Urinary Incontinence

As many as 25 million Americans are affected by bladder control problems. Many more suffer from pelvic disorders such as interstitial cystitis, vaginal prolapse, uterine prolapse or “dropped” bladder. These disorders are a sensitive issue and many women suffer in silence, too embarrassed to tell anyone – even their physician.

Because these disorders are not widely discussed, many people are reluctant to talk about them, believing that their situation is unique. Many women simply believe that as they get older, leakage of urine in some amount is inevitable and needs to be tolerated. However, clearly as the above numbers show you are not alone- these conditions are quite common. More importantly, these conditions are quite treatable. Proper treatment starts with proper diagnosis.

Pelvic relaxation is the loss of support to pelvic organs such as the bladder, vagina, uterus or rectum. This may be caused by injuries from childbirth, aging, muscle weakness, or nerve injury due to surgery. Symptoms often worsen with standing or other vigorous activity (sneezing, coughing, exercise, etc.).

Symptoms of pelvic relaxation may include:

  • Bulge outside the vagina
  • Pressure or discomfort in the vagina
  • Pain or discomfort with intercourse
  • Feeling the bladder is not completely empty after voiding
  • Severe chronic constipation and or straining with bowel movements
  • Frequent urination

Urinary Incontinence (leakage of urine) may be caused by a number of conditions such as previous childbirth (especially when traumatic), degenerative changes associated with aging, muscle weakness, infections, medications or neurologic disorders.

Symptoms of urinary incontinence may include:

  • Leaking urine when coughing, sneezing, lifting or exercise
  • Frequent urination
  • Increased urge to urinate
  • Leaking of urine associated with a strong urge
  • The need to wake up at night and rush to get to the bathroom

Effective treatments depend on the source of the problem. Although symptoms may seem similar to patients, the underlying problem may represent an irritable bladder, a problem with the urethral sphincter or increased mobility of the urethra. Treatments range from surgery to medication to bladder retraining and pelvic floor exercises including electrical stimulation and biofeedback.

Proper diagnosis can now be made with a simple test called multichannel urodynamics. A special continence nurse visits Dr. Goldstein’s office several days each month to perform these tests on patients. The process is painless and leads to an accurate diagnosis of the underlying cause, providing Dr. Goldstein with sufficient information to determine an appropriate, and effective treatment plan for patients. The test is covered by virtually all insurance.

Dr. Goldstein has been treating women experiencing urinary incontinence issues for most of his 25 year practice. He works closely with his patients to review, address and diagnose causes of urinary incontinence.

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