Incontinence: More Common Than You Think

Did you know that 50% of women have incontinence at some point in their life? Here’s what you can do to take control.

Incontinence is the loss of urine in an uncontrollable fashion. There are many reasons as to why people have it. Some of them are very easy to treat successfully and are easily cured, and some of them are very challenging to cure. But we can usually get significant improvement with treatment. Incontinence is one of my favorite conditions to see a new patient with; I can often cure them outright and almost always make a big improvement for them with fairly little intervention.

Most people put up with it and hope that it’s going to get better, or put if off until tomorrow, only to realize that several years have passed and it’s only gotten worse.

In generations past, people have looked at the loss of urine as a normal part of aging or normal consequences of childbearing, both of which I think are mistakes. What I would encourage people to think about is the fact that although incontinence is not painful, it’s not normal. People really don’t like to deal with it because it’s embarrassing. But they should realize, it’s very common, and often very easy to treat.

However, correctly treating incontinence means also that you have an understanding of what the true diagnosis is, very much like a headache. There are many different causes for it and the headache itself is usually a symptom of an underlying abnormality of some type, just as incontinence can be caused by many different things. 

Relief for women dealing with bladder control issues typically takes one of three routes:

• It can be as simple as a 10-minute outpatient procedure or a prescription for  medication.
• It may require a combination of therapies to get someone to a much better function.
• Sometimes we need to treat an underlying, undiagnosed urinary tract infection, which should be evaluated further, as it could possibly be a sign of other diseases such as MS or diabetes. 

There are varying levels of incontinence, all of which can be diagnosed and treated to help you return to a normal, active lifestyle.

Spasm and bladder irritability:

• Conditions where a person is urinating frequently and up a lot at night with a sudden sense of urgency (similar to the television commercials you see)
• Tends to be a neurologic, irritational aspect to the bladder
• There are a handful of different medications that are typically used to treat this

Stress incontinence:

• People leak a small amount of predictable urine every time they cough, sneeze, lift or jump
• Will not get better with time
• Often times this can be treated effectively with proper Kegel exercises, but a lot of times that treatment requires ongoing and continuous exercise by the person, and sometimes even then it won’t hold up over time
• Should that fail, we can proceed with a small, 15-minute, outpatient procedure that is very successful (such as some type of sling procedure), which in the past was a very big surgery and nowadays really can be done quickly with a very fast return to full function status

When incontinence affects how you function, what you’re doing, your clothing choices or travel plans, it’s just a shame not to get an evaluation and treatment—because so often, it is actually fairly easy to fix with many different treatment modalities. 

Suffice it to say, there are many treatments for many different causes in the many unique types of patients out there. But I would encourage readers to not for a minute think that this is a normal part of aging and something they simply have to “put up with.”  I would encourage them to seek medical evaluation and intervention, because if you’re thinking about the fact that you’re leaking urine, then it is probably affecting you on a daily basis.

Dr. Eric Eberts is an Obstetrician/Gynecologist at Women’s Care of Wisconsin. Contact Dr. Eberts at 920-729-7105.

The providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com.

The Benefits of In-Office Procedures

There has been an interesting transition over the years from a surgery done originally in an inpatient setting, where the patient would stay in the hospital for several days, to an outpatient surgery setting.  We have essentially accomplished this with procedures up to the hysterectomy, which once was a 4-day hospital stay and included 8 weeks of recovery. Oftentimes, it can now be a same-day surgery, going home the same day. That, of course, is for the big surgeries.  Twenty years ago we were doing operating room procedures for urinary incontinence and bleeding and it again started off as inpatient surgery, migrated to outpatient surgery and recently has become essentially an office procedure. 

Many advantages of in-office procedures have become apparent, and this drive will continue in the future as it offers many excellent outcomes, opportunities and advantages for the patient as well as for the health care system from a delivery standpoint.   First, this transition is based upon the idea that these procedures are becoming less invasive.  When these procedures are done here in the office setting, as opposed to the hospital setting, they also offer more of a personal savings while delivering an equal or better outcome.  These issues in combination with an office setting save the health care system, insurance companies and oftentimes the patient a very significant amount of money. This is because the procedures become less intricate with fewer people involved, faster stays, fewer drugs and less equipment is required.

Here at Women’s Care of Wisconsin we have transformed many surgeries over the past years.  Traditionally, these procedures were urinary incontinence and LEEP procedure of the cervix, which have been done in the office setting successfully for more than twenty years.  We have now added several other office procedures that nationally and state-wide continue to be done in hospital settings. Women’s Care does office Botox for incontinence of the bladder and frequency and urgency symptoms.  This procedure is very effective when other medication has not been successful.  There’s no incision, it typically takes about 20 minutes, it’s often covered by insurance, very durable and we have again had very excellent outcomes with this in the office-based setting.

