incontinence Archives

Gabrielle prolapsed bladder patient photo

By James Haley, MD, FACOG, FPMRS “As GYNs, we address bladder issues on a daily basis, so when we discovered that our longtime patient suffered from a prolapsed bladder, we asked her to share her story of life before — and after — bladder surgery”, says Dr. Haley. Living with a Prolapsed Bladder “I knew every bathroom in town,” recalls Gabrielle, a vibrant woman in her mid-50s, a common age for women to experience bladder problems. “I never leaked but I had to use the bathroom ALL the time,” she explained. “My husband used to complain, ‘I hate running errands with you because you have to go to the bathroom at every stop.’ “I knew every bathroom in town. I never leaked but I had to use the bathroom ALL the time,” Gabrielle discussing her bladder problems “It started in my late 40s, when I began getting this weird feeling that my bladder had ‘fallen’. It got worse and worse, and it just became this constant pressure. It affected everything. When I exercised it was never painful, but I felt this constant sensation of pressure. I finally talked to my GYN, and he said it was caused by a prolapsed bladder.” What is Prolapsed Bladder? Prolapsed bladder, also known as fallen bladder or cystocele, is a condition where the bladder drops down from lack of support. Pelvic floor muscles and tissues hold the bladder and other organs in place, but they can weaken over time. This causes the bladder to descend from its fixed position and slip downwards into the vagina. In more severe cases, the bladder may dangle completely outside of the vagina. What Causes Prolapsed Bladder? There are four main reasons a woman may develop a prolapsed bladder: Childbirth: A difficult delivery, long labor, a large baby or multiple births Strain: Heavy lifting, strained bowel movements, excessive coughing Menopause: Lack of estrogen, which is vital in maintaining the health of vaginal tissue Obesity: Excess weight, which puts undue strain on pelvic muscles and tissues What are the Symptoms? Sensation of pressure in the bladder or vagina Leakage of urine when coughing, sneezing, laughing, etc. Protrusion of tissue from the vagina A sensation that the bladder is not completely empty right after urinating Difficulty urinating Pelvic pain or discomfort Painful intercourse Life After Treatment Gabrielle relates that she was given multiple treatment options but ultimately chose a permanent treatment solution called a surgical bladder lift, which was a great success, even years later. “That surgery literally changed my life. It’s been five years, and I’ve never had a problem. AND no more crazy bathroom trips!” Gabrielle on life after treatment When Should You See Your Doctor? If you notice that you have any of these symptoms and you suspect a prolapsed bladder, you should see your doctor immediately. This is not a condition that repairs itself. It usually worsens over time. However, it can be fixed, thanks to many modern methods available today. Why Our FPMRS Specialists are Experts in Bladder Prolapse Our board-certified OB/GYNs Dr. Michael Litrel and Dr. James Haley have earned board certification in Female Pelvic Medicine and Reconstructive Surgery. FPMRS is a surgical subspecialty addressing the problems women experience with the changes to their anatomy from having children and pelvic prolapse. FPMRS surgeons are also known as board-certified urogynecologists. Cherokee Women’s Health Specialists has unique surgical expertise in the Southeast United States as an OB/GYN practice with three double board-certified urogynecologists. To schedule an appointment, call our office today at 770.720.7733 or schedule an appointment online.

GYN Problems, Urinary Incontinence Education

What is Overactive Bladder Syndrome?

