Posts in Category: Your Pelvic Health

A Q&A about the MonaLisa Touch

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When I first learned about the MonaLisa Touch laser, I wondered if it was too good to be true. Could a vaginal laser really help post-menopausal women and breast cancer patients experience healthy regrowth of their thinning vaginal walls? I had to see it to believe it. I traveled to California in November 2015 to watch other doctors perform the treatment. To my amazement, many women reported back with noticeable changes after only one session.

I had to bring the MonaLisa Touch to Houston Female Urology – and the response has been amazing. Not only are the treatment sessions approximately five minutes, my patients say that the laser is virtually painless and they can continue on with their day as soon as they leave the office.

I want to share some honest answers with you. I asked one of my patients, Sharon S., to answer a few questions and share her real experience with the MonaLisa Touch. See what she said:

What was life like before your first MonaLisa Touch treatment?
I had age-related symptoms of dryness, burning and pressure resulting in frequent trips to the bathroom. I also experienced drips when sneezing and coughing. I thought I was going to have to learn to live with these problems; however, after my first MonaLisa Touch treatment, I saw improvements in all areas, and I couldn’t wait for my second and third treatments.

Tell me about the day you had the treatment…
On the day of my first treatment, I left the office and continued with what I had scheduled without a problem. The procedure was no worse than having a pap smear. Within the first week of my first treatment I saw a difference in each of the symptoms I was experiencing. I was actually pleasantly surprised that I had improvements so soon.

How did your MonaLisa Touch treatment impact your life?
I have had all three of my treatments, and I can say there has been an even bigger difference with the symptoms I was experiencing. I stopped using my estrogen cream because the problem with dryness was gone, the burning is not a problem, and the pressure when needing to urinate is gone. I am making less trips to the bathroom at night (unless I drink an unusual amount of water before bed), and experiencing no drips. Not only have I experienced a difference, but my husband said that he could tell a difference during intimacy. I also have been able to tell a difference. It is worth it, and I would do the procedure again without question.  

This really works. My patients and other women throughout the world are seeing results. Are you ready to learn more? Join me for a free seminar at my office about the treatment. Give us a call! (281) 717-4003

-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

It’s World Continence Week! Reach out for help

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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

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

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!