Toronto hospital offers effective but rarely used treatment for severe incontinence

TORONTO- A Toronto hospital offers an effective but relatively unknown treatment for severe incontinence, a condition that affects approximately 10 per cent of Canadians.

“Overactive bladder is a common condition that affects 1 in 10 Canadians, 13 per cent Canadians. It affect men and women equally. It’s more common than osteoporosis or diabetes but isn’t talks about as much because it’s embarrassing, but it’s incredibly prevalent and common in Canada,” said Dr. Dean Elterman, a urologic surgeon at Toronto Western Hospital and assistant professor of Urology at the University of Toronto.

Elterman is one of two urologic surgeons in Ontario who perform a surgery to correct for severe incontinence. The treatment involves implanting a bladder pacemaker for people who have overactive bladders, overactive bladders with a loss of urine, people who have urinary retention or people who have fecal incontinence, Elterman said.

“Frustrating is a word that comes to mind. A constant battle and frustration. An urgency to find a bathroom and it was just a need to try and find a fix,” said Stephanie Carpenter, a 46 year old mother from Barrie, Ontario who spent 20 years frustrated by her severely overactive bladder.

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“I wasn’t able to drink caffeine. I had to avoid quite a few food that were diuretics and it was just a constant need to know where a bathroom was,” said Carpenter.

The average person’s bladder can hold between 300-500 ml of liquid, roughly the amount in a can of pop or bottle of water, according to The Canadian Continence Foundation. The group provides information about the condition,a quiz to determine if you have a bladder problem, a tips on control.

“I started with frequent medicines, bladder stretches, I also had Botox done,” said Carpenter.

Wanting a better solution and a normal life, Carpenter found out about the bladder pacemaker and the surgery offered at Toronto Western Hospital.

“The bladder pacemaker works just like a heart pacemaker. You can imagine our body is a network of signals travelling through the nervous system. What happens with a heart is that those messages are being transmitted in a bad way, and the heart pacemaker would help the heart to beat regularly. So what happens with an overactive bladder is messages from the bladder to the brain via the spinal cord are abnormal. What we can do with a bladder pacemaker is correct those messages,” said Elterman.

To ensure the devise, small enough to fit in your palm, works patients are first fitted with a temporary system which they wear for three days. If their symptoms improve by more than 50 per cent they will be considered a candidate.

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Carpenter had the operation in March of 2014.

“I no longer have to go hunting for a washroom, it’s so much better. I can go for walks and not have to worry about it. I can sit at my desk at work and not constantly have to get up and sleeping beautifully.”

Yet few people know about the bladder pacemaker.

“There are a couple of reasons why this hasn’t become popular, especially because this is only available in specialized centres. Up until a year ago there was only one physician in all of Ontario practising this procedure, my partner. (Dr. Madgy Hassouna) He’s a pioneer in this technology but we were limited in the number of procedures we could do because lack of funding from the Ministry of Health. Now that we can do this more often, the challenge is getting the word out, not only to physicians but to patients,” said Elterman.