Selected Podcast
I'm a Female Experiencing Discomfort in My Pelvic Region. What Do I Need To Know?
Pelvic floor disorders, which occur when the muscles or connective tissue in the pelvis do not work as they should, affect one in five women in the United States. Urogynecologists, like Dr. Jeff Fahy, are experts in the female pelvis organs and pelvic floor. He provides comprehensive care through preventive and corrective therapies as well as experienced diagnosis and treatment of related issues with minimally-invasive surgical and non-surgical interventions. He joins us today to discuss two of the most common pelvic floor disorders that many women face.
Featuring:
Jeff Fahy, MD, FACOG, FPMRS
Dr. Fahy is a Yale University-trained gynecologist and pelvic surgeon who specializes in minimally-invasive surgical procedures for pelvic organ prolapse, incontinence, benign pelvic masses, and pelvic pain. He is a board-certified gynecologist and pelvic surgeon who also specializes in advanced hormone therapy, including bio-identical hormone pellet therapy and reversing tubal ligations. A nationally recognized surgeon, he was selected as one of America’s Top GYN doctors by the Consumer Research Council and has received the Patients’ Choice Award for outstanding patient care. Dr. Fahy teaches urologists, gynecologists and resident physicians-in-training innovative and minimally invasive urinary incontinence and pelvic floor defect procedures. He has served as a consulting surgeon and preceptor a number of innovative medical equipment companies over the past 20 years. Transcription:
Caitlin Whyte: Do you have to cross your legs with the hopes that you won't leak when you laugh or cough or sneeze? Have you had to race to the bathroom to make it in time before you need a change of clothes? Does something feel lax or out of place in your pelvic region after physical activity or standing for long periods of time?
Well, pelvic floor disorders which occur when the muscles or connective tissue in the pelvis do not work as they should actually affect one in five women in the united. Urogynecologists like Dr. Jeff Faye are experts in the female pelvic organs and pelvic floor. He provides comprehensive care through preventative and corrective therapies, as well as experienced diagnosis and treatment of related issues with minimally invasive surgical and nonsurgical interventions.
He joins us today to discuss two of the most common pelvic floor disorders that many women face.
Welcome to Life Cast by Infirmary Health. My name is Caitlin White. Well, Dr. Fay, so great to have you on the show today. To start off our conversation, can you tell us just what is Urogynecology?
Jeff Fahy, MD, FACOG, FPMRS: So Urogynecology is a subspecialty of OB gyn or obstetrics gynecology, which has four different subspecialties, one of which is specializing in the pelvic floor and incontinence for women.
So Urogynecology specifically focuses on pelvic floor dysfunction. In fact, they've changed the name essentially to call it female Pelvic Medicine and Reconstructive Surgery. So that's what we do. We specialize in incontinence and pelvic organ prolapse or pelvic floor disorders for women. Well, you touched
Caitlin Whyte: on it a bit saying you care for women, but who do your gynecologist care for?
What kind of patients are you seeing?
Jeff Fahy, MD, FACOG, FPMRS: Well, we see people of all ages, but primarily women who are in their reproductive years. Or our postmenopausal, because the risk of incontinence and the risk of pelvic organ prolapse and pelvic floor disorders increases with age. So we definitely see a lot of people who are in their forties, fifties, and sixties, sometimes seventies, eighties, and nineties as well.
Caitlin Whyte: Mm. And you mentioned a few, but what are some of the most common conditions treated by a urogynecologist?
Jeff Fahy, MD, FACOG, FPMRS: We treat stress urinary incontinence, which is incredibly common. It affects one in four women over the age of 18, and it's estimated that up to 15 million women in the United States suffer with stress incontinence, where they have involuntary leakage of.
Bladder leakage with coughing, sneezing, or straining. That's one of our primary areas of treatment. We also treat women who have pelvic organ prolapse, and it's estimated that one in five women are affected by this, or a total of about three and a half million women who have pelvic organs. That are prolapsing causing kind of a herniation and pressure through the vagina.
