Many American men and women suffer from urinary incontinence. Some may be hesitant to seek treatment as they may be embarrassed about this condition, or they may think nothing can be done.
In this segment, Dr. Erin Katz, Urologist and member of the Medical Staff at Corona Regional Medical Center, discusses urinary incontinence and why seeking treatment may offer a better quality of life for those that suffer with this highly treatable condition.
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Incontinence: Treatment May Offer a Better Quality Of Life
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Learn more about Dr. Erin Katz
Erin Katz, MD
Dr. Erin Katz is a Urologist and member of the Medical Staff at Corona Regional Medical Center.Learn more about Dr. Erin Katz
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Incontinence: Treatment May Offer a Better Quality Of Life
Melanie Cole (Host): Many American men and women suffer from urinary incontinence. Some may be hesitant to seek treatment as they may be embarrassed about this condition or they may think nothing can be done. However, seeking treatment may offer a better quality of life for those that do suffer from this highly treatable condition. My guest today, is Dr. Erin Katz. She’s a urologist and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Katz. There are different types of incontinence; please describe those for the listeners.
Dr. Erin Katz (Guest): Melanie, thank you for having me. There are many different types of incontinence and incontinence is basically the involuntary leakage of urine – a person urinates when they don’t want to. The most common type is actually a mixed type. You have leaking with coughing, laughing, sneezing, movement, which is called stress incontinence. And then there’s the overactive bladder, or OAB, which is leaking with frequency, the sudden urge to get to the bathroom and not making it to the bathroom in time, so most people have a little bit of both.
Melanie: So what causes incontinence? Are women more susceptible to this because we’ve had babies, or does weight gain change it? What are some of the causes you can identify?
Dr. Katz: You’re absolutely right. It is more common in women, and unfortunately, there are multiple contributing factors. You named a few, pregnancy, childbirth – multiple child births, menopause, just contribute to the overall weakness of the pelvic floor muscles. Overactive bladder can also occur when we eat or drink certain foods that cause irritation to the bladder.
Melanie: People might be hesitant to come see you – as I said in the intro it could be a little bit embarrassing. What do you want to tell listeners about getting this treated, getting help for it, and coming to see a urologist so that they can get help and not being embarrassed?
Dr. Katz: You’re absolutely right. It’s a very embarrassing occurrence for people, and people don’t like to talk about it. All I Can say that there are certain lifestyle changes that you can do to help improve your situation, and then if those things don’t work to come in and see a urologist because we have so many different options now for treatment of all types of incontinence.
Melanie: So then let’s discuss a few of them, Dr. Katz, starting with things that they can do at home – lifestyle changes and things – what do you tell them about these types of changes that they can make and exercises for the pelvic floor?
Dr. Katz: The biggest one that does work, if you’re consistent with it and performs them every day, and multiple times a day, are Kegel exercises. It’s a little awkward to describe how to do the Kegel exercises correctly, but basically, if you can try and hold passing gas, tightening the rectum at a count of three and then relaxing at a count of three and repeat 10 to 15 different times once and then three times a day. Over the next few weeks, there should be an improvement of the incontinence or leaking.
Other easy things to do at home, you want to urinate when you get up in the morning, you want to urinate before you go to bed. We should all try and urinate every two to three hours, and that will help with the control and incontinence.
The other thing – there’s always the questions of how much fluid should I be drinking in a day and that’s a made-up number, but I do believe that four to six glasses of fluids a day is adequate. If you drink more, if you hydrate more, obviously, you’re going to have more frequency, which can also lead to the urgency and leaking.
Melanie: So when does it require medicational intervention, Dr. Katz? If people have tried the Kegel exercises and they’ve tried voiding on time and looking at their liquids and doing the pelvic floor exercises, what do you recommend then when it comes to medications?
Dr. Katz: Certainly, someone who has tried the lifestyle changes and the Kegel exercises and they don’t see any improvement, that’s the time to come in and see a urologist to see what is available. The other thing if you start getting bladder infections, that’s a time to come in, also. I forgot to say some of the biggest lifestyle changes you can make are limiting or avoiding coffee, and anything that’s carbonated sodas or carbonated water and other things that people just didn’t know about that can affect the bladder – spicy foods, artificial sweeteners – those things can also make the bladder spasm and leaking worse.
Melanie: So then if they do come to see you, what can you do for them?
