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New Ulm Medical Center

Help for women with common bladder problems

Many women are too shy or embarrassed to talk about leaking urine when they sneeze or constantly having to run to the bathroom.

That’s unnecessary, said Victor Khayat, M.D., an obstetrician and gynecologist at New Ulm Medical Center (NUMC). Women should feel free to discuss their bladder issues with their doctor because often they can be helped quite easily.

Because so few talk about it, it is hard to know exactly how many women experience urinary incontinence. But Dr. Khayat believes more than 50-- percent of women who have given birth have some bladder issues.

“Women who have no other health issues will suddenly develop urinary incontinence,” Dr. Khayat said. “This can happen- quite often.”

Bladder issues can affect women of all ages.

Urge and Stress Incontinence

The most common problems are small leaks or overt incontinence. The two main types of incontinence are urge incontinence and stress incontinence. “They can overlap and you can have a diagnosis of both called mixed incontinence,” Dr. Khayat says.

Women who have urge incontinence or overactive bladder feel a sudden and strong urge to go. They find it hard to get to a bathroom on time. Women with stress incontinence leak urine when they laugh, run, cough, sneeze or do other activities.

Treatment depends on which type of incontinence a woman has. “If she has both, usually one is more dominant and you try to treat that one first,” Dr. Khayat said.

Dr. Khayat performs a simple test to identify the problem. “We fill the bladder with sterile water and monitor the pressure in the bladder,” he said. “This gives us an indication of what the bladder dynamics entail.”

Help With Medications, Physical Therapy

Women who have urge incontinence or overactive bladders may be treated with medications. The medications can help them relax their muscles, said Dr. Khayat.

Physical therapy can help as well. Among other tools, it includes learning to retrain the bladder.

One part of that retraining is to go to the bathroom by the clock rather than the urge. “Women go to the bathroom every hour on the hour until they have no leaking. Then they expand it to two hours, three hours, four hours,” Dr. Khayat said. “If we can get patients to go to the bathroom every four hours without having strong urges most are very happy.”

Physical therapy is a part of treatment for stress incontinence as well, said Amanda Forstrom, a physical therapist at Sister Kenny Institute-New Ulm’s urinary incontinence program.

Physical therapy may include Kegel exercises which help women regain strength in their pelvic floor muscles. “Most women know about Kegel exercises, but struggle with doing them correctly so they may think they don’t work,” Forstrom says.

Biofeedback may be used to help women learn Kegel exercises. During biofeedback, small electrodes are placed by the pelvic floor muscles to monitor their activity. Women watch a screen and can see when they are doing the exercises correctly.

Women also are encouraged to keep diaries so that they can recognize patterns that may cause leakage and to monitor their fluid intake.

“Some foods can irritate the bladder and cause it to become more sensitive,” Dr. Khayat said. “Once they identify them, women learn to avoid the foods and spices that irritate the lining of their bladder.”

Out-Patient Surgery

If conservative treatments don’t help, women may consider an outpatient surgical procedure for stress incontinence.

During the procedure, a sling made of mesh is placed under the midpoint of the urethra, the tube that carries urine from the bladder, to provide support.

The surgical procedure takes about 40 minutes not including postoperative observation. “You come in and have the surgical procedure and go home the same day,” Dr. Khayat said. “You may be a little sore afterward, but the recovery is usually pretty quick.”

Between 80 and 90 percent of women who have this procedure for stress incontinence find they have better control of their urine afterward, said Dr. Khayat.

Losing weight and quitting smoking also will help alleviate symptoms of urinary incontinence in some women, Dr. Khayat said.

Learn More About Treatment

Women should not be afraid to speak up when they suffer from bladder issues because “we are here to help,” said Dr. Khayat.

To learn more about options for treating bladder issues, call 507-217-5011 and make an appointment with Dr. Khayat.


Source: Krames StayWell
Reviewed by: Victor Khayat, MD
First Published: 05/01/2012
Last Reviewed: 05/01/2012