Caitlin Whyte: Okay. So it sounds like urinary incontinence is one of the most common issues that you see. Can you tell us about the different types and how they're treated?
Jeff Fahy, MD, FACOG, FPMRS: There are basically three types of incontinence in general. One is, as I mentioned earlier, stress urinary incontinence. The other. U incontinence where people have an overwhelming urge to empty their bladder and can't make it to the bathroom in time.
And then the third is really a combination of both. We call it mixed incontinence, so an element of stress leaking with coughing, sneezing, straining, and also an element of urge where they can't make it to the bathroom in time because of significant urinary. We always like to start our treatment with conservative things.
Stress incontinence can be treated with weight loss as well as pelvic floor exercises. Those types of things can help a number of people, but people who don't do well with weight loss and pelvic floor exercises can have a surgical procedure, which is an outpatient simple procedure called a sling procedure, which has become.
Gold standard for treatment for stress incontinence. Urg incontinence, on the other hand, is treated with pelvic floor exercises as well as avoiding things that are antagonistic to the bladder, trying to get away from. Too much caffeine and sodas and things that can really be irritative as well as medications that relaxed bladder.
These unfortunately can have some side effects, so we try to avoid the meds if we can. If the meds don't work after we've tried them, we actually can go on to treat people with a bladder stimulator, believe it or not, to help them have like a pacemaker for the bladder to relax the bladder so that they don't have a problem with.
Overactive bladder are urge incontinence, and interestingly enough, we've also used Botox in the bladder to help relax the bladder.
Caitlin Whyte: Oh, wow. Well, it's great to hear that there are so many innovative options for treatment out there. I'd love to also focus on pelvic organ prolapse. How does that affect someone, and then how is that treated?
Jeff Fahy, MD, FACOG, FPMRS: So a pelvic organ prolapse, as I kind of mentioned earlier, A lot more common than people realize. When I see patients, they think they're the only one who's ever had this problem, but as I mentioned it, it affects up to one in five women, you know, in the United States. So, you know, nearly half of all the women between ages 50 and 80 will have some degree of pelvic organ prolapse.
So you ask the question, what is pelvic organ prolapse? Well, when you think about the spaces that we're working in, we're working with walls of the vagina that basically support the bladder and the rectum, as well as those who have a uterus still have a uterus in place. So all these things can possibly prolapse or fall down, if you will, so people can.
Prolapse of their bladder pushing down into the vaginal opening or prolapse of the rectum, pushing down in that direction or the, uh, the uterus can actually come down and be pushing out essentially. And the nice thing is all these things are very correctable, but you know, people who who experienced this are just overwhelmed with what's happening to my body and something gonna actually fall out of my body.
You know, that kind of thing. And we're able to tell 'em, listen, nothing's gonna fall out and we can. We can fix these problems. Most of these are fixed with surgery, but in the elderly we also do use a little device called a pessary that is inserted in the vagina to give support.
Caitlin Whyte: Mm. Thank you for that.
And do you limit your practice to just urogynecology or what do you see on a day to day basis?
Jeff Fahy, MD, FACOG, FPMRS: I am board certified in urogynecology and pelvic surgery and do a lot of that in my practice, but because of where I practice in the United States, there's a need for general gynecology. So we take care of patients who are adolescent all the way into.
The elderly patients who are in their eighties or nineties. In between that, uh, we do a bunch of different surgeries, including laparoscopies for people with chronic pelvic pain. We help people who have very large urine fibroids who live in rural areas. Who have not been able to seek care and need major abdominal surgery to help them with that.
I even do, uh, tubal reversal surgeries for people who have had their tubes tied, but want to reverse those because they're interested in having more children. And we also provide this population with implantable hormone pellet therapy, which are bioidentical pellets for people with menopausal syndrome and issues related to the.
Caitlin Whyte: Wonderful. Well, doctor, we covered a lot of information here today. Is there anything else you'd like to share with our listeners?
