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Female Urinary Incontinence a Common, Treatable Condition

It’s a topic that’s usually discussed in hushed tones, laughed off as part of the aging process for women, or ignored altogether. Common but not normal, female urinary incontinence affects about 30-40% of all women, and that number rises to around 50% for women over age 55. After more than 20 years of ignoring her problem, Janelle Phillips, 54, decided it was time to do something about it. “It started out small, a leak here or there with a cough or sneeze. Then as I got older, it became worse, making it next to impossible for me to exercise. About five years ago, I really got on a health kick and after a while, I couldn’t run without leaking. It just became so inconvenient,” she said.

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Janelle had a common experience when she tried to talk with her family doctor about incontinence -- she felt as though she wasn’t taken seriously, her concerns were brushed aside. A surgical nurse at Good Samaritan Hospital (closed in 2018), she sought out advice and recommendations of her colleagues and decided to schedule an appointment with urogynecologist William Rush, MD. A relatively new sub-specialty of gynecology recognized by the American Board of Obstetrics and GynecologyOff Site Icon and the American Board of UrologyOff Site Iconsince 2013, urogynecology focuses on the pelvis, bladder and rectum.

Janelle went to Dr. Rush’s office in the spring of 2012, initially for irregular menstrual periods. During that visit, she ended up talking with him about her incontinence and was pleasantly surprised by his desire to help. “He realized this was actually a problem, and it was negatively impacting my life,” she said. So, they took action to fix things.

A Complex Problem

A number of tests were performed to diagnose what she was experiencing -- they showed there was more than one issue. “She had a complex problem with multiple aspects that required treatment,” Dr. Rush said. A urodynamics study tested her bladder strength; a cystoscopy showed Dr. Rush that she would benefit from surgery. She had multiple procedures performed during one laparoscopic surgery, including repair of her prolapsed bladder and weakened urethra.

Recovery took the typical six weeks. “It wasn’t bad – there really wasn’t much pain at all. After a couple of weeks, I was taking short walks,” Janelle said. For most women, recovery is normally very tolerable and they are walking the first night after surgery. Janelle had experienced both stress and urge incontinence, according to Dr. Rush. Stress incontinence occurs when there is physical stress – coughing, exercising, heavy lifting -- on the bladder and a weakness of the urethra. Urge incontinence, also known as overactive bladder, happens when women have the need to go, but can’t get to the bathroom quickly enough.

Urinary incontinence has no definite, identifiable causes; risk factors include pregnancy, vaginal deliveries, lifting jobs, activities that require bearing down, and chronic cough. “This condition has always been out there, and we need to communicate to women that there are many things we can do to help,” he said. Depending on the severity of the condition and personal preferences, there are pharmaceutical options, physical therapy, and surgery. To best determine a course of action, Dr. Rush said, women should have a complete physical examination that includes medical history. Testing is also necessary, which often includes a bladder diary (and yes, it’s what it sounds like).

Dr. Rush has an unassuming, relaxed demeanor that can initially belie his serious, board-certified urogynecologist side when he talks about the problems incontinence can cause for women. “The question every woman needs to ask herself is, ‘How does this impact my life?’ If it has a negative effect, there are ways to fix the problem and move on. You should be able to live your life like you want,” he said, matter-of-factly. Janelle appreciated his direct, professional approach. He talked openly about every part of the process, explaining clearly. “He made me feel comfortable, never uneasy or ashamed. He was always respectful,” she said.

‘Talk to your doctor and look into your options’

Dr. Rush and his patient are both strong advocates for women to address and treat their incontinence issues. (He added that fecal incontinence affects up to 15% of women and can be treated as effectively.) Janelle has talked extensively with many women so they are aware of options, should treatment become necessary. She champions Dr. Rush to her girlfriends. “I’ve talked to my friends and have been very open with my daughters about my life before and after surgery. I don’t want any woman to live with this problem. My life isn’t interrupted anymore,” she said.

The experienced physician has transitioned his practice solely to urogynecologic issues because of an increased need. “We all need to work together and encourage women to act. We need to talk about it more. Even though it’s common, it’s not normal and can be corrected,” he said. He laughed when he shared that patients regularly tell him their girlfriends are waiting to see if treatment works so they can make appointments. He’s also working with his colleagues to educate them about options for their patients who are experiencing problems.

“As women, we all have girlfriends that we talk to, we sit around talking and laughing about this, but we all know it isn’t very funny. It’s stressful and makes many situations rather difficult,” Janelle said. “I think women believe we have to live like this, but we don’t. If you have a problem, talk to your doctor and look into your options. And if your doctor doesn’t take it seriously, talk to another doctor. Don’t take no for an answer.”

Content Updated: July 16, 2018

These Miami Valley Hospital locations offer Gynecology Services.
Gynecology at Miami Valley Hospital
One Wyoming St. Dayton, OH  45409
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