Gotta Go? Women of Every Age Can Improve Bladder Health

While there’s no shortage of advertisements touting products for “leaky pipes,” many women hesitate to broach the topic of bladder problems with their doctors. Some may dismiss the issue, believing that it’s a normal part of aging.

Certainly, urologists can tackle some of the issues women face, but the proximity of a woman’s bladder and urinary tract to her reproductive organs can complicate issues. Urogynecologists — specially trained physicians with expertise in both gynecology and urology — may be best equipped to address issues unique to women’s bladder health.

We sat down to discuss bladder health issues specific to women with urogynecologist Gunhilde Buchsbaum, M.D., who is hosting a free educational event for women on Nov. 14, “Maintaining Your Bladder Health.” (Please click here for details.)

Scripts:  When women think of the term “bladder health” they probably think mostly about incontinence. Are there other related issues they should be concerned about?

Buchsbaum:  Besides the common concern of incontinence, many women experience urinary tract infections, problems with frequent urination, and even bedwetting. Other concerns include painful bladder syndrome, bacterial cystitis, and bladder cancer.

It’s important for women to be aware of these problems, and to know they aren’t alone in facing them. So many women suffer in silence, either embarrassed by the problem or believing nothing can be done for it. In reality, there are many tools for evaluating and treating bladder problems, as well as steps women can take on their own to improve bladder health.

Scripts: What are some symptoms that might signal bladder problems?

Buchsbaum:  There are many things women can look for, some of which they might write off as normal, but may be worth investigating. Take urine leakage. It’s a common complaint of women. If you have this problem, you should tell your doctor. Don’t assume it’s something you just have to live with; there are many things that can be done to address it. Frequent or painful urination is another fairly common symptom, which may be a sign of infection or urethral stricture.

Other signs include blood in urine, which can indicate infection, kidney or bladder stones, or, in some cases, even bladder cancer. Without exception, if you find blood in your urine, you should consult your doctor. While it doesn’t necessarily mean there is a serious problem, if there is one, catching it early can make a big difference in identifying and treating a problem.

Scripts:  Issues with incontinence and that “gotta go” feeling seem so prevalent now. TV ads tout medications for it and women often crack jokes about it. Is it a normal part of a woman’s aging, especially if the woman has gone through childbirth? And is there really anything you can do to avoid it, or to treat it?

Buchsbaum: While it’s true that urinary incontinence becomes more common with age, it’s not a normal part of aging. There are steps women can take to help prevent it. These include doing pelvic floor exercises (think Kegel’s exercises); avoiding consumption of bladder irritants like caffeine, alcohol, and artificial sweeteners; and developing habits that will help with the urge to go to the bathroom.

When necessary, there are various treatment options depending on the type of incontinence and of the needs of the woman. For instance, stress incontinence – which occurs commonly with exercise, coughing, sneezing, or laughing – may be corrected with pelvic floor exercises, insertion of a device called a pessary to help control leakage, or surgical intervention.  Urge incontinence – a sudden and/or strong urge to urinate – can be treated with behavioral changes and, in some cases, medication or nerve stimulation techniques. Overflow incontinence – also known as urinary retention, when bladder is unable to fully empty – is usually treated with self-catheterization or, in certain cases, surgical intervention.

The bottom line is that there are very effective treatment options. Just ask.

Scripts:  What should women in their 20s know that might help them in their 30s, 40s and beyond? And if a woman is 50+, is it too late?

Buchsbaum: It is never too early and rarely too late for starting good bladder habits. Developing strong pelvic floor muscles (again, by performing Kegel’s excercises) is key for addressing stress and urge incontinence at all ages, but it’s best to start young, especially for women in childbearing years.  Limiting caffeine in your diet is a smart habit at any age.

Also, it is helpful for women to recognize symptoms of urinary tract infections (bladder) infections. These may vary from person to person and become less obvious in elderly women. For example, a young woman usually has the classic symptoms: urgency, frequency, and pain with urinating. An older woman may notice fatigue, confusion, low backache, or perhaps an increase in urinary incontinence. Women of all ages should know that incontinence is not normal.  Bladder leakage can get worse if not treated.

Scripts: What one thing do you recommend that a woman asks her doctor at her annual checkup with her primary care physician or gynecologist?

Buchsbaum: All women should ask about Kegel’s exercises, why they are important, and how to do them properly. They are perhaps the simplest step a woman can take to maintaining her bladder health.

Gunhilde Buchsbaum is a professor Obstetrics and Gynecology, professor of Urology, and director of urogynecology at URMC. She founded and directs the Pelvic Health and Continence Specialties practice at URMC’s Women’s Health Pavilion.

Final Gifts: Organ Donation Could Help Families Grieve

There’s no way around it: Funerals are hard. But when your loved one has made a final gift that can save lives and bring healing to other families, something positive can come out of the pain.