Diane /

Overactive bladder syndrome, also referred to as OAB, is an uncontrollable need to urinate, often at the worst possible times. For most of us, when the bladder fills to about half its capacity, the urge to void is triggered. Much like a snooze button on an alarm clock that lets us sleep awhile longer, we can hold off until we’re closer to a bathroom, or the timing is more convenient. Not so for OAB sufferers. Their urgency is more like the constant demand of a malfunctioning alarm clock without that button — intense, shrill and non-stop until it’s turned off. OAB sufferers feel more like their bladders are overflowing. They don’t have the luxury of waiting, needing relief immediately. If they’re unable to void right away, leakage may occur. OAB is unbiased. Whether you’re at work or play, it disrupts concentration, performance and pleasure, negatively impacting your life. In time, those afflicted with OAB may become depressed, withdrawing socially. What Causes Overactive Bladder? No one really knows, but it’s believed that involuntary contractions of the detrusor muscle in the bladder transmits false messages to the brain. Symptoms Contributing factors: Age may contribute to, but does not always cause Overactive Bladder Syndrome. Never assume you’re doomed to live with OAB based on the number of years you’ve roamed the earth. Speak to your gynecologist. Don’t be ashamed. They’ve heard it before—often. They can help. Diagnosis You will need to provide your doctor with your medical history, including all drugs, vitamins and supplements you are taking. A physical examination will also be necessary.Sometimes, a urine culture, ultrasound, and neurological tests may be needed to rule out any sensory or reflex problems. If necessary, you might need more extensive analysis such as: You may be asked to keep a journal that includes information like fluid intake, urinary outflow, any leakage, and a time chart of bathroom visits to assess your condition more accurately. Treatment Options Medications and Treatments Other treatments may include: For more resistant cases, surgery, bladder augmentation, or the use of catheters may be necessary. Overactive bladder does not have to isolate you. Help is available. Speaking to your OB/GYN is always the first step to overcoming the problems associated with this syndrome, restoring your confidence, happiness, and quality of life.

GYN Problems, Urinary Incontinence Education, Urinary Incontinence Treatments Education

Leaky Bladder Symptoms and Remedies

Diane /

One in five women endures the symptoms of leaky bladder, or urinary incontinence. Yet often, a suffering woman does not acknowledge it as an issue. She may be self-conscious about mentioning the condition to her doctor, or she may assume it’s a normal part of being a woman. Two of the most commonly accepted situations are incontinence after pregnancy and incontinence during exercise. The truth is, although urinary incontinence is common, it is not considered normal. Needing to urinate frequently, as well as urinary urgency, are signs that one may be dealing with a leaky bladder. Fortunately, for a woman experiencing these symptoms, she can find both surgical and non-surgical options in treatment to minimize or even eliminate these symptoms permanently. What is Urinary Incontinence? Weakening of the pelvic floor can affect bladder control and urethra function, causing issues with urination. Women suffering from urinary incontinence find themselves running to the bathroom frequently. Strong urges to use the restroom, even after urinating, is another sign that a woman may be dealing with urinary incontinence. It is important to not brush off the occasional leak experienced while exercising or shifting position, because there are treatments available for women dealing with urinary incontinence. Types of Urinary Incontinence One important step in the diagnosis process is identifying the type of urinary incontinence, in order to find the best treatment option. Stress Incontinence This type of incontinence occurs when urine leaks out of the bladder during certain strenuous activities. Jogging or other exercising can cause urine leakage. Coughing and laughing can also bring on an unexpected leak. More severe symptoms of stress incontinence may include urine leakage during low stress activities such as changing position or walking. Many pregnant women can experience stress incontinence as the growing uterus puts pressure on their relaxed pelvic floor and the organs shift to make room for baby. Sometimes the symptoms are dismissed as an annoying pregnancy symptom, but if they do not subside after delivery, they may need medical assistance to prevent symptoms from worsening. Urge Incontinence Commonly referred to as overactive bladder, or OAB, urge incontinence is a continued sensation of needing to urinate. This sensation is often an overwhelming, powerful urge which sends women dodging for the nearest restroom. Urge incontinence is different from stress incontinence in that it occurs suddenly, without pressure on the bladder from strenuous activity. In addition to strong urges to urinate, women with urge incontinence may find themselves waking up at night to use the restroom, interfering with a full night’s rest. Sometimes, there may be an underlying condition that is causing the undeniable urges to urinate. An honest discussion about symptoms with a doctor can help them determine any underlying conditions so they can better treat you. Preventing Urinary Incontinence Many situations can result in urinary incontinence. There are some factors that do make a woman more prone to the condition, including pregnancy and childbirth. Women who want to lessen the chance of experiencing urinary incontinence can follow the advice below: Leaky Bladder Remedies Don’t be ashamed or embarrassed to mention your symptoms to one of our double board-certified FPMRS specialists. Treatment options will be chosen based on the severity of the symptoms but can include:

