Women’s treatment options
Female urinary incontinence
Urinaryincontinence includes stress urinary incontinence (leaking urine duringcoughing or activities due to a weakness in the urinary sphincter) or urgencyurinary incontinence (suddenly needing to urinate so urgently that youdon’t reach the washroom in time).
What causes urinary incontinence in women?
Stressurinary incontinence in women is often related to past pregnancies ordeliveries. Urgency urinary incontinence is often caused by overactive bladder.Other health problems or age can play a role in exacerbating the problem, butincontinence is not an inevitable consequence of aging.
How do we test for female urinary incontinence?
Dr.Campeau offers complete evaluations, including cystoscopy and urodynamictesting, to understand your condition and determine the best course of action.Cystoscopy uses a small camera to do an internal visual inspection of the lowerurinary tract. In urodynamic testing, small tubes are inserted into yourbladder so we can assess your bladder function. You can read more about thesetests here.
How do we treat female urinary incontinence?
Constantlyworrying about finding a washroom can cause anxiety and stress. Luckily, thereare many treatment options for urinary incontinence.
Thereare some non-surgical treatments you can try before considering surgery. Youcan learn more about them from this helpful brochure produced by the CanadianUrological Association.
Dr.Campeau has specialized expertise in a range of treatment options for urinaryincontinence, from medical management to surgery.
Treatments:
Urethral bulking agent
How does urethral bulking work?
Urethral bulking involves injecting a bulking agent (Bulkamid®) around your urethra to increase its resistance. This helps to reduce leakage. The procedure is done with the help of a cystoscope (tiny camera).
Intravesical Botulinum toxin (Botox®) injections using cystoscopy
How do intravesical Botox® injections treat urinary incontinence?
Injections of Botulinum toxin (Botox®) can relax your bladder muscles and reduce the symptoms of incontinence. This procedure involves injecting small amounts of Botulinum toxin (Botox®) into the wall of the bladder through the urethra. To do this, we use a cystoscope (tiny camera). It only takes a few minutes. The procedure decreases urgency incontinence and reduces the need to urinate urgently. The effect of the treatment lasts, on average, 9 months, and will need to be repeated.
If non-surgical approaches have not helped you, there are other options. Dr. Campeau can help you decide which one may be right for you.
Synthetic mid-urethral sling
How does a mid-urethral sling work?
We insert a narrow (about 1 cm) strip of mesh, called a sling, to support the urethra and prevent leaking. Within 4-6 weeks, your own tissues grow into the mesh and keep it in place.
Autologous fascia pubovaginal sling
How does a pubovaginal sling work?
We take a strip of your own tissue, usually from the abdomen or leg, and place it under the urethra. The tissue is placed in such a way that it tightens when you cough or move, stopping leaks.
Sacral neuromodulation surgery
How does sacral neuromodulation (SNM) surgery work?
In sacral neuromodulation (SNM), an electrode and a device similar to a pacemaker are surgically implanted to send low-intensity electrical pulses to the nerves in your sacrum. This normalizes the signalling between the brain and bladder/bowel.
Pelvic organ prolapse and vaginal laxity syndrome
Pelvic organ prolapse is when one or more of your pelvic organs shifts, usually because the muscles and tissues holding your organs in place have been weakened. You may feel the organ bulging or pressing against the vagina, which can be uncomfortable or even painful. It can also cause difficulty peeing or having bowel movements, lower back pain, and sexual problems.
Vaginal laxity syndrome is when the delicate tissues of the vagina lose their natural elasticity and tone. This can lead to decreased sensation during sex.
Symptoms of pelvic organ prolapse and vaginal laxity syndrome are often underreported because they relate to intimate functions of the body, and because women don't think anything can be done about them. While these conditions are not typically considered serious health issues, they can really affect your confidence and comfort. But these conditions are more common than you probably think, and you're not alone.
How are pelvic organ prolapse and vaginal laxity syndrome treated?
If youhave symptoms of pelvic organ prolapse, Kegel exercises and maintaining ahealthy weight can help. If non-surgical approaches have not helped you, otheroptions are available too. Dr. Campeau provides individualized treatment for pelvicorgan prolapse and vaginal laxity syndrome. She can work with you to choose theright treatment.
