m fall 2012 - Inova Health System

STOP
the Leak
Urinary incontinence has minimally
invasive treatment options
Common But Not Normal
Pelvic floor disorders are the conditions women experience
when their pelvic muscles and tissues weaken, which can result
in the shifting of pelvic organs and cause uncomfortable symptoms.
Some women are more at risk for developing pelvic floor
disorders. Risk increases for women who:
Have had children
Have gone through menopause
Are overweight
Genetically have weaker, more stretchy tissue
Have undergone certain pelvic surgeries
Experience constipation or other chronic increases in
abdominal pressure
For women in their 20s and 30s, pelvic floor conditions, such
as urinary incontinence, may occur shortly after vaginal delivery.
“During this time, moms are busy with babies and are not necessarily
thinking about themselves. They leak [urine], and they
think, ‘Oh, it’s there, and it’s no big deal,’” Dr. Welgoss says.
“It’s important to be aware that these things exist and realize
that it’s not normal to leak urine because you just had a baby,”
he continues. “It’s common, but it’s never normal.”
Urinary incontinence can be an embarrassing condition that
interferes with a woman’s quality of life. It’s also quite common,
affecting 30 to 50 percent of women at some point during their
lives, according to Jeff Welgoss, MD, Medical Director of
Urogynecology at Inova Fairfax Hospital.
While it occurs across a variety of age groups, urinary
incontinence becomes increasingly common as women get older.
“It’s not uncommon to see people who have been leaking urine
for 10–15 years before they come in and get checked out, so we
end up doing procedures to compensate for their weakened floor
muscles,” says Dr. Welgoss. Women who receive treatment
during the mild and earlier stages of incontinence are possibly
more likely to avoid surgery, he notes.
Two types of incontinence are stress incontinence — leaking
urine with coughing and sneezing — and urge incontinence —
feeling the need to urinate but not being able to make it to the
bathroom fast enough. Urge incontinence can be treated with
nonsurgical methods, such as pelvic floor or Kegel exercises;
avoidance of bladder irritants, such as caffeinated beverages; and
medications. InterStim therapy is also a treatment option, which
involves the implantation of a device that stimulates the sacral
nerves so that the bladder and its related muscles can function
properly. An in-office therapy called tibial nerve stimulation, where
a nerve in the lower leg is stimulated, can also be effective.
For stress incontinence, a minimally invasive surgery is
performed to place a mesh hammock under the urethra. “Basically,
it creates a backstop for the urethra so when the patient coughs or
sneezes, the urethra moves down onto the mesh, and that closes
off the urethra when the muscles don’t,” Dr. Welgoss says. The
recovery from this procedure is minimal. “People go home the same
day — within a couple of hours — and they are driving and back to
working physically non-strenuous jobs in a couple of days,” he says.
Ask the Expert
You’re Not Alone
Learn more about treatment for incontinence and other
pelvic floor disorders at inova.org/women. Click on
“Gynecology” on the left-hand side of the home page.
4 | FALL 2012 | Inova Fairfax Hospital
Don’t Live With Leaky Pipes: Treatment
Options for Pelvic Floor Disorders
Jeff Welgoss, MD, will discuss the causes and treatment
options for female pelvic floor disorders, including stress
and urge incontinence. This FREE lecture will take place
on Tuesday, Oct. 16, at 7 p.m. at Reston Community
Center, Lake Anne Gallery, 1609–A Washington Plaza,
Reston, VA. To register, call 1-855-694-6682
(1-855-My-Inova) or visit inova.org/
AskTheExpert.
Jeff Welgoss, MD
Urogynecologist