Posts in Category: Your Pelvic Health

It’s World Continence Week! Reach out for help

WCW-2015-Group

Yes, there is a day or a week for just about everyone and every cause these days! But this one is near and dear to my heart, because I see women every day whose lives are affected negatively by incontinence. Fortunately, I also get to see how their lives are greatly improved by our treatments. World Continence Week is an annual initiative with a primary goal of raising awareness about issues related to bladder control. You probably know that incontinence is the involuntary leakage of urine, but did you realize that bladder control problems are preventable, and they can be managed and often cured?

This is a hard topic for many people to talk about, and believe me, I completely understand. Of all the medical issues that women talk about with their friends, for some reason, they do not want to talk about this issue. Some of my patients even hide it from their husbands. Incontinence is a sensitive subject, and it affects an estimated 400 million people around the world.

Because this sometimes feels too taboo to discuss, World Continence Week has stepped in to draw attention to the problems and increase awareness about the condition. At the end of the day, this week is about giving a voice to those who suffer while boosting their confidence to seek help from a doctor and improve quality of life.

I want you to know that if you are suffering with incontinence issues, or you know someone who suffers, you can start the process today to begin changing your life for the better. Here are three easy steps that you can begin right now. I have found these to actually be curative in some cases.

  • Reduce your intake of caffeine. Think coffee, tea and sodas.
  • Make diet modifications. Spicy and acidic foods can trigger an overactive bladder.
  • Establish a bathroom schedule. Urinate before you have the urge.

There are many other options to consider in your journey to treat and cure incontinence. I have created a bladder treatment pathway to make it easy to see the various treatment options and guide you most quickly to the therapy that will work for you. We can discuss the best route for you during a visit to my office. My staff and I talk about this every day, so leave your embarrassment at the door! We are here to care for you and walk beside you as we tackle this issue.

We can discuss:

  • Pelvic Floor exercises, either at home or through our pelvic muscle toning program
  • Bladder neurostimulators that retrain the bladder nerves and is often a permanent solution
  • Bladder Botox, administered easily in the office to relax the bladder muscle
  • Medications
  • Surgery, such as a simple outpatient 15 minute procedure with 95% success rates

Take action this week! I promise it’s worth it. It can literally change your life.

Dr. P

Originally posted 2015-06-25 14:53:05.

Hope for Leaky Bladders

Are you suffering from a leaky bladder?  Is it hard for you to empty your bladder completely? Or maybe you feel like you need to go way too often.

These are common issues for many women and frequently go unaddressed. The good news is that if you do suffer from the above symptoms, I offer specialized urodynamics tests in my office that allow me to narrow down the cause of your bladder problems to properly address your symptoms and provide treatment options specific to your needs.

Urodynamics consists of several tests that provide valuable insight to how a patient’s lower urinary tract (urethra and bladder) are functioning. These tests determine how well the bladder is holding urine and evaluates the bladder’s ability to empty properly. Urodynamic testing is key to determining the cause of bladder incontinence.

It is fascinating what all the tests can tell us! Urodynamics commonly includes the following:

  • Uroflowmetry: measurement of urine volume and speed
  • Postvoid Residual Measurement: measures the amount of urine remaining in the bladder after urination
  • Cytometric Test: measures how much the bladder can hold when it communicates with the brain that it is full
  • Leak Point Pressure Measurement: determines the point at which the bladder leaks are involuntary
  • Pressure Flow Study: measures the pressure the bladder requires to urinate
  • Electromyography: evaluates for nerve or muscle damage

If you are one of the 25% to 45% of women who suffer from bladder leakage, I encourage you to give my office a call! To patients, bladder symptoms may feel like an embarrassing or uncommon problem but I promise it isn’t. Don’t let your bladder condition hold you back from the things you love, my team is here to help you get your life back again.

-Dr. P

Originally posted 2017-03-03 12:40:36.

Bladder lifts 101

As I await my surgery this morning, which is a biological graft bladder lift, I thought I would take the opportunity to discuss bladder lifts.  What they are and the various options.

As we age, and especially if we have had vaginal deliveries, the bladder can start to fall.  The ligaments that surround the bladder get stretched out and the vaginal wall isn’t strong enough alone to support the bladder anymore.  This is called a cystocele.  It is sort of like a hernia in the vagina.