Treatments:
Vaginal pessary fitting
How does a vaginal pessary work?
A vaginal pessary is a removable device we can place in your vagina to support the vaginal or uterine walls if they have become weakened and prolapsed. A vaginal pessary can be worn occasionally or continuously.
Vaginal laser therapy
How does vaginal laser therapy work?
In vaginal laser therapy, we use laser to stimulate collagen production and enhance vascularization in the vaginal walls.
Outcomes are subjective and vary between individuals. Since this treatment is elective, it is not covered by the Régie de l’assurance maladie du Québec (RAMQ).
If non-surgical approaches have not helped you, you may wish to consider surgical options. Dr. Campeau can help you decide which one may be right for you.
Anterior colporrhaphy
How does anterior colporrhaphy work?
Colporrhaphy is a surgical procedure in which we repair weakness in the vaginal walls. In anterior colporrhaphy, we tighten the muscles holding your bladder in place. This procedure is also called an anterior repair or cystocele repair.
Posterior colporrhaphy
How does posterior colporrhaphy work?
Colporrhaphy is a surgical procedure in which we repair weakness in the vaginal walls. In posterior colporrhaphy, we tighten the muscles holding your rectum in place. This procedure is also called a posterior repair or rectocele repair.
Sacrospinous ligament fixation
How does sacrospinous ligament fixation work?
In a sacrospinous ligament fixation, we stitch the top of the vagina or cervix to a pelvic ligament to help correct the prolapse.
Uterine-sparing interventions for pelvic organ prolapse
What are uterine-sparing interventions?
In uterine-sparing interventions, the uterus is not removed. There are different reasons patients may choose to preserve the uterus, including a desire to retain the option to have a child in the future. Uterine-sparing procedures include robotic-assisted laparoscopic abdominal sacrohysteropexy or vaginal sacrospinous hysteropexy. Dr. Campeau can work with you to choose the approach that best suits your situation.
What is abdominal sacrohysteropexy?
Abdominal sacrohysteropexy is a minimally-invasive procedure in which tissue or synthetic mesh is sewn onto the prolapsed organ(s). Robotic-assisted laparoscopic surgery uses robotic arms to make smaller incisions than with standard surgery. A piece of mesh is stitched onto the uterus/vagina as well as a ligament to place the organs in their correct position.
What is vaginal sacrospinous hysteropexy?
Vaginal sacrospinous hysteropexy is done through a vaginal incision, so there are no cuts on your abdomen. We stitch the uterus to a strong ligament in the pelvis to strengthen the tissues and hold your organs in place.
Vaginal hysterectomy with sacrospinous ligament fixation
How do vaginal hysterectomy and sacrospinous ligament fixation work?
In a vaginal hysterectomy, we remove the uterus via the vagina, then stitch the top of the vagina or cervix to a pelvic ligament.
Are uterine-sparing interventions preferable to removing the uterus?
While many patients choose to preserve the uterus, removing it may still be the best option in some cases. Dr. Campeau can guide you in this decision.
Robotic-assisted laparoscopic abdominal supracervical hysterectomy and sacrocolpopexy (with or without salpingo-oophorectomy)
How do robotic-assisted laparoscopic abdominal supracervical hysterectomy and sacrocolpopexy work?
In these procedures, we remove the uterus using small incisions made by robotic arms. The cervix is left intact. A piece of mesh is stitched onto the cervix/vagina as well as a ligament to place the organs in their correct position.
What is salpingo-oophorectomy?
In some cases, we may also decide to surgically remove the ovaries and fallopian tubes.
Vaginoplasty, levatorplasty, and perineoplasty
How do vaginoplasty, levatorplasty, and perineoplasty work?
In these reconstructive procedures, we tighten the vagina to increase friction, making sex more gratifying.
Since these treatments are elective and not considered medically necessary, they are not covered by the Régie de l’assurance maladie du Québec (RAMQ). These treatments are offered to individuals who wish to address personal concerns related to appearance or subjective comfort in the vulvar and vaginal areas, in the absence of disease or functional impairment.
Female voiding and pelvic floor dysfunction
Voiding dysfunction is when you experience hesitancy, straining, or incomplete emptying. These symptoms can be really frustrating, and are often misdiagnosed.