Likewise, hysteroscopy and ablation, which is the destroying of the lining of the uterus, has also migrated to the office setting and is often covered by insurance. This procedure is done to effectively eliminate or at least successfully diminish the amount of pain and bleeding encountered by a woman during her cycle. With this procedure, there are no incisions, it only takes a few minutes of time and offers the ability for the patient to return to work typically the next day.  This procedure is particularly helpful in an office setting as we are able to perform this procedure at a much lower cost to the insurance company and that is often reflected in what the patient has to pay. We are effectively delivering this procedure in a fashion that is if anything better, more pleasing to the patient, a fraction of the cost, and has an identical outcome.

While all of these office procedures have offered significant cost savings to patients and their insurance companies, the goal has been to offer better service with the same outcomes in a more personal setting.  I think we have achieved this and we have been able to bring the cost down while delivering this perfect triad of advanced care.  By creating an environment where we can have less paperwork, fewer handoffs between strangers and essentially taking this into an office setting where the patient can oftentimes be functioning the next day. At Women’s Care we are continuously improving ourselves as we drive towards a better delivery system in general. In particular, Women’s Care strives to deliver to our patients and our communities excellent care of which we can all be proud.

If you have any questions, feel free to contact us and see what services we can provide for you. I’m sure that you will be most pleased with the outcomes that we can deliver.

Dr. Eric Eberts is an Obstetrician/Gynecologist at the Appleton and Neenah locations of Women's Care of Wisconsin. Contact Dr. Eberts at 920-729-7105.

Providers at Women’s Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care. From adolescence through menopause and beyond, you can depend on us. Meet our providers and learn more about gynecology, pregnancy care, infertility, procedures and surgery, incontinence, osteoporosis, menopause and more at www.womenscareofwi.com.

 

 

The Importance of Full Term Pregnancies

Pregnancy is one of the most exciting and vulnerable times of a woman's life. Most of us have thought about pregnancy and how our pregnancy would go long before we were actually pregnant. Most of the time, everything goes just right. However, almost one in eight women deliver preterm (defined as less than 37 weeks).                                                      

If a woman believes she is in preterm labor, she should call her doctor immediately and be evaluated. 

Why do women give birth early?

Half of preterm deliveries are because of preterm labor, while the other half has a medical indication for early delivery such as preeclampsia or their bag of water may have broken early.

Who is at increased risk?

There are some risk factors for preterm delivery. They include women with a history of preterm delivery, short cervical length noted on ultrasound, a history of cervical surgeries such as a D&C, and smoking (another reason to quit, ladies). If a woman is found to have a short cervical length, there are medical management options. Women with a history of preterm delivery are treated with medications in later pregnancies. 

The providers of Women’s Care believe having a healthy pregnancy starts before a woman is pregnant. Healthy babies begin with healthy mothers. We promote a well-balanced lifestyle to our patients, which means preconception care, proper nutrition, routine exercise, a healthy, safe environment, as well as a daily prenatal vitamin with folic acid. With good guidance, avoidable conditions that may have everlasting consequences may be prevented. We would love the privilege to take care of you and answer any questions you might have about pregnancy care or preterm deliveries.

The physicians at Women's Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care.

Meet our providers and learn more about infertility, gynecology, pregnancy care, midwifery services, procedures and surgery, incontinence, osteoporosis, menopause management and more at www.womenscareofwi.com. Or call or text us at 920.729.7105.

Endometrial Ablation in the Office Setting

Abnormal uterine bleeding, in the form of heavy menstrual flow or irregular cycles, is one of the most common complaints that bring women in to see a gynecologist. A procedure called an endometrial ablation is a minimally invasive treatment option that uses technology to destroy the lining of the uterus to reduce menstrual flow. It can be performed right in your doctor’s office without the use of general anesthesia and with minimal down time.

Endometrial ablation in general refers to any procedure that destroys (i.e., ablates) the endometrium (uterine lining). When this technique was initially introduced, laser was used as the energy source. This limited the performance of endometrial ablation to operating rooms that were equipped with expensive and oftentimes cumbersome laser equipment.

More recently, newer ways of achieving quick, effective destruction of the uterine lining using other energy sources, such as heated fluid and radiofrequency electricity, have allowed physicians to offer endometrial ablation safely in an office setting.

Endometrial ablation is not appropriate for every woman suffering from abnormal uterine bleeding. Premenopausal patients with a normal uterus, without evidence of cancer or pre-cancer and who have completed childbearing, are considered candidates for this procedure. Your physician will run tests, such as a pelvic ultrasound and a biopsy of the lining of the uterus, to determine the advisability of ablation in your particular case.

Endometrial ablation itself does not provide effective contraception and any pregnancy that occurs after a woman has had an ablation is extremely dangerous. Therefore, your doctor will often recommend permanent sterilization as well if you have not already undergone tubal ligation, or your partner has not had a vasectomy.

For more information or to schedule an appointment, call or text 920.729.7105.