Posts in Category: Bladder Health

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

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

What is Vaginal Rejuvenation?

I am thrilled with the growth of vaginal rejuvenation treatments in my field. More and more women are starting to have the conversation with their doctors about their feminine health, and the range of non-surgical procedures to improve women’s vaginal health is expanding.

However, the language commonly used around the revolutionary treatments such as ThermiVa and MonaLisa Touch can be vague. What does the term feminine or vaginal rejuvenation mean and how does a woman know if the treatments can fix her uncomfortable symptoms?

Vaginal or feminine rejuvenation is the enhancing of the vagina’s function and cosmetic appearance.

The desire for better sex, a more youthful appearance, and convenience are the main reasons women are choosing non-surgical procedures for rejuvenation. Additional reasons include:

• Perimenopausal and menopausal women experiencing dryness, leaky bladder, or laxity
• Women suffering from dryness due to bioidentical hormones
• Women experiencing dryness from breast cancer treatments
• Women who have discomfort wearing yoga pants, a bathing suit, or riding a bike
• Women that have difficulty achieving orgasm
• Mothers that have vaginal laxity, leaky bladder, prolapse, or decreased sensitivity due to vaginal births

Lastly, I wanted to leave you with a few other notes about vaginal rejuvenation that I think are helpful to be aware of. First, the results can last up to one year and can vary from person to person. Secondly, the procedures are not typically covered by insurance.

If you are interested in vaginal rejuvenation, my team and I are available to help you determine which non-surgical treatment option is best for you. Email us today at info@houstonfemaleurology.com!

-Dr. P

Squashing Myths About In-Office Cystoscopy Tests

Many women are frightened by the idea of a cystoscopy test. When I sit down with my patients to discuss the procedure, they mainly express concern about pain and discomfort.  However, this procedure can provide great insight into a patient’s bladder health and should not be feared. Below is a list of FAQ’s to help ease your mind about your upcoming cystoscopy test.

What is an in-office cystoscopy?
A cystoscopy test is a procedure that allows me to examine the bladder lining, by inserting a scope into the bladder through the urethra. A cystoscopy test can be compared to a colonoscopy, but for the bladder.

Why would a woman need to have this procedure?
A woman would need a cystoscopy test if she has a polyp, tumor, or other abnormality. Additional reasons for a cystoscopy include blood in the urine that a physician found in a laboratory exam, bladder irritation, overactive bladder, or continuous bladder infections.

What misinformation have women heard about this procedure that’s wrong? Why should they not be nervous?
Most women think a cystoscopy test is very painful. Usually women hear this from others who have had a cystoscopy performed in the past, using a rigid scope. Now, we use a flex scope that is much smaller and less painful. The cystoscopy test only takes two to three minutes and the level of discomfort felt can be compared to a pap smear.

How should women prepare for this procedure?
It is important to come to the office with a full bladder so we can take a urine sample.  If you feel like you might have an infection, please let my office know before the procedure so we can treat the infection before performing the cystoscopy.

What does the process of having an in-office cystoscopy look like at Houston Female Urology?
First, the patient comes in for a regular appointment. We then take a urine sample to check for infection. Next, the medical assistant prepares the area and inserts a numbing jelly in the urethra. Once the area is numb, I fill the bladder with water. The scope is then inserted through the urethra into the bladder for the quick test. The results are discussed with the patient right away. Once complete, the patient will get dressed and go to the bathroom to empty the bladder. If there is any discomfort, we can provide a medication to help.

Will the patient feel much pain after they leave the office?
A patient should not feel any pain once they leave our office. There can be a slight burning but the feeling should go away after a couple of hours and is not a common side effect.

Please call my office if you have any other questions about your cystoscopy test. My team is always available to make sure you feel comfortable before coming in for your visit!

-Dr. P

Bladder Botox: bringing relief to my patients

Botox is well known for its cosmetic purposes. If we’re honest, the first thing that comes to mind for most people is a procedure that targets and relaxes facial wrinkles. Fortunately for those suffering with urinary incontinence, Botox can also provide a powerful answer for this problem. This can be treated with an injection in the muscle of the bladder to ease the symptoms of an overactive bladder.

The New York Times recently conducted an in-depth report on incontinence. The study found that, “About 20 million American women … have urinary incontinence or have experienced it at some time in their lives. The number, however, may actually be higher because most patients are reluctant to discuss incontinence with their doctors. In fact, research indicates that many patients will not admit to having the problem even when questioned directly.”

As a urologist who exclusively treats females, the last thing I want is for my patients to feel like they have to stay quiet and learn to live with this condition. I’m always pleased to tell women about bladder Botox and the relief and freedom it provides. I understand that this is a tough topic to approach for many, but my team at Houston Female Urology handles this discussion with empathy, care and kindness.

Bladder Botox is a quick in-office procedure that is well tolerated by our patients. The treatment begins by flushing the bladder with a local anesthesia through a catheter to numb the bladder. Then a scope is passed up the urethra into the bladder, and a small needle is placed through the scope where several injections are made to spread the Botox throughout the muscle of the bladder. This significantly relaxes the bladder, and my patients are able to return home on the same day of the procedure.

The Botox begins to work at about one week with its full effects beginning at two weeks. While this procedure is not permanent, it lasts approximately six to eight months when injected in the bladder. There are no limitations to the extent of use, and my patients are so happy with the results I tend to see them once or twice each year for Botox injections.

One of the best parts of my job is bringing hope to women who often silently struggle with urology issues. It’s so rewarding to see my patients’ faces when they see the light at the end of the tunnel after Botox – they have their lives back.

Dr. P

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!

 

 

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.