What causes voiding dysfunction?
There are numerous possible causes, such as a hypertonic pelvic floor (vaginismus), a urethral stricture, an underactive bladder, or a bladder outlet obstruction from a past incontinence procedure.
How do we test for voiding dysfunction?
Dr. Campeau offers complete evaluations, including cystoscopy and urodynamic testing, to understand your condition and determine the best course of action. Cystoscopy uses a small camera to do an internal visual inspection of the lower urinary tract. In urodynamic testing, small tubes are inserted into your bladder so we can assess your bladder function. You can read more about these tests here.
Treatments:
Clean intermittent catheterization teaching
What is clean intermittent catheterization?
Clean intermittent catheterization (CIC) means having a catheter that you insert and remove on your own to help you urinate. This treatment is often provided for patients with underactive bladder. Dr. Campeau can show you how to do a CIC (putting in and taking out the catheter) safely and easily.
Pelvic floor Botulinum toxin (Botox®) injections
How do pelvic floor Botulinum toxin (Botox®) injections work?
To treat a hypertonic pelvic floor or vaginismus, we can inject Botulinum toxin (Botox®) into the pelvic floor, which relaxes the muscles and improves symptoms. The effect usually lasts for 3-9 months after the injection.
If non-surgical approaches have not helped you, there are other options depending on the cause.
Female buccal graft urethroplasty
How does urethroplasty work?
Urethroplasty is used to treat a urethral stricture. It is a procedure in which we widen your urethra using tissue taken from inside your mouth (buccal mucosa).
Vaginal mesh excision
What is vaginal mesh excision?
Dr. Campeau can remove (excise) part or all of the vaginal mesh that was previously implanted to treat your pelvic organ prolapse or urinary incontinence.
Urethrolysis
What is urethrolysis?
In urethrolysis, we remove scar tissue or a blockage that resulted from a previous surgery. This procedure is usually done vaginally (through the vagina).
Sacral neuromodulation surgery (SNM)
How does sacral neuromodulation (SNM) surgery work?
In sacral neuromodulation, an electrode and a device similar to a pacemaker are surgically implanted to send low-intensity electrical pulses to the nerves in your sacrum. This normalizes the signalling between the brain and bladder/bowel.
Cosmetic urogynecology
As an experienced urogynecologist, Dr. Campeau provides compassionate care for women who wish to address functional, sexual, or anatomical issues. She applies an evidence-based, patient-centred approach to improve your well-being, quality oflife, and personal dignity.
Treatment:
Labiaplasty
How does labiaplasty work?
This surgery is typically done to reconstruct the vulva labia minora (the inner lips of the vulva) and clitoral hood so you feel more comfortable and confident.
Since this treatment is considered elective and not medically necessary, it is not covered by the Régie de l’assurance maladie du Québec (RAMQ). It is offered to individuals who wish to address personal concerns related to appearance or subjective comfort in the vulvar and vaginal areas in the absence of disease or functional impairment.
Men’s treatment options
Male urinary incontinence
Urinary incontinence includes stress urinary incontinence (leaking urine during coughing or activities due to a weakness in the urinary sphincter) or urgency urinary incontinence (suddenly needing to urinate so urgently that you don’t reach the washroom in time). Both forms are common, and either form can cause a lot of distress. Luckily, there are many treatment options. The first step is to determine the cause of the incontinence.
What causes urinary incontinence in men?
Stressurinary incontinence in men is often caused by a past prostate surgery orradiation therapy for prostate cancer, since these treatments can affect yourability to control your urinary sphincter.
How do we test for male urinary incontinence?
Dr.Campeau offers complete evaluations, including cystoscopy and urodynamictesting, to understand your condition and determine the best course of action.Cystoscopy uses a small camera to do an internal visual inspection of the lowerurinary tract. In urodynamic testing, small tubes are inserted into yourbladder so we can assess your bladder function. You can read more about thesetests here.
How do we treat male urinary incontinence?
If you’re dealing with urinary incontinence, there are some approaches that can help, like pelvicfloor exercises ,healthy bladder habits, and pelvic floor physiotherapy. There is also a range of treatment options we can consider for you, from medical management to surgery.
