ABSTRACT
I. INTRODUCTION An estimated 13 million Americans suffer from urinary incontinence. Urge incontinence is conservatively estimated to account for the difficulties of 40% of all incontinent patients [1]. Of this population, two thirds suffer from chronic or established incontinence. Yet, patients diagnosed with urinary incontinence due to detrusor instability have had limited treatment options. Conservative interventions such as diet modification, behavioral techniques (pelvic muscle exercises, biofeedback, timed voiding), drug therapies, and containment devices are commonly used to treat the condition. If these therapies fail or are unsatisfactory to the patient, a surgical intervention may be the next step. Procedures such as bladder denervation, augmentation cystoplasty, or even urinary diversion can be considered. These alternatives have their own set of risks and consequences, making them unattractive to the majority of patients. According to the 1996 National Association for Continence (NAFC) survey of 2000 incontinent persons in the United States, although more treatments are now available to urge-incontinent patients, 62.6% of these patients reported they were “not satisfied” with their treatment outcomes. The lack of effective treatment for urge incontinence is particularly disturbing given the debilitating nature of this condition. Incontinent patients commonly experience loss of self-esteem, shame, depressive symptoms, embarrassment, anger, and a significant loss of quality of life [1]. Urge incontinence is especially difficult given the severity and unpredictable nature of leaking episodes. Consequently, patients restrict or avoid social interactions, become iso-
lated, and have difficulties meeting daily responsibilities. Although not life threatening, the condition tends to be socially devastating.