Jeff Fahy, MD, FACOG, FPMRS: I appreciate the opportunity to chat with you today and, uh, just wanna let our listeners know that we're available, uh, in the, uh, south Alabama area to help you with all of your gynecologic needs and hormone needs.
And, uh, we thank you so much for, uh, your patronage, those who have come to see us.
Caitlin Whyte: Absolutely. Well, thank you so much for sharing and being with us today, doctor, as the first choice for healthcare for the Gulf Coast region, infirmary Health is here for you here for life. Visit us@infirmaryhealth.org slash women to learn more about our comprehensive Women's health services or to find a physician near you.
And thank you for listening to Life Cast by Infirmary Health. I'm Caitlin White. Be well.
Caitlin Whyte: Do you have to cross your legs with the hopes that you won't leak when you laugh or cough or sneeze? Have you had to race to the bathroom to make it in time before you need a change of clothes? Does something feel lax or out of place in your pelvic region after physical activity or standing for long periods of time?
Well, pelvic floor disorders which occur when the muscles or connective tissue in the pelvis do not work as they should actually affect one in five women in the united. Urogynecologists like Dr. Jeff Faye are experts in the female pelvic organs and pelvic floor. He provides comprehensive care through preventative and corrective therapies, as well as experienced diagnosis and treatment of related issues with minimally invasive surgical and nonsurgical interventions.
He joins us today to discuss two of the most common pelvic floor disorders that many women face.
Welcome to Life Cast by Infirmary Health. My name is Caitlin White. Well, Dr. Fay, so great to have you on the show today. To start off our conversation, can you tell us just what is Urogynecology?
Jeff Fahy, MD, FACOG, FPMRS: So Urogynecology is a subspecialty of OB gyn or obstetrics gynecology, which has four different subspecialties, one of which is specializing in the pelvic floor and incontinence for women.
So Urogynecology specifically focuses on pelvic floor dysfunction. In fact, they've changed the name essentially to call it female Pelvic Medicine and Reconstructive Surgery. So that's what we do. We specialize in incontinence and pelvic organ prolapse or pelvic floor disorders for women. Well, you touched
Caitlin Whyte: on it a bit saying you care for women, but who do your gynecologist care for?
What kind of patients are you seeing?
Jeff Fahy, MD, FACOG, FPMRS: Well, we see people of all ages, but primarily women who are in their reproductive years. Or our postmenopausal, because the risk of incontinence and the risk of pelvic organ prolapse and pelvic floor disorders increases with age. So we definitely see a lot of people who are in their forties, fifties, and sixties, sometimes seventies, eighties, and nineties as well.
Caitlin Whyte: Mm. And you mentioned a few, but what are some of the most common conditions treated by a urogynecologist?
Jeff Fahy, MD, FACOG, FPMRS: We treat stress urinary incontinence, which is incredibly common. It affects one in four women over the age of 18, and it's estimated that up to 15 million women in the United States suffer with stress incontinence, where they have involuntary leakage of.
Bladder leakage with coughing, sneezing, or straining. That's one of our primary areas of treatment. We also treat women who have pelvic organ prolapse, and it's estimated that one in five women are affected by this, or a total of about three and a half million women who have pelvic organs. That are prolapsing causing kind of a herniation and pressure through the vagina.
Caitlin Whyte: Okay. So it sounds like urinary incontinence is one of the most common issues that you see. Can you tell us about the different types and how they're treated?
Jeff Fahy, MD, FACOG, FPMRS: There are basically three types of incontinence in general. One is, as I mentioned earlier, stress urinary incontinence. The other. U incontinence where people have an overwhelming urge to empty their bladder and can't make it to the bathroom in time.
And then the third is really a combination of both. We call it mixed incontinence, so an element of stress leaking with coughing, sneezing, straining, and also an element of urge where they can't make it to the bathroom in time because of significant urinary. We always like to start our treatment with conservative things.