The symptoms may be a bulging in the vagina, a feeling that you are sitting on a ball, difficulty emptying your bladder, recurrent urinary tract infections, and some women even have to push their bladder up to be able to empty it.  We fix it when it the bulging becomes too great a bother, the bladder cannot empty well at all, or there are a lot of bladder infections.

The first thing we’ll try is a pessary.   This is like a donut that we can insert in the office that will literally push the bladder up where it belongs.  When fitted properly, it will stay in place but you won’t be able to feel it.  This can be a long-term solution or a temporary measure until surgery.   The maintenance on it is to come in to the office every 8 weeks to have it cleaned and to check the vaginal walls.

Surgically, there are four main options:

  1. Traditional tissue plication.  This is the old-fashioned lift where we simply stitch the walls of the vagina tighter to make a shelf for the bladder.  It works for a lot of people, but the failure rate is reported in some studies as high as 40%, so that’s why we started looking for other alternatives.   You may know someone who has had numerous bladder lifts.  It is still an option, however, and is done quite frequently.
  2. Biological graft placement.  This procedure uses tissue that has been processed to make a supportive sheet about 3X4 inches in size.  The two main ones that I use are Xenform, which is made from calf skin and looks like a sheet of pure collagen, and Repliform which is made from human cadaveric skin.  The cells are taken out of the graft to make it just a sheet of collagen and to prevent spread of any disease at all.  These grafts supplement your natural tissues which have been proven to be weak.  I put these in with a vaginal procedure.
  3. Mesh graft placement.   Mesh??   “The mesh from those lawyer commercials?”  Yes, the mesh from the commercials. It is still a good option.   There have been no recalls of mesh at all.   It does have to be done properly, and I reserve it for the patients who have failed other techniques.   Having done hundreds of mesh implants, I can tell you that it works very well and patients do well.  It’s not perfect, but, then again, no surgery is.
  4. Robotic bladder lift.   This procedure is approached from above with scopes through the abdomen, in contrast to the other three methods which are all done through the vaginal wall.  This method is usually done in conjunction with the gynecologist doing a hysterectomy.  The robot helps me sew the mesh onto the vagina more efficiently and precisely.

All of these surgeries typically involve one night in the hospital and low levels of pain.  You do have to avoid heavy lifting or heavy exercise for about six weeks afterwards while you heal.

And there you have it.  I use all of these options regularly.  It just depends on the patient: how bad the cystocele is, her age, prior surgeries, the health of the vaginal wall.  That’s where I spend time getting to know you, evaluating you and what you need.

Please call our office if you would like a consultation about your bladder:  281-717-4003.   This is what we do!

 

 

Originally posted 2014-07-30 08:30:29.

What IS Female Urology????

When I first signed up for a urology rotation in medical school, I thought I was going to spending the next 6 weeks seeing old men with prostate cancer.  I really was not interested in urology at that time, but I needed something to fill my fourth year schedule. What I really wanted to do was anesthesiology: putting in IVs and breathing tubes, lots of fun procedures.

But, the anesthesia rotation was already spoken for. So, now what? Well, I was planning to be a gynecologist, so I thought, well, at least if I do urology, then I’ll get more exposure to the pelvic anatomy. Get a refresher course on all the blood vessels and structures. That will be helpful, right? Even if it is just old men and their prostates.
Well, I couldn’t have been more wrong. Even then I didn’t realize just how wrong I was. Now as I sit here practicing not just urology, but 100% female urology, it is ironic that I thought that it was only prostates!
Of course, urology does encompass prostates in men. It includes everything in the urinary tract from the kidneys through the bladder and out the urethra. Urologists have medical treatments and all kinds of surgeries to treat patients. We treat patients from birth through death, men and women, boys and girls for everything from bedwetting to terrible cancers. It is a great variety surrounding that one part of the body. That’s the reason I fell in love with urology and switched from my pursuit of gynecology.
Female Urology, of course, focuses on the female urological tract. We don’t have prostates, so we don’t need to worry about that (thank God!), but we do have other issues. The most common issue that we have is overactive bladder and incontinence. God made us with short urethras (the pipe that the urine comes through) and a big opening in our pelvis muscles to allow us to have babies. If that opening gets stretched out, such as after having babies, then we start to have problems with organs dropping and having a difficult time controlling our urine. Sometimes it happens even if one has had only C-sections, or has no children.
Female urology is here to help with that! We have everything from physical therapy to medications to surgery to pacemakers, Botox and more. It is a very exciting time because we have some very effective treatments for this now, whereas ten years ago, the options were very limited. You don’t have to live with those pads your whole life!
That is not all that Female Urology entails. It also includes urinary tract infections, painful bladder conditions, kidney stones, evaluation of blood in the urine, slow urinary stream, bladder and kidney tumors, and more.
There is even now a subspecialty, in which I am certified, called Female Pelvic Medicine and Reconstructive Surgery, which focuses on certain conditions of the pelvic floor, especially prolapse (dropped organs) and incontinence. There are even more advanced surgeries that can be used to treat these conditions, including robotic surgery, which I have been doing for several years with beautiful results (beautiful from a pelvic surgeon’s perspective!).
Over the last twelve years, I have narrowed my urology practice down to females only. I couldn’t be more pleased with my choice. I get to treat some lovely women and see them get their life back: from a life of pads and worrying about where every bathroom is to urine control. And for others, it is helping them with infections, pain, stones, or reassuring them that the blood found in the urine isn’t serious for them. Female Urology is my complete career focus and my mission.