GYN Problems, OB, Pelvic Organ Prolapse Education

Pelvic Organ Prolapse and Pregnancy – Steps To Take

Diane /

When you’re diagnosed with pelvic organ prolapse, you’re faced with a challenging and emotionally painful question: Should I continue adding children to my family? Whether you’ve always wanted a big family, or just two children, you know that your health is in a precarious and delicate state. You’re afraid of worsening your prolapse, but even more afraid that you will regret not choosing to become pregnant again. Talking with a urogynecologist who specializes in Female Pelvic Medicine and Reconstructive Surgery may help to make this decision easier for you to make. Since there are surgical and non-surgical treatment options for any stage of prolapse, your doctor can offer insight that may alleviate your fears and concerns. Once you’ve settled on an additional pregnancy, it is important to take care of yourself physically in order to optimize a birth and post-partum period that will accommodate your body and your prolapse. Pelvic organ prolapse doesn’t have to rule your decisions. Don’t let your limitations hold you back from living the life you want. During and After Pregnancy Prolapse Care Pelvic Floor Physical Therapy – The exercises and touch therapy included in PT can help to keep your symptoms to a minimum throughout your pregnancy. Ask your urogynecologist or OB/GYN for a referral to a physical therapist who specializes in women’s health. After you deliver, check with your urogynecologist and OB/GYN to be cleared to begin the healing process of post-partum physical therapy. Prenatal and Post-Partum Support – When worn correctly, a maternity belt can ease pressure on the pelvic floor and lower back, allowing you to move easier and prevent straining. Different from a waist-trainer or girdle, effective post-partum support can be therapeutic for a healing pelvic floor. Run these products by your doctor to see if they will work for you and your limitations. Conscientious Movement – Remember that you are growing a baby, as well as nursing your prolapse. Move with purpose, and don’t push yourself to the point of pain. Lifting should be kept to a minimum, as well as bending over. When you do have to make larger movements, engage your transverse abdominus and kegel muscles. Keeping theses muscles strong will help support your pelvic floor, and help prevent any stress urinary incontinence. When recovering from birth, give yourself time to heal. Move slowly, and deliberately, and “baby” your pelvic floor. Ask your doctor how soon you can resume any pelvic floor exercises, and start slowly, working yourself up to your pre-pregnancy status. Simple life adjustments can have a big impact on a successful pregnancy and post-partum period. Cherokee Women’s Health Can Help Our board-certified physicians are female pelvic health experts and can help. Call us today at 770.720.7733 or schedule an appointment online.

