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October 2011 | 0 Comments | Print
Urogynecology

Board Certification

Obstetrics & Gynecology 

Education

Cairo University College of Medicine

Residency

Good Samaritan Hospital

Fellowship

University of California Los Angeles School of Medicine

Community Affiliations

President and Co-founder, Foundation for Female Health Awareness

Regain control of your bladder

Your 25th wedding anniversary. Insight. Laugh lines. Grandchildren. The joys of aging are abundant, so don’t miss out on these moments due to urinary incontinence, or loss of bladder control.

“Four out of 10 women above the age of 60 have socially debilitating incontinence,” says Mickey Karram, M.D., medical director of urogynecology at The Christ Hospital. “Women consider the subject taboo because they’re embarrassed and often misinformed that treatment isn’t possible.”

Simply educating women on how their pelvic organs work might help them curb urine leakage or help them understand it’s nothing to be ashamed of, Dr. Karram adds.

Why the pipes leak

The bladder, urethra and pelvic floor muscles work in tandem to support the urinary tract. As women age, muscles weaken and can lead to two common types of incontinence:

  • Urge incontinence (overactive bladder) occurs when women feel a sudden urge to urinate followed by an involuntary loss of urine.
  • Stress incontinence happens when added stress is suddenly placed on the bladder, such as when coughing, sneezing or during exercise.

Long-term incontinence can lead to urinary tract infections or skin problems below the waist. It can also affect your quality of life. “If you’re not doing things you would normally do because of a bladder control problem, it’s time to seek help from your doctor,” Dr. Karram says.

Start living without the worry

The great thing about treating incontinence is that it doesn’t always involve surgery. “Urge incontinence, for example, is commonly treated with behavioral therapy and medication,” Dr. Karram says. The following are some simple approaches that work well:

  • Retrain your bladder muscles through exercise. Kegal exercises work to strengthen the pelvic floor muscles. To do a kegal, squeeze the muscles you would use to stop urinating, hold for three seconds and repeat.
  • Change your diet. Eliminate caffeine, spicy foods or drinking liquids late in the evening. These can irritate an already overactive bladder.
  • Practice timed voiding. Emptying the bladder based on the clock and not your urges can help you establish more control over your bladder. For example, you could void every hour and gradually work your way up to waiting between three and four hours.   
  • Take medication. Medications known as anticholinergics can treat urge incontinence by relaxing the bladder.

In women with stress incontinence, if conservative approaches don’t work, minimally invasive surgery may be an option. “Minimally invasive treatments, such as the sub-urethral sling, can be done as an outpatient procedure, leaving the patient with minimal pain and minimal downtime,” Dr. Karram says.

The surgery involves a small incision made under the urethra. The surgeon then inserts a synthetic piece of tape between the vagina and the urethra, which prevents urine from leaking during rises in intra-abdominal pressure, such as when coughing or exercising. The procedure takes about 15 minutes, and patients can go home the same day and return to non-strenuous daily activities within a week.

“Women no longer have to feel like incontinence is something they have to live with,” Dr. Karram says.

If you have symptoms of urinary incontinence, stop living in the shadows. Find a physician who can help by calling 877-904-4YOU. 

Regional (gynecology)

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