Originally posted 2014-07-15 18:10:05.

Meet the MonaLisa Touch

 

MonaLisaTouchI am thrilled to announce that I will be introducing a new vaginal laser treatment as an outpatient procedure this fall at Houston Female Urology. As the first urologist in Houston who’s taking advantage of this groundbreaking technology, I can’t wait for my patients to reap the benefits! Meet the MonaLisa Touch.

The MonaLisa touch is a treatment aimed at combating vaginal atrophy. Vaginal atrophy may be caused by hormonal changes during menopause, and it may also occur in women who experience a decreased estrogen production due to cancer or breastfeeding. Thinning, drying and inflammation of the vaginal walls are typical characteristics, and it may cause intercourse to be painful and contribute to problems with urination.

My patients who experience these symptoms will now be able to restore youthful, trophic conditions in the vulvo-vaginal area with the MonaLisa Touch. The MonaLisa Touch is a minimally invasive laser method that is completely reliable. Its CO2 laser source emits an impulse, and the method does not trigger negative effects like some hormone-based therapies.

Often during the period of menopause, the vagina is subject to a loss of swelling and hydration of tissues, which may cause discomfort for many women. As I mentioned earlier, some of the symptoms include itchiness, dryness, burning, loosening of the vagina and pain during sexual intercourse. Not only do these symptoms cause discomfort, but they can also interfere with your quality of life.

I am excited about the MonaLisa Touch because it naturally and painlessly overcomes vaginal atrophy by triggering physiological processes that eliminate signs of aging. Most importantly, the treatment brings an improvement in physical conditions that enable women to feel like their vulvo-vaginal areas are aging in reverse.

Stay tuned as we share more information throughout the coming days and weeks about the MonaLisa Touch. I think you’re going to love it!

Dr. P

Originally posted 2015-09-21 10:17:35.

There’s blood in my urine?

It’s a scary thing to find. When a patient sees blood their urine (hematuria), there are often many unknowns that race through their mind. I always stress that patients need to seek medical attention the first time they see it. Don’t even ignore a small amount. Call our office immediately, and make an appointment.

During the appointment, we will look at the entire urinary tract, first with imaging of the kidneys by a CT scan or a renal ultrasound and follow that with a KUB. Then, we will do a scope of the bladder, called a cystoscopy. It is a quick procedure with numbing medicine. While it sounds intimidating, patients are often surprised at how easy it is. The discomfort is similar to a Pap smear.

The most common cause of hematuria is a UTI. The infection can irritate the bladder wall to the point that it often bleeds. Other things we look for are a kidney stone, kidney tumor or bladder cancer.

While it is uncommon, occasionally we find a bladder or kidney tumor as the source of bleeding. Obviously, the sooner that a tumor is found and treated, the better. Tumors in the kidney and bladder will need to be removed surgically. Fortunately, we have great, minimally invasive options to remove these tumors without a large incision.

Often we will see patients for microscopic blood in the urine detected by their primary care doctor. While not as serious, it still requires a complete panel of testing.

