Incontinence is one of those problems that many people have, but nobody wants to talk about.

Incontinence is one of those problems that many people have, but nobody wants to talk about.
“Women wait an average of eight years before they discuss this problem with their doctor,” said Christopher Roberts, M.D., gynecology/incontinence specialist at the Southwest Women’s Center, Joplin, Mo.
He discussed the problem and therapies to treat it Thursday during a program at the Knights of Columbus Towers.
Roberts noted that there are several types of incontinence with different causes.
“The first thing we need to do with a patient is find out where the problem is located, because not all incontinence is treated the same,” he said.
Whatever the cause, incontinence can have a profound effect on a person’s life.
“I had one lady who was going through 12 adult diapers a day, just soaked,” Roberts said. “Through treatment, I was able to get it down to one pad a day, and this opened up her life for her. One woman told me that now she was able to try on a dress at a department store without fear of soiling it, which was something I’d never thought of before. Incontinence can keep you from being active in the workforce, active as a mom, as a wife.”                    
He added, however, that men are not immune from the problem, especially as they age and develop prostate problems.
Roberts said the first step is to get a good medical history and do testing to determine just what the problem is. Stress incontinence, for example, the type that occurs when a person coughs or sneezes, is often successfully treated with surgery — the so-called “bladder lifting” procedure.
“We also have some new medications that work well for some patients,” Roberts said.
Urge incontinence, or bladder spastically, is a different matter.
“There may not be anything the matter with the bladder here,” the doctor said. “Instead, there is a problem with the nerve carrying the signal from the bladder to the brain.”
Roberts now uses InterStim Therapy, which involves implanting a neurostimulator near the sacral nerves that control the bladder, sphincter and pelvic floor muscles.
“It’s a lot like a pacemaker, but instead of pacing your heart, the InterStim device paces your bladder,” he explained. “It gives you back volitional control of your bladder.”
InterStim, made by Medtronic, was introduced in the 1990s.
“I was skeptical about it for seven or eight years, but I asked about it, and finally went to Little Rock, Ark., for training,” Roberts said. “I’ve been doing the InterStim therapy for about two years now, and I believe I’m the only one in the area who does it.”
He said that the InterStim device is implanted under local anesthesia.
“This is a real help, because many of those who have urge incontinence have other health issues, such as diabetes or hypertension,” Roberts said. “With this, we don’t have to subject them to a major surgical procedure.”
Patients receive a remote control for the device, and four possible programs for the neurostimulator, then undergo a period of fine-tuning to see just what settings work best to control their problem.
“I tell patients that they’d better like the way I look because they’re going to see a lot of me before we figure out what works best,” Roberts said.
He added that, as the body ages and changes, adjustments may need to be made to the programming.
“It’s not that the device worked at first, then it didn’t any more,” Roberts said. “We just may need to tweak it over time.”
However, the treatment is reversible and can be discontinued at any time.
The doctor, who started out delivering babies, is now focusing his practice on dealing with incontinence problems.
“I feel God has put me here on this earth to do something to help people who are having problems with their bladder,” Roberts said. “But I’m not telling anybody that they have to come to me. My big message is that people do not have to put up with incontinence, and they need to talk to somebody about it.”