Stress incontinence can be treated with weight loss as well as pelvic floor exercises. Those types of things can help a number of people, but people who don't do well with weight loss and pelvic floor exercises can have a surgical procedure, which is an outpatient simple procedure called a sling procedure, which has become.
Gold standard for treatment for stress incontinence. Urg incontinence, on the other hand, is treated with pelvic floor exercises as well as avoiding things that are antagonistic to the bladder, trying to get away from. Too much caffeine and sodas and things that can really be irritative as well as medications that relaxed bladder.
These unfortunately can have some side effects, so we try to avoid the meds if we can. If the meds don't work after we've tried them, we actually can go on to treat people with a bladder stimulator, believe it or not, to help them have like a pacemaker for the bladder to relax the bladder so that they don't have a problem with.
Overactive bladder are urge incontinence, and interestingly enough, we've also used Botox in the bladder to help relax the bladder.
Caitlin Whyte: Oh, wow. Well, it's great to hear that there are so many innovative options for treatment out there. I'd love to also focus on pelvic organ prolapse. How does that affect someone, and then how is that treated?
Jeff Fahy, MD, FACOG, FPMRS: So a pelvic organ prolapse, as I kind of mentioned earlier, A lot more common than people realize. When I see patients, they think they're the only one who's ever had this problem, but as I mentioned it, it affects up to one in five women, you know, in the United States. So, you know, nearly half of all the women between ages 50 and 80 will have some degree of pelvic organ prolapse.
So you ask the question, what is pelvic organ prolapse? Well, when you think about the spaces that we're working in, we're working with walls of the vagina that basically support the bladder and the rectum, as well as those who have a uterus still have a uterus in place. So all these things can possibly prolapse or fall down, if you will, so people can.
Prolapse of their bladder pushing down into the vaginal opening or prolapse of the rectum, pushing down in that direction or the, uh, the uterus can actually come down and be pushing out essentially. And the nice thing is all these things are very correctable, but you know, people who who experienced this are just overwhelmed with what's happening to my body and something gonna actually fall out of my body.
You know, that kind of thing. And we're able to tell 'em, listen, nothing's gonna fall out and we can. We can fix these problems. Most of these are fixed with surgery, but in the elderly we also do use a little device called a pessary that is inserted in the vagina to give support.
Caitlin Whyte: Mm. Thank you for that.
And do you limit your practice to just urogynecology or what do you see on a day to day basis?
Jeff Fahy, MD, FACOG, FPMRS: I am board certified in urogynecology and pelvic surgery and do a lot of that in my practice, but because of where I practice in the United States, there's a need for general gynecology. So we take care of patients who are adolescent all the way into.
The elderly patients who are in their eighties or nineties. In between that, uh, we do a bunch of different surgeries, including laparoscopies for people with chronic pelvic pain. We help people who have very large urine fibroids who live in rural areas. Who have not been able to seek care and need major abdominal surgery to help them with that.
I even do, uh, tubal reversal surgeries for people who have had their tubes tied, but want to reverse those because they're interested in having more children. And we also provide this population with implantable hormone pellet therapy, which are bioidentical pellets for people with menopausal syndrome and issues related to the.
Caitlin Whyte: Wonderful. Well, doctor, we covered a lot of information here today. Is there anything else you'd like to share with our listeners?
Jeff Fahy, MD, FACOG, FPMRS: I appreciate the opportunity to chat with you today and, uh, just wanna let our listeners know that we're available, uh, in the, uh, south Alabama area to help you with all of your gynecologic needs and hormone needs.
And, uh, we thank you so much for, uh, your patronage, those who have come to see us.
Caitlin Whyte: Absolutely. Well, thank you so much for sharing and being with us today, doctor, as the first choice for healthcare for the Gulf Coast region, infirmary Health is here for you here for life. Visit us@infirmaryhealth.org slash women to learn more about our comprehensive Women's health services or to find a physician near you.
And thank you for listening to Life Cast by Infirmary Health. I'm Caitlin White. Be well.