Your treatment options will depend on what the testing shows. A UTI will be treated with antibiotics, water and other measures of prevention. If we find a kidney stone, then the treatment could be a number of various options to eliminate the stone, including laser and shock wave therapy, which are both minimally invasive options.

Whatever the cause, it is of the utmost importance to call our office at the first sign of blood in your urine. Our caring staff is here to help you.

– Dr. P

Originally posted 2016-04-26 11:31:37.

Restoring Your Health, After the Storm

To all of our patients who were impacted by flooding, we are deeply sorry and send our prayers to each and every one of you. We hope that you and your families are all safe and dry, and on your way to recovering from the storm.

In the aftermath of Harvey, I know we are all trying to figure out how to pick up the pieces and start to return our lives to normal. Looking around at all of the devastation, it’s hard to see that things will ever be the same again, but we can start with baby steps and hopeful hearts.

As women, we have been consumed with caring for others. Protecting our families and homes has been our sole focus lately, and there hasn’t been much energy left to look inward at our own well-being. Now that the rebuilding process has begun, it is so important that we rebuild our health, as well.

Hurricane Harvey compromised many of our patients’ urological and pelvic health, and we want to help guide you back to a healthier state. Two female urological problems have come to the forefront during this disaster:

  1. Urinary Tract Infections (UTI)
    Have you been helping in flooded areas? The standing water is not clean, and it contains all sorts of things that can cause a UTI. If you are experiencing pelvic pain, an increased urge to urinate, pain with urination, or blood in the urine, please call our office. Another cause of UTIs is being out of your regular routine and not drinking enough water. Think about it: what have you been drinking over the last couple of weeks? I bet it has been more soda and wine, and less water. Our bodies need water to re-balance what has gotten off track. Make an effort to increase your water intake, and your urinary tract will thank you.
  2. Interstitial Cystitis and Pelvic Floor muscle spasm
    Hunkering down always seems to include a variety of unhealthy meals and snacks. It’s hard to focus on healthy eating in the middle of a hurricane, and unfortunately your pelvic health suffers. If you were already dealing with Interstitial Cystitis (painful bladder syndrome) or Pelvic Floor muscle spasms, chances are you are feeling worse these days. Now it’s time to focus on healthy foods again.

While you are working to restore your sense of normalcy, please remember to take time for yourself. Getting back to a healthy routine will help both you and your families feel better.

Cheers to a healthy you!
-Dr. P

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Preventing Kidney Stones in women

Did you know that women are just as likely to get kidney stones as men???  I don’t know why, but there is a perception that women don’t get stones as often as men.  But we all have two kidneys, which is where stones originate.

Stones are literally just that: rocks.  If you have never actually seen a kidney stone, they look exactly like rocks.  They are made of minerals that crystallize in the kidneys and then conglomerate together to form a stone.  As long as the stones are sitting up in your kidney, they usually don’t cause any pain.  But if they decide to pass and start heading down the urinary tract, look out.   It is the worst pain that humans endure.  Women who have had natural childbirth and have a passed a kidney stone will tell you that they would much rather have a baby any day!

You do not want a kidney stone!  As much as a I love stone surgery (laser surgery is like playing a video game, all that time playing Ms. Pac-man is paying off now, Mom), I know you don’t want to have to go through that.  Here’s how to prevent them:

  1. Number one is to drink more water and lemonade.  The solution to pollution is dilution.  If there is so much water flushing through the kidneys that the minerals can’t crystallize, then you won’t get a stone.  Lemonade naturally has citric acid which is a stone inhibitor.   Homemade lemonade is best, but I’ll be happy if you drink Crystal Light or Chik-fila lemonade.  Definitely better than soda or iced tea.  Those drinks actually cause stones.
  2. Drink enough water so that your urine comes out clear.
  3. Avoid soda and iced tea.  Yes, repeating myself.
  4. Become a vegan.  Well, as much as possible.  Not only is it the healthiest lifestyle for yourself and the planet, but some of the biggest culprits of kidney stones are meat and dairy.  By meat, that includes chicken and fish, as well as beef and pork.   You do not need to eat animals to live.  I have seen so many people develop kidney stones after doing the Atkins Diet.  If you feel you can’t give up your meat, at least limit it to two servings the size of your palm per day.  Animal protein metabolizes into something called acid ash which causes stones.  It also leaches the calcium from your bones and causes osteoporosis.  Read The China Study (the most comprehensive study on nutrition ever conducted) and become vegan.  It is not as hard as you think.  I did it five years ago.