Dr. Katz: Well, we first have to come up with the correct diagnosis, and some of the simplest things we ask patients to do is keep a bladder diary. This just means at home you would keep a list of things that you drink, the times that you urinate, the times you have accidents, so we can get an idea of -- is it the volume of fluid? Is it what and when you’re drinking -- and truly get an idea of how severe the incontinence is. We would obviously do a physical exam and check simple things like a urinalysis to make sure there’s no infection and sometimes what’s called a post-void residual, which just tells us how much urine is left over after we ask you to completely empty your bladder.
The more advanced studies that we would do in the office may be what’s called a cystoscopy, which is taking a small instrument and looking into the bladder to make sure the lining looks healthy, and urodynamics, which is a specialized functional test for the bladder. All of these things we use as tools to diagnose and treat the incontinence.
Melanie: And people hear medical devices and procedures – what might be involved? Why might somebody need one of these medical devices? Speak about some of them.
Dr. Katz: That’s a good question. For treatment of the spastic bladder or the overactive bladder, meaning the frequent urination, the urgency, and leaking before you make it to the bathroom, we certainly have medications that we can use. If medications don’t work, we have something called the InterStim device, which is a sacral nerve stimulator device. It’s an implantable device that is implanted underneath the skin, and the wires tickle the nerve from the spinal cord to the bladder to really correct the connection between the bladder and correct the leaking. That’s a nice, simple outpatient procedure to implant something like that.
We also have Botox for the bladder, which almost everyone knows Botox is used for cosmetic reasons, but we’ve been using it for years for the bladder. This could be performed in the office with local numbing medication or as a simple outpatient procedure. And then the last thing we have is an acupuncture treatment for treatment of the bladder that is performed in the office. The similar reasoning behind that -- we’re accessing a nerve around the ankle that impulses to the bladder, so that’s a nice option for people if the medications don’t work.
Melanie: So then give us a wrap up of what you would like people to know about incontinence, about getting in to see one, what would you like them to know when they’re seeking care?
Dr. Katz: I just want everyone to know that incontinence is a very common and treatable condition. Yes, it’s embarrassing to talk about, but it’s more common than the amount of diabetes or high blood pressure in the United States right now, so it’s a very common condition. We have lots of different treatment options available that can fit someone’s own lifestyle, so I just want to let everyone know, you don’t have to live with this. This is a lifestyle change. There are things we can do to help.
Melanie: And why should they come to Corona Regional Medical Center for their care?
Dr. Katz: Corona Regional Medical Center is a very nice, multidiscipline facility that we have all the equipment available there and we have all the latest techniques to help with incontinence. It’s a very nice facility to perform procedures.
Melanie: Thank you, so much for being with us today, Dr. Katz. You’re listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to CoronaRegional.com, that’s CoronaRegional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much for listening.
Incontinence: Treatment May Offer a Better Quality Of Life
Melanie Cole (Host): Many American men and women suffer from urinary incontinence. Some may be hesitant to seek treatment as they may be embarrassed about this condition or they may think nothing can be done. However, seeking treatment may offer a better quality of life for those that do suffer from this highly treatable condition. My guest today, is Dr. Erin Katz. She’s a urologist and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Katz. There are different types of incontinence; please describe those for the listeners.
Dr. Erin Katz (Guest): Melanie, thank you for having me. There are many different types of incontinence and incontinence is basically the involuntary leakage of urine – a person urinates when they don’t want to. The most common type is actually a mixed type. You have leaking with coughing, laughing, sneezing, movement, which is called stress incontinence. And then there’s the overactive bladder, or OAB, which is leaking with frequency, the sudden urge to get to the bathroom and not making it to the bathroom in time, so most people have a little bit of both.
Melanie: So what causes incontinence? Are women more susceptible to this because we’ve had babies, or does weight gain change it? What are some of the causes you can identify?
Dr. Katz: You’re absolutely right. It is more common in women, and unfortunately, there are multiple contributing factors. You named a few, pregnancy, childbirth – multiple child births, menopause, just contribute to the overall weakness of the pelvic floor muscles. Overactive bladder can also occur when we eat or drink certain foods that cause irritation to the bladder.
Melanie: People might be hesitant to come see you – as I said in the intro it could be a little bit embarrassing. What do you want to tell listeners about getting this treated, getting help for it, and coming to see a urologist so that they can get help and not being embarrassed?
Dr. Katz: You’re absolutely right. It’s a very embarrassing occurrence for people, and people don’t like to talk about it. All I Can say that there are certain lifestyle changes that you can do to help improve your situation, and then if those things don’t work to come in and see a urologist because we have so many different options now for treatment of all types of incontinence.