Treatments
Intravesical Botulinum toxin (Botox®) injections (cystoscopy )
How do intravesical Botox® injections help with male urinary incontinence?
Injections of Botulinum toxin (Botox®) can relax your bladder muscles and reduce the symptoms of incontinence. This procedure involves injecting small amounts of Botulinum toxin (Botox®) into the wall of the bladder through the urethra. To do this, we use a cystoscope (tiny camera). It only takes a few minutes. This reduces the need to urinate urgently. The effect of the treatment lasts, on average, 9 months, and will need to be repeated.
Sacral neuromodulation surgery
How does sacral neuromodulation (SNM) work?
In sacral neuromodulation (SNM), an electrode and a device similar to a pacemaker are surgically implanted to send low-intensity electrical pulses to the nerves in your sacrum. This normalizes the signalling between the brain and bladder/bowel.
AdVance XP male perineal sling
What is an AdVance XP male perineal sling?
AdVance is a strip of mesh that acts like a hammock, supporting your urethra so it stays closed and doesn’t leak.
ATOMS adjustable male perineal sling
What is ATOMS?
ATOMS (Adjustable Trans-Obturator Male System) is an adjustable device we can place to treat incontinence. Since every body is unique, the ATOMS device sometimes needs to be adjusted after it is placed in order to achieve maximal benefit and reduce leakage as much as possible. This adjustment can be done easily via an injection given during a return visit to Dr. Campeau’s office.
Artificial urinary sphincter AMS800
How does the AMS800 work?
The AMS800 is an artificial urinary sphincter (AUS) we can implant surgically so that you can urinate normally. It may be the best option depending on the severity of your incontinence. You activate the AMS800 manually each time you need to urinate.
BPH and male LUTS
Male lower urinary tract symptoms (MLUTS) and benign prostatic hyperplasia (BPH) with enlargement and obstruction (also known as enlarged prostate) are common conditions that can really affect your quality of life. They can often occur together.
If you have BPH, the prostate can grow within your urethra as it enlarges, which can block the flow of urine and cause the bladder to work harder to empty itself. Over time, the bladder muscles are affected and can weaken or become irritated, which can lead to voiding difficulties and urinary retention.
There are advanced medical and surgical treatments available to treat male LUTS and BPH. Dr. Campeau has expertise in a variety of treatments and can recommend the option that suits you best.
Treatments:
Water convection therapy (Rezūm)
How does water convection therapy work?
Rezūm water convection (or water vapour) therapy uses steam to reduce excess tissue blocking your urethra. Once your body gets rid of the treated tissue (within about 2 weeks of the first treatment), the urethra opens and BPH symptoms start decreasing. You will need to keep a urethral catheter for a brief period after the procedure.
Anatomic endoscopic enucleation of the prostate with laser holmium or thulium (HoLEP/ThuLEP)
What are HoLEP and ThuLEP?
Also known as LEP (laser enucleation of the prostate), these surgeries treat BPH by removing excess tissue from the prostate gland using a laser, either Holimu or Thulium. Both lasers offer similar success rates and recovery times. The method chosen will depend on Dr. Campeau’s recommendation based on your unique situation.
Greenlight photovapourization of the prostate
How does greenlight photovapourization of the prostate work?
This procedure uses laser to remove and vapourize excess prostate tissue that may be blocking your urethra and obstructing the flow of urine. The recovery time is faster than for traditional prostate surgery as there is less bleeding.
Bipolar transurethral resection of the prostate (TURP)
How does TURP work?
Transurethral resection of the prostate (TURP) is a common procedure in which we surgically trim away excess prostate tissue.
Women and men’s treatment options
Overactive bladder
Overactive bladder (OAB) affects men and women. With OAB, you experience urinary urgency (having an urgent and/or frequent need to urinate) even when your bladder isn't really full. You may also experience incontinence (leaking). Living with OAB can be very frustrating.
What causes overactive bladder?
It can be difficult to pinpoint the cause of OAB. In women, there is often more than one factor, including prolapse or vaginal atrophy. In men, BPH is often a contributing factor. In all genders, there are certain factors that can exacerbate OAB, such as diabetes, metabolic syndrome, constipation, obesity, or smoking.
How do we test for overactive bladder?