If you have a family history of stones, you are more prone to get one yourself, so get on this!  If you have ever had a stone, you have a 10% chance each year thereafter that you will get another one.

Be healthy and hydrated!!

Dr. P

 

Originally posted 2014-10-24 10:48:56.

Help for Leaky Bladders. It’s Not Too Late!

Did you know there are ways to improve your bladder control without surgery, no matter how old you are? Leaking urine is often the result of a weakened pelvic floor, and our Pelvic Floor Toning therapy is helping women in all stages of life.

90% of patients notice a significant improvement in strength and bladder control.

When you think about strength exercises and toning, your pelvic floor muscles probably don’t come to mind. In fact, you may be wondering exactly what your pelvic floor is and why it’s important.

Let’s start at the beginning. Your pelvic floor is a group of muscles, connective tissue and ligaments that supports your pelvic organs and controls the flow of urine and bowel movements. When the pelvic floor is weakened – from things like childbirth and menopause – your pelvic organs don’t function the way they are supposed to. In many cases, this means you leak urine.

Remember when you were pregnant and newly post-partum, and your obstetrician told you to do Kegel exercises? If you are like most women, you had great intentions but probably forgot to do the exercises consistently. Now, years later, your leaky bladder is reminding you.

Fortunately it’s not too late, and we can help. The Houston Female Urology pelvic floor specialist is like a personal trainer for your bladder. Our Pelvic Floor Toning program is a combination of in-office treatments and exercises you can do at home, and most patients are healed without medication or surgery. In fact, about 90% of patients notice a significant improvement in strength and bladder control.

It’s a proven technique and it is covered by almost all insurance carriers and Medicare.

How does it work?

Our pelvic floor specialist will meet with you for a series of 4-8 sessions. First, she will assess your current pelvic floor strength. Then, she uses a painless vaginal probe to create electrical stimulation that speeds muscle growth and resets the bladder nerves. Treatments take less than an hour, and after completing all sessions, about 2/3 of women are healed and do not need surgery or other procedures.

The second part of treatment is at-home exercises. Based on your individual strength, our pelvic floor specialist will teach you the proper way to do Kegel exercises so that you can prolong your benefits. And, we can even prescribe a home therapy device you can use on your own.

If you are struggling with overactive bladder and making too many trips to the bathroom during the night, or frustrated by urine leakage when you cough, sneeze or exercise, this treatment may be just what you need.

Cheers to a healthy you!

-Dr. P

To learn more about the Pelvic Floor Muscle Toning treatment at Houston Female Urology please watch our below YouTube video.

Have you had a great experience with Houston Female Urology? We are so grateful for reviews from our patients, and would be honored if you would take a few minutes to tell others about your experience.

 

How To Conquer Interstitial Cystitis (Bladder Pain) Symptoms

 

Interstitial Cystitis (IC), or simply referred to as bladder pain, is chronic pain and discomfort in the bladder. Shockingly, 3 to 8 million women in the US suffer from IC, according to the Interstitial Cystitis Association. Symptoms of this disease include: urgency, urinary frequency, burning with urination, burning in the bladder, and pelvic pain.

IC can be a hard disease for women to live and cope with. However, patients should be encouraged by the options available to help manage symptoms. At Houston Female Urology, we have several treatments to help women find relief from their pain. Depending on the patient, treatments can range from a simple medication to BOTOX for the bladder. Our staff works with every patient to make sure we determine the best path to relief.

Below are a few simple steps that you can try on your own to help conquer your symptoms.

  1. Modify your diet.

Often specific foods and beverages can impact bladder symptoms. It is usually best to shop for fresh foods when possible and keep a diary as you experiment to determine which foods may trigger symptoms.

  1. Take steps to manage stress.

Common stress management tools include meditating, getting a massage, or exercising.

  1. Try to establish healthy sleeping habits.

A few tips include: cutting caffeine and alcohol, keeping your bedroom cool and comfortable, start winding down about an hour before you go to sleep, and sticking to the same bedtime every night.

To learn more about Interstitial Cystitis and the treatment options available, please visit Houston Female Urology’s YouTube page!

-Dr. P