GYN Problems, Pelvic Organ Prolapse Education

Pelvic Floor Dysfunction Dos and Don’ts

Diane /

Sometimes suffering with pelvic floor dysfunction, or PFD, can make you feel like you are limited in what you can do. If you’ve been diagnosed with pelvic organ prolapse, urinary incontinence, or bowel control issues, it can be confusing or frustrating for you as you try resuming your normal daily routine without irritating your symptoms. Being able to lead a full, satisfying life with PFD is important, but engaging in activities which aggravate your disorder can cause your symptoms to worsen. Here are some things to keep in mind about PFD as you go about your daily life. 1. DO Exercise Don’t choose a workout that includes heavy-lifting such as crossfit, or will put intense pressure on your pelvic floor such as running, or plyometrics. The straining in those types of activities can cause your PFD to get worse over time. Choose exercises such as restorative yoga, walking, and other low impact exercise that will not put pressure on your pelvic floor. Looking for something specific? Check out Hab-It, or Pfilates™ 2. DO Pelvic Brace Don’t forget to engage your transverse abdominus (your lower abdomen) and your Kegel muscles when you sneeze, cough, or laugh can cause urine leakage to occur. Brace yourself and save a trip to the bathroom and a change of underwear. When you engage these muscles, your pelvic floor will not feel the downward pressure that results from these everyday movements. 3. DO Retrain your Bladder Don’t head to the bathroom every time you feel the slightest urge to pee. Your bladder needs retraining to stop triggering frequent restroom breaks out of habit. To start retraining, avoid taking bathroom trips less than two hours apart. Over time, you will you find that you have the urge to urinate less frequently and you will be urinating larger amounts. Not sure if you’re releasing a full bladder? Count how long you urinate for. A full bladder should be a stream of at least ten seconds long. Don’t forget to count with a “Mississippi” in between each number! Tell your bladder who’s in control and retrain yours! 4. DO Seek Treatment Don’t suffer from the interfering symptoms of PFD. There are treatment options available that will fit your lifestyle and diagnosis. The first step is finding a urogynecologist who can assess your needs and suggest a treatment that will work for you. Some of those choices may include: physical therapy, pessaries, medicines, or surgery. 5. DO Live Your Life Don’t let your PFD slow you down or dampen your spirits. Modify your activities, but not your life to adjust to your diagnosis. Consider joining an online support group to help you cope with the struggles of PFD. Visit voicesforpfd.org for more information about how you can reach out to others who are suffering from PFD, as well. Cherokee Women’s Health Can Help Our board-certified physicians are female pelvic health experts and can help. Call us today at 770.720.7733 or schedule an appointment online.

The Bulge After the Baby: You’re In Good Hands

Diane /

You just had a baby, but something feels “off “down there. You’re not quite sure what to expect because you’re new to the whole postpartum process, but you’re certain that a bulge in your vagina is not normal. When the vaginal pressure does not ease up, you decide to check in with your doctor, only to find out that you have a type of Pelvic Organ Prolapse called Uterine Prolapse. As scary as this diagnosis may sound to you, there are options available to relieve symptoms, or repair the prolapse. Uterine Prolapse: Causes and Treatments You wonder how this prolapse happened. One day your uterus is snugly in place, and the next, you are suffering the unpleasant symptoms of pain, pressure and an aching lower back. A prolapsed uterus is a common occurrence after a vaginal birth, but even women who have never given birth can also develop a prolapse. When damage to the fascia, ligaments and muscles of the pelvic floor occurs, it can cause the uterus to sag into the vaginal canal – leading to incontinence, and a feeling that something is “stuck” or “falling out.” These problems may worsen with age, as decreased estrogen causes the pelvic floor to relax even more. Fortunately, you don’t have to deal with these meddling symptoms. There are options, depending on the severity of your symptoms. Relax – not every uterine prolapse will require surgical repair. You and your doctor can work together to decide the best course of action to fit your lifestyle and diagnosis. Many women with mild symptoms find that pelvic floor physical therapy is helpful in reducing symptoms. Those with more moderate symptoms might find reprieve by wearing a device known as a pessary, which is fitted to your vagina, and worn internally. A pessary can help to lift the uterus out of the vagina, and relieve many of the distressing symptoms. If your symptoms are more severe, Pelvic Reconstructive Surgery may be the best option to ensure that you are not living with the troublesome effects of uterine prolapse. You are not alone! Many other women are dealing with the inconvenience and pain of a prolapsed uterus, and you don’t have to suffer in silence. Make a list of questions and concerns and contact your doctor today. A prolapsed uterus doesn’t have to rule your life. We Are Specialists in Female Pelvic Anatomy Physicians who are board-certified in Female Pelvic Medicine and Reconstructive Surgery (FPMRS) understand complex female anatomy, and are able to offer a range of effective treatment options when problems occur. In fact, Cherokee Women’s is the only OB/GYN practice in the southeast with multiple OBs who are also board-certified in FPMRS. You’re in good hands–during your pregnancy and after. Talk to your FPMRS physician about your options to find relief for your symptoms and help that “bulge” disappear.

