Straight Talk: Female Incontinence Treatments | El Camino Health


>>When I was in residency my
professor said that 50 percent of women would develop
incontinence some time in their life times. That made me decide to
be a passionate advocate so that women would know that
they did not have to suffer that without alternative. So in my practice I spend a
lot of time talking to women about their voiding dysfunctions
and what we can do about it. There are two different
types of voiding dysfunction that are most classic, one would
be urgency or urge incontinence where women just cannot get to
the bathroom in time and for that we can use medication
and it can be life altering. But the more typical
and the incontinence that most women don’t talk about
but fear that they will develop in their life times would
be stress incontinence and although children blame
their mothers for everything that occur to them we
get to blame our children for this development because
most typically it occurs because the vagina gets
distorted from child birth so as women then age when their
bladders get full the muscles that support the bladder can
no longer hold it in position, it drops out of position and
when they cough or bear down or perform abdominal
stress, not emotional stress, but when they stress those
support muscles they leak urine involuntarily so they can’t
exercise and stay dry, they can’t walk or spontaneously
run across the street or lift anything without leaking
and it becomes a shameful, life interrupting type of
disorder because they’re afraid to go out, they’re afraid to
exercise with their friends, they’re afraid to tell anyone that they might have
an accident. So they wear pads and the
pads get thicker and thicker and it’s expensive and
it’s embarrassing and so in my practice I spend a lot
of time counselling and trying to determine what
we have to offer that can change this pattern. It is not a natural part of
aging; it is a distorted one and most of the time we can
make a positive difference. One of my favorite things as
a urologist is to meet someone who has a relatively
clear cut reason for their incontinence
that I can fix. So when I meet a patient and
she says I get to the toilet in time, I don’t get up at night
to urinate but if I can try and do the things I enjoy I have to urinate five times before
hand and I still get wet an hour into it and I can’t exercise and
my favorite story was a patient who was worried because
she leaked urine if she got sexually
excited or tried to do any type of
physical exercise. In the most classic type of incontinence we can
support the urethra and prevent the bladder from
dropping out of position when a woman coughs,
sneezes, exercises or is physically active and
that would be a sling procedure. So without terrible
prolapsing or herniating of the pelvic organs we can
do a simply outpatient sling procedure and cure the
type of incontinence that causes most women
so much distress. In that setting we can
do an outpatient surgery, the patient is in the operating
room typically first thing in the morning, home by noon,
has a catheter in her bladder over night to drain urine
just to give the area a chance to heal a little bit and
then we teach her how to remove the catheter
first thing in the morning and by the time I
see her in the office in the afternoon she’s
urinated comfortably, maybe the urine is a little
slower because we’ve gotten in the way and that’s
what we want to accomplish but if she coughs or sneezes
accidentally she miraculously surprised, no leakage of urine. That’s what we shoot for, that’s
what makes it all worth while. One of my favorite stories is
a recent patient that I met who was thinking about getting
married again and did not want to surprise her new husband
with her distressing, embarrassing story and I
feel incredibly gratified that I was part of a different
ending for that story. I’ll introduce you now to Linda.>>When I was about 51 years
old I started having some minor leakage problems. I considered a big part
of it to be age related as exercise was not something I
ever really did the way I should have and for me it was
sneezing, coughing, laughing which made it very
difficult, I was a teacher, I just retired recently, I’m
in the classroom, I would laugh at something with the
children or be working with them and have an accident. I felt very old; I felt
out of control of my body, I started buying pads. Medication worked for a short
while then the doses…excuse me dosages started to increase,
different types of medication, that pads got thicker, day time
pads, night time pads sometimes as the years went by it
actually went to depends which to me was the
ultimate embarrassment. About the age of 59 I had pretty
much given up on anything other than wearing the
pads until one day on the internet a high school
sweetheart…my high school sweetheart from 1968
found me and reconnected. We were both single at the
time and after…he was on the west coast, I was on
the east coast, after many, many e-mails and phone
calls he proposed and asked me to move out west. So it was the beginning of
a new life at 59 years old. I established myself with
a primary physician here and explained to her my problem, fortunately for me she
recommended Dr. Levine, came to see her, she listened
so patiently to everything I had to say, to my story, to my years
of embarrassment, frustration, previous surgery, medications
and then she counselled, she gave me alternatives. It was her bedside manner, her
ability to talk to me woman to woman and explain
that what I was going through was not something
I had to live with, it could be fixed,
I could change this. So I had the surgery, next
day came into the office, I had removed the catheter,
everything was exactly as she had described,
surgery worked perfectly, I was married four weeks later. Now I’m a 61-year-old newly wed. Things have been wonderful;
we go out all the time. It is so nice to walk down
the aisle of a super market, a grocery store or Costco
and not have to spend 30 or 40 dollars on pads. It’s also nice to go
to Walgreen’s and pick up medications not
related to incontinence. Next to reconnecting to
my high school sweetheart, that was the best decision
of this part of my life and I can thank Dr.
Levine for that.

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