Posts in Category: Bladder Health

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.

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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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