Dr. Campeau offers complete evaluations, including cystoscopy and urodynamic testing, to understand your condition and determine the best course of action. Cystoscopy uses a small camera to do an internal visual inspection of the lower urinary tract. In urodynamic testing, small tubes are inserted into your bladder so we can assess your bladder function. You can read more about these tests here.
How do we treat overactive bladder?
Lifestyle changes and healthy bladder habits that can help with OAB include bladder training/pelvic floor exercises, fluid management, reducing caffeine intake, increasing physical activity, dietary changes, and mindfulness. There are also oral medications that may help.
If these options have not worked for you, other treatments are available, such as Botulinum toxin (Botox®) injections or sacral neuromodulation surgery. Dr. Campeau has expertise in each of these treatment approaches.
Treatments
Intravesical Botulinum toxin (Botox®) injections (cystoscopy)
How do intravesical Botox® injections treat overactive bladder?
Injections of Botulinum toxin (Botox®) can relax your bladder muscles and reduce the symptoms of incontinence.
This procedure involves injecting small amounts of Botulinum toxin (Botox®) into the wall of the bladder through the urethra. To do this, we use a cystoscope (tiny camera). It only takes a few minutes. This reduces the need to urinate urgently. The effect of the treatment lasts, on average, 9 months, and will need to be repeated.
Sacral neuromodulation surgery
How does sacral neuromodulation (SNM) surgery work?
In sacral neuromodulation (SNM), an electrode and a device similar to a pacemaker are surgically implanted to send low-intensity electrical pulses to the nerves in your sacrum. This normalizes the signalling between the brain and bladder/bowel.
Neurogenic lower urinary tract dysfunction (NLUTD) (neurogenic bladder)
What causes NLUTD?
Also called neurogenic bladder, NLUTD is when your bladder function is disrupted because of an injury or disease. The signals between your bladder and your nervous system (brain) are affected and can cause a loss of control when it comes to urination. NLUTD can show up in the form of several possible symptoms, from urinary retention to incontinence.
Whatever the cause of your NLUTD, it can seriously affect your confidence and quality of life.
How do we test for NLUTD?
Dr. Campeau offers complete evaluations, including cystoscopy and urodynamic testing, to understand your condition and determine the best course of action. Cystoscopy uses a small camera to do an internal visual inspection of the lower urinary tract. In urodynamic testing, small tubes are inserted into your bladder so we can assess your bladder function. You can read more about these tests here.
How do we treat NLUTD?
Dr. Campeau has extensive experience treating NLUTD, and is one of the authors of the Canadian guideline on this condition.
Your bladder may need to be emptied using a catheter. This can be done with clean intermittent catheterization, or by having a suprapubic catheter or indwelling urethral catheter placed.
Some patients with NLUTD can be treated with Botulinum toxin (Botox®) injections or sacral neuromodulation surgery.
Treatments:
Suprapubic catheter
What is a suprapubic catheter?
A suprapubic catheter is a tube put into your bladder through your lower abdomen. It can be easier to manage and more comfortable than a catheter in the urethra. It is inserted through a small incision.
Clean intermittent catheterization teaching
What is clean intermittent catheterization?
Clean intermittent catheterization (CIC) means having a catheter that you insert and remove on your own to help you urinate. This treatment is often provided for patients who can’t urinate on their own. Dr. Campeau can show you how to do a CIC (putting in and taking out the catheter) safely and easily.
Intravesical Botulinum toxin (Botox®) injections (cystoscopy)
How do intravesical Botox® injections treat overactive bladder?
This procedure involves injecting small amounts of Botulinum toxin (Botox®) into the wall of the bladder through the urethra. To do this, we use a cystoscope (tiny camera). It only takes a few minutes. This reduces the need to urinate urgently. The effect of the treatment lasts, on average, 9 months, and will need to be repeated.
Sacral neuromodulation surgery
How does sacral neuromodulation (SNM) surgery work?
In sacral neuromodulation (SNM), an electrode and a device similar to a pacemaker are surgically implanted to send low-intensity electrical pulses to the nerves in your sacrum. This normalizes the signalling between the brain and bladder/bowel.
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Your urological wellness matters.
If you have bothersome symptoms, or if you are worried about your urological or pelvic floor health, treatment is possible.