Maggie McKay (Host): Meaningful Medicine is a Novant Health podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future.

Today, I'm sitting down with Dr. Tim Chase, and we're going to be talking about bladder leaks. Before we get started, I'd love to know how women's health became a passion of yours and what made you become a Urogynecologist.

Dr. Tim Chase: Well, it started in medical school, I was originally going to be a pediatrician. And when I went through all my rotations in medical school, I went to OBGYN, and when I went to OBGYN, I was able to do surgery, plus do obstetrics and deliver babies, which is one of the most fantastic times in a couple's life, and I got to experience that.

And then when I went to residency in OBGYN, I had a mentor that was doing Urogynecology before even Urogynecology was a specialty. That's where I found my passion for Urogynecology.

Host: Dr. Chase, how common is it that women experience bladder troubles?

Dr. Tim Chase: Well, it's very common. Bladder leakage is about one in three patients, three females in our country.

Host: Wow.

Dr. Tim Chase: Very common. And it's not just, you know, older ladies, it's women that are in their twenties, thirties, forties, up until seventies and eighties.

Host: That's what I was going to ask because I've always heard it mostly in the older population. So do women usually seek care immediately or do they delay treatment?

Dr. Tim Chase: It really varies and it's interested me over the years. I think over the last 10 years, I think more patients are seeking out care. Twenty years ago, it was more like, this is kind of how it's supposed to be, but it's not something you have to live with. There's solutions for the problems.

Host: Well, that's the good news. What causes bladder leaks?

Dr. Tim Chase: Well, there's two main types. There's stress incontinence and then there's urge incontinence. Stress incontinence is where you cough, laugh, sneeze, exercise, try and play with the kids and leak. Urge incontinence is when you get that sudden urge to go and can't get there in time. So stress incontinence is caused by a weakness of the pelvic floor muscles. And then urge incontinence is caused by a contraction of the bladder when it's not supposed to.

Host: So a lot of people think that it's something you have to live with, as you mentioned, and just get used to it. And that's the way it is. But this isn't true. What treatments do you offer?

Dr. Tim Chase: It depends on what type of incontinence. So stress incontinence, the main treatments that we offer surgically, are two outpatient procedures. One is a periurethral injection, and then the other is a bladder sling. And both of these surgeries take approximately 30 minutes. You're done on an outpatient basis, you go home the same day without a catheter, and pretty much go about your daily living and lifestyle the next day. And then, urge incontinence for surgery wise has had tremendous advancements over the last 10-15 years. We actually have a sacral neuromodulator, which is basically a pacemaker for the bladder. Where we're able to do a test in the office and see if that's good thing for the particular patient and then we can put a pacemaker, the sacral neuromodulator in and go home the same day also.

Host: That is very encouraging. Are there alternatives to surgery that women can try?

Dr. Tim Chase: Yeah, definitely. So the first things I like to do after I see the patient and we kind of come up with the idea of whether it's stress incontinence or urge or whether it's a mixture of the two. So first is behavioral techniques, or doing pelvic floor exercises like Kegel exercises, or pelvic physical therapy, which has become much more popular over the last five years.

Host: And so will patients see immediate results from a surgical procedure?

Dr. Tim Chase: Yes.

Host: Alright. That day?

Dr. Tim Chase: Yes.

Host: Wow, that is amazing. Are there any common misconceptions that you encounter on this topic of bladder leaks?

Dr. Tim Chase: Yeah, all the time. And I think the biggest one is that the bladder tacks of yesteryear, of your mom and your grandmother, are not what we do anymore. The surgeries we do to help patients with these problems are, they're indicated to last a lifetime. So I've been doing this a while, and I almost want to shout it from the rooftops. There is solution out there. And so that's what I want to encourage patients to do. You know, if you have this problem, it might just be one leak every couple of weeks, or it might be several leaks a day. Just when it becomes a problem to you, seek out help because help is available.

Host: And don't be embarrassed, right? Because I think a of people don't get help because they don't want to admit it or it's embarrassing.

Dr. Tim Chase: Right, and it's a very common problem.

Host: I always heard it was mostly older women and women who had had a lot of children, but you're saying it's pretty common.

Dr. Tim Chase: No, I think one of the most, one of the most satisfying is a patient that may be 35, 40 years old and they've had a couple children and they can't play with their children because they're going to leak.

Host: Hmm. No good.

Dr. Tim Chase: There is a solution out there for that.

Host: Well, that is very encouraging. In closing, Doctor, is there anything else you'd like to add?

Dr. Tim Chase: No, I think that's, we covered it well. But if you have this problem, definitely seek out your health care provider and talk about the solutions because everybody's individual. So, talk and work together with your physician and decide what's best for you.

Host: Good to know there are options. Thank you so much for sharing your expertise on this sensitive topic. We appreciate your time.

Dr. Tim Chase: Oh, you're welcome. Thank you for having me.

Host: Again, that's Dr. Tim Chase, and to find a physician, visit NovantHealth.org. For more health and wellness information from our experts, visit HealthyHeadlines.org. If you found this podcast helpful, please share it on your social channels, and check out our entire podcast library for topics of interest to you.

I'm Maggie McKay, thanks for listening to Meaningful Medicine, a Novant Health podcast.