Melanie: So then let’s discuss a few of them, Dr. Katz, starting with things that they can do at home – lifestyle changes and things – what do you tell them about these types of changes that they can make and exercises for the pelvic floor?
Dr. Katz: The biggest one that does work, if you’re consistent with it and performs them every day, and multiple times a day, are Kegel exercises. It’s a little awkward to describe how to do the Kegel exercises correctly, but basically, if you can try and hold passing gas, tightening the rectum at a count of three and then relaxing at a count of three and repeat 10 to 15 different times once and then three times a day. Over the next few weeks, there should be an improvement of the incontinence or leaking.
Other easy things to do at home, you want to urinate when you get up in the morning, you want to urinate before you go to bed. We should all try and urinate every two to three hours, and that will help with the control and incontinence.
The other thing – there’s always the questions of how much fluid should I be drinking in a day and that’s a made-up number, but I do believe that four to six glasses of fluids a day is adequate. If you drink more, if you hydrate more, obviously, you’re going to have more frequency, which can also lead to the urgency and leaking.
Melanie: So when does it require medicational intervention, Dr. Katz? If people have tried the Kegel exercises and they’ve tried voiding on time and looking at their liquids and doing the pelvic floor exercises, what do you recommend then when it comes to medications?
Dr. Katz: Certainly, someone who has tried the lifestyle changes and the Kegel exercises and they don’t see any improvement, that’s the time to come in and see a urologist to see what is available. The other thing if you start getting bladder infections, that’s a time to come in, also. I forgot to say some of the biggest lifestyle changes you can make are limiting or avoiding coffee, and anything that’s carbonated sodas or carbonated water and other things that people just didn’t know about that can affect the bladder – spicy foods, artificial sweeteners – those things can also make the bladder spasm and leaking worse.
Melanie: So then if they do come to see you, what can you do for them?
Dr. Katz: Well, we first have to come up with the correct diagnosis, and some of the simplest things we ask patients to do is keep a bladder diary. This just means at home you would keep a list of things that you drink, the times that you urinate, the times you have accidents, so we can get an idea of -- is it the volume of fluid? Is it what and when you’re drinking -- and truly get an idea of how severe the incontinence is. We would obviously do a physical exam and check simple things like a urinalysis to make sure there’s no infection and sometimes what’s called a post-void residual, which just tells us how much urine is left over after we ask you to completely empty your bladder.
The more advanced studies that we would do in the office may be what’s called a cystoscopy, which is taking a small instrument and looking into the bladder to make sure the lining looks healthy, and urodynamics, which is a specialized functional test for the bladder. All of these things we use as tools to diagnose and treat the incontinence.
Melanie: And people hear medical devices and procedures – what might be involved? Why might somebody need one of these medical devices? Speak about some of them.
Dr. Katz: That’s a good question. For treatment of the spastic bladder or the overactive bladder, meaning the frequent urination, the urgency, and leaking before you make it to the bathroom, we certainly have medications that we can use. If medications don’t work, we have something called the InterStim device, which is a sacral nerve stimulator device. It’s an implantable device that is implanted underneath the skin, and the wires tickle the nerve from the spinal cord to the bladder to really correct the connection between the bladder and correct the leaking. That’s a nice, simple outpatient procedure to implant something like that.
We also have Botox for the bladder, which almost everyone knows Botox is used for cosmetic reasons, but we’ve been using it for years for the bladder. This could be performed in the office with local numbing medication or as a simple outpatient procedure. And then the last thing we have is an acupuncture treatment for treatment of the bladder that is performed in the office. The similar reasoning behind that -- we’re accessing a nerve around the ankle that impulses to the bladder, so that’s a nice option for people if the medications don’t work.
Melanie: So then give us a wrap up of what you would like people to know about incontinence, about getting in to see one, what would you like them to know when they’re seeking care?
Dr. Katz: I just want everyone to know that incontinence is a very common and treatable condition. Yes, it’s embarrassing to talk about, but it’s more common than the amount of diabetes or high blood pressure in the United States right now, so it’s a very common condition. We have lots of different treatment options available that can fit someone’s own lifestyle, so I just want to let everyone know, you don’t have to live with this. This is a lifestyle change. There are things we can do to help.
Melanie: And why should they come to Corona Regional Medical Center for their care?
Dr. Katz: Corona Regional Medical Center is a very nice, multidiscipline facility that we have all the equipment available there and we have all the latest techniques to help with incontinence. It’s a very nice facility to perform procedures.
Melanie: Thank you, so much for being with us today, Dr. Katz. You’re listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to CoronaRegional.com, that’s CoronaRegional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks, so much for listening.