Urogynecology: What Every Woman Needs to Know About Pelvic Health

Urogynecology and Pelvic Reconstructive Surgeon, Dr. Justin Lee discusses urinary incontinence, issues associated with an overactive bladder, pelvic floor rehabilitation and pelvic organ prolapse.
Urogynecology: What Every Woman Needs to Know About Pelvic Health
Featured Speaker:
Justin Lee, MD
Justin Lee, MD completed his undergraduate degree in Molecular Cell Biology at the University of California, Berkley and completed his medical doctor degree at St. George’s University, School of Medicine in the field of Obstetrics, Gynecology, and Reproductive Sciences.

Dr. Lee later trained in the area of Female Pelvic Medicine and Reconstructive Surgery at the Women’s Continence Center in Rochester New York.

Dr. Lee is a published physician who has worked and taught in leading clinics and universities around the country. He is fluent in Vietnamese and Cantonese and enjoys playing guitar, skiing and tennis. His practice is committed to offering best in class Urogynecology services and Pelvic Reconstructive Surgery for the community of Kern County.

Learn more about our physicians at www.dignityhealth.org/ourdoctors.
Transcription:
Urogynecology: What Every Woman Needs to Know About Pelvic Health

Bill Klaproth (Host): Pelvic health is something every woman should know, as it plays a role in many areas of life, including complete physical, mental, social, and sexual well-being. Here to talk with us about women's pelvic health and urogynecology is Dr. Justin Lee; a urogynecology and pelvic reconstructive surgeon at Dignity Health. Dr. Lee, thank you for your time. Can you explain to us what is urogynecology?

Dr. Justin Lee, MD (Guest): Well, urogynecology was formerly known as specialized practitioners or surgeons who focused their practices in women's urology and female pelvic medicine that deals with urinary and fecal incontinence and pelvic organ floor prolapse such as bladder drop, protrusions of the rectum, or the prolapse of the uterus.

Host: So, what are some of the more common pelvic health issues that women face? I know you just mentioned some of them. What are some of the other ones?

Dr. Lee: Well, some other conditions that might involve with women's health, especially in the pelvic regions, are recurring urinary tract infections, uncontrollable bladder issues, and sexual health, and particularly elderly and post-menopausal women.

Host: So, you were just mentioning urinary. What is urinary incontinence and what are the treatment options?

Dr. Lee: Well, urinary incontinence commonly breaks down to very common issues that women do every day. One is what we call stress urinary incontinence. Stress urinary incontinence is when patients or women might have leakage of urine when they cough, when they sneeze, when they laugh, when they exercise, or when they lift heavy objects, or when they exert any pressure in the abdomen that cause women to have uncontrolled leakage of urine.

The other conditions of urinary incontinence are involved with overactive bladder including urinary frequency, urgency, and especially urinary urge incontinence where they feel the urge to go and they're not able to control their bladder.

Host: Are there women that are at a higher risk for this? Or is this just a normal symptom of aging?

Dr. Lee: Good question. Actually nearly 50% of urinary incontinence are increased with age. It's actually in fact about 10% to 20% of all women, nearly 80% of elderly in the nursing home. Very prominent condition, and most studies recently show that 17% of women above the age of twenty, and even double in elder patients who- I would say older than sixty years old, estimated approximately 6.8 million of primary diagnoses of urinary incontinence are most likely to be under diagnosis and affect women who seek care, and those are less than half who receive treatment.

Host: And what are the treatment options, Dr. Lee?

Dr. Lee: The treatment options are a variety in terms of different options for women from conservative management medical treatment into surgical options. The behavior modifications, pelvic floor exercises, medicine to help their ability to control their bladder. And for different conditions, especially for overactive bladder with urge continence, there are what we call Kegel nerve stimulations or neuromodulations, Botox injections into the bladder, and InterStim, which is a neuromodulation. Oftentimes we call them as bladder pacemakers.

Host: And Dr. Lee, what is pelvic organ prolapse?

Dr. Lee: Well, pelvic organ prolapse is a medical terminology, but it's involved with- most of the time with women who have either bladder drop or the uterus that's protruding toward the vaginal opening. Oftentimes patients might present with a rectum that's protruding toward the vaginal opening, and vaginal prolapse, so for those who have hysterectomy.

Host: And Dr. Lee, how do you treat pelvic organ prolapse?

Dr. Lee: Yeah, pelvic organ prolapse has different options. Of course conservative management, if it doesn't bother the patient, they can actually monitor and watch out for their conditions. Second options are pessary uses to help to support of the prolapse. And lastly, surgical options.

Host: Dr. Lee, for a woman who is experiencing pelvic floor issues or has concerns, at what point should she seek medical advice?

Dr. Lee: As I mentioned before, it is very common conditions for women to experience daily. They first initially seek out treatment options with their primary care physicians when the concerns and experience of urinary incontinence worsening and has not much improvement. Then they should be referred to a urogynecologist or someone who specializes in female urology and pelvic organ prolapse.

Host: So when it comes to pelvic health, is this something that can be managed over a lifetime if treated fairly early?

Dr. Lee: It is a quality of life, and the risks involved also increase with age. Certainly the earlier detection or early treatment and help in regard of their condition certainly will improve their quality of life throughout their lifetime.

Host: And Dr. Lee, if you could wrap it up for us; what else should we know about pelvic health?

Dr. Lee: Well, it's important for women to know about pelvic health because it is not a condition that we oftentimes think that is a natural occurrence during their lifetime. It is a condition that affects their quality of life and there are treatment options that we have to provide to the patient to improve their daily experience.

Host: Alright Dr. Lee, well thank you so much for your time today. We appreciate it. For more information, please visit www.DignityHealth.org/bakersfield/womens-center. That's www.DignityHealth.org/bakersfield/womens-center. This is \Hello Healthy; a Dignity Health podcast. I'm Bill Klaproth, thanks for listening.