Bladder Leakage? Know Your Options

Chrys Peterson sat down with Dani Zoorob,MD, a urogynocologist with ProMedica Physicians, to discuss urinary incontinence in women.

Chrys Peterson: Dr. Zoorob, I want to talk about something I hear about from a lot of my girlfriends and that is incontinence issues. As we grow older and maybe we’ve had a child, two, three, or four, it seems it gets harder and harder to control that. Why does that happen?
Dr. Zoorob:
Well there are different reasons why leakage happens. There’s leakage because of activity, such as stress incontinence because you’ve had babies for example, or something that changes in the vagina anatomically due to age, due to weight, due to lots of medical conditions. There are also other reasons why you can go often to the lady’s room. For example, active bladder. That’s when you wake up multiple times at night, when you go every couple of hours to the bathroom, when you can’t make it to the bathroom, etc. Those are very different entities and they get treated very differently, too. So, there are lots of reasons why people can leak.

If you are finding you need to urinate frequently, that is a much different problem than if you are leaking. Maybe that is a medicinal solution?
The going often to the lady’s room is very often treated with a pill, with medicine. We do change some behavioral habits of the patient; we advise her changes in lifestyle but typically the medication is one of the things that helps patients with these conditions. The leakage with coughing and laughing is a little different, though.

Is that something you may need a surgical solution for?
Very often surgery is the ideal solution for leakage with coughing and laughing. There are other options such as pelvic floor physical therapy or pessaries (an inserted device to support your pelvic organs), but ideally the best solution is surgery.

What does the surgery entail and how long is the recovery?
Most of the time the surgery for the leakage from coughing and laughing is a 30-minute procedure, outpatient basis so you are going home the same day. It’s a very tiny cut in the vagina, sometimes there are two pokes in the bikini line and that’s it. You are literally up an walking immediately after the surgery and you will see results practically immediately.

Are there restrictions on physical activity afterwards?
There should be restrictions just so you heal. If you want a good result long term, then you want to follow the restrictions for a few weeks after the surgery.

So there are medicinal solutions and surgical solutions. The point is there are solutions for us, ladies, which is really great news for us to hear! Why is finding a specialist so important?
A urogynocologist is a fellowship-trained physician. They’ve done OB/Gyn for four years, they are board-certified in OB/Gyn. We also do three years of extra training specific to incontinence and prolapse. That’s why it is important to have someone who has done these extra years to make sure that they know well how to treat these problems.

1 in 5 women suffers from pelvic floor disorders, including incontinence.

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