as plan the most effective treatment. These extensive tests are especially important in diagnosing interstitial cystitis because all other causes of urinary urgency, frequency, and pain must be ruled out before surgery can be suggested. Cystoscopy is done under anesthesia and often works as a treatment for IC. Once the doctor has made the diagnosis of urinary incontinence due to sphincter insufficiency, he or she will explain and discuss the surgical implant with the patient. SNS may be tried out on a temporary basis. The same pattern of diagnosis and treatment is used for patients with IC and fecal incontinence. Temporary implants can help eliminate those patients who will not benefit from a permanent implant.
Much of the difficulty in brain surgery recovery comes with healing of the skull and covering of the brain. This video shows that a tumor in a particular location can be removed by entering through the nose, rather than the skull. The endoscopic endonasal approach or EEA is associated with rapid recovery times compared to most other types of brain surgery.
Sacral nerve stimulation, also termed sacral neuromodulation, involves the implantation of a programmable stimulator under the dura matar which delivers low amplitude electrical stimulation to the S3 or S4 root. Currently, the FDA has approved InterStim Therapy, by Medtronic, as a safe sacral nerve stimulator for treatment of Urinary Urge Incontinence, Urinary Frequency, and Urinary Retention. Sacral nerve stimulation is under investigation as treatment for a host of other conditions, though.
Select comparative data from 1999 to 2006 include a decrease of 14 percent in the number of neurosurgeons in private practice and a decrease of 13 percent in the number of neurosurgeons in solo practice.
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