GYN Problems, Mesh Education

The Great Mesh Debate: Unraveling the Basics

Diane /

Pelvic organ prolapse (POP) is a condition that affects nearly one-third of middle-aged women. It occurs when the muscles that support the pelvic organs weaken, leading to a bulge or protrusion in the vaginal area. Many patients often describe this condition as a “vaginal hernia.” Symptoms of POP can include pelvic pressure, urinary incontinence, and sometimes discomfort during sexual activity. The weakening of the pelvic muscles and tissues causes the organs to shift from their normal positions, and the severity of symptoms can vary from person to person. Why Is Mesh Used in POP Surgery? In some cases, a woman’s natural tissue may not be strong enough to support a successful repair of the pelvic organs. This is where synthetic mesh or biologic grafts come into play. The use of these materials is intended to provide additional support and durability for the pelvic organs after surgery. However, since the 2008 FDA Public Health Notification about the use of transvaginal mesh in POP repairs, the subject has been a source of significant controversy and concern. Many women have seen advertisements or heard from others that mesh can be dangerous, leading to hesitations about its use. Patients frequently ask, “Are you going to use mesh in my surgery? I’ve heard it’s risky.” It’s important to understand that while there are potential risks, the use of mesh, when done by a trained and experienced surgeon, is generally safe and has a low complication rate. The Importance of Specialized Surgeons in POP Treatment Pelvic organ prolapse requires specialized care from doctors who have received advanced training in female pelvic medicine and reconstructive surgery (FPMRS). Board-certified surgeons have undergone rigorous training in diagnosing and treating POP, including the use of mesh in surgical procedures. For patients to achieve the best possible outcomes, it is crucial that they receive treatment from surgeons who are skilled in these procedures and understand the specific risks and benefits. When mesh is properly placed by a board-certified pelvic reconstructive surgeon, the risk of complications is significantly minimized. Part of the job as FPMRS specialists is to clearly communicate the potential risks and benefits of each procedure to patients, ensuring they are well-informed and confident in their treatment decisions. Individualized Treatment Plans for Optimal Care A key aspect of treating pelvic organ prolapse is creating a personalized treatment plan that is tailored to each patient’s unique needs. This starts with a thorough consultation that includes: Discussion of Symptoms: It’s important to understand the specific symptoms that are most bothersome to the patient. Complete Physical Exam: A physical exam helps the surgeon determine the exact nature and severity of the prolapse. Comprehensive Treatment Plan: This plan may include both non-surgical and surgical options, depending on the patient’s condition and preferences. For some women, non-surgical options such as pelvic floor exercises or lifestyle changes may be sufficient. However, for those requiring surgery, we explore the most suitable approach, including whether mesh might be used. It’s also essential to discuss lifestyle changes—such as maintaining a healthy diet, quitting smoking, and engaging in regular exercise—that can help prevent a recurrence of the prolapse. Empowering Patients with Knowledge The decision to undergo surgery for pelvic organ prolapse can be daunting, especially with the concerns surrounding mesh use. However, when patients are provided with accurate, evidence-based information, they are better equipped to make informed decisions about their health. Surgeons aim to empower patients byc explaining all available options and offering reassurance that, when performed by a skilled surgeon, mesh procedures have a high success rate and low risk of complications. If you’re experiencing symptoms of pelvic organ prolapse and are unsure about the best course of treatment, a consultation with a pelvic floor specialist can help you understand your options. Remember, you have choices, and individualized care is key to achieving the best possible outcome. To schedule an appointment or surgical consultation, call 770.720.7733. Or, simply schedule an appointment online. We are here to support you in every step of your treatment journey.

incontinence

Bathroom Again – Gabrielle’s Story

What is Overactive Bladder Syndrome?

Leaky Bladder Symptoms and Remedies

Pelvic Organ Prolapse and Pregnancy – Steps To Take

Pelvic Floor Dysfunction Dos and Don’ts

The Bulge After the Baby: You’re In Good Hands

The Great Mesh Debate: Unraveling the Basics

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