“There’s a great deal of support for organ donation in the Rochester community,” said Rob Kochik, executive director of Finger Lakes Donor Recovery Network (FLDRN), a division of URMC.

“Even so, we often find that some of the same people who are quick to express support at the idea of donation have not actually taken the step to officially register themselves. It’s probably because they haven’t spent much time considering their own potential to leave a legacy of hope.”

We spoke to Kochik to learn more about organ donation – and the incredible power one person can have to change lives. Read on.

Scripts: Not to downplay the very real struggle that grieving families face – we know time is the true healer of deep wounds – but is there any research showing that organ donation can help surviving family members make sense of their loss?

Kochik: There’s definitely evidence behind the idea. At FLDRN, we offer support to organ donors’ family members for a minimum of two years following their loved one’s gift. A number of these donor family members go a step further and serve on our FLDRN’s Donor Family Advisory Committee, giving us insight were incredibly grateful for. Who best to learn from than previous donors’ family members?

In a recent survey, family members told us they were motivated by the prospect that “something positive could come out of [their] loss,” that “someone else would have a better life,” and that, in a way, “[their] family member would live on.” This idea of paying life forward, and having something beautiful come out of their tragedy, is certainly compelling. It can be something encouraging to cling to in those first difficult days, months, even years.

Scripts: That’s a great way to describe it. But why do you think some people “never get around to” thinking about organ donation?

Kochik: Naturally, none of us likes to think about our loved ones dying, much less to consider our own death.

Even so, it’s inevitable that each of us will die at some point – so it’s really important that we make this very personal decision and share our wishes with our family members. When we make the choice ourselves, and document it, we spare our family members from being burdened with one more emotional decision at a time when they’ll likely be overwhelmed. We know this firsthand; family members of loved ones who’ve taken the time to elect to be (or not be) donors repeatedly tell us they are very much relieved that they didn’t t have to make this potentially exhausting decision.

Scripts: I bet many people don’t think of it from that angle, but it’s a fair point. On another note, though – can donor families and transplant recipients ever meet up?

Kochik: Great question. Transplant recipients often send thank you cards and letters to their donor’s family members; it’s one small way to express their appreciation for a very big gift – life. And in the other direction, donor family members often enjoy sharing some more information about their loved one with transplant recipients; it’s a way for them to see that their loved one’s story is being told, and they’re living on. Periodically, when both parties wish to meet in person, FLDRN helps coordinate that.

Scripts: What a special thing. Before we wrap up, tell us: Of all the myths that muddy the issue of organ donation, which one would you most like to see cleared up?

Kochik: Hands down, the most frequent reason people tell us they’ve not signed up to be a donor is because they’ve (wrongly) assumed that their age or medical condition would render them ineligible.

That couldn’t be further from the truth. The fact is, that there are absolutely no age restrictions to become an organ donor – and each donor’s medical condition is carefully evaluated at the time of donation. Everyone is encouraged to enroll in the registry, no matter their age or medical history.

Work at URMC? Join URMC’s Campaign 4 Life

URMC and Finger Lakes Donor Recovery Network are teaming up to launch the URMC Campaign 4 Life, a month-long initiative during October to raise awareness about organ donation and transplantation and to ask each URMC employee to take action by declaring their consent to be an organ donor by enrolling in the New York State Donate Life Registry. The goal of the campaign is for 65 percent of URMC employees – there are nearly 15,000 – to either simply confirm they are already registered OR to become a new registered donor by completing an enrollment form. Please click here to participate in the URMC Campaign 4 Life survey. It takes less than 30 seconds.

To learn more about organ donation and transplantation, please visit the Finger Lakes Donor Recovery Network website, or the Facebook page for the bLifeNY awareness campaign, developed by the URMC Division of Solid Organ Transplantation and Hepatobiliary Surgery. Or call FLDRN at (585) 272-4930.

CNN Features CEO Dr. Berk: From Doctor to Patient

On Tuesday, Nov. 16, CNN’s American Morning featured Dr. Brad Berk’s story on its “Human Factor” segment.

The “Human Factor” segment routinely highlights people who have overcome incredible medical circumstances. This particular installment showcased Berk sharing the personal story of his 2009 bicycle accident — and demonstrating how, even while running a medical center, he continues to make time for physical therapy.

Did you miss the segment? You can watch the clip below.

Prescription: Hope for a Hunter

This week, we’re deviating from our normal two-minute video snippet and instead pointing your attention to a beautiful column that a local sports columnist wrote about one of our patients.

The man featured is Larry Hogestyn, a former Xerox engineer (he holds eight patents!) who suffered a debilitating brainstem stroke several years ago, leaving him imprisoned in his own body. You may remember a French book, The Diving Bell and the Butterfly, whose author,  journalist Jean-Dominique Bauby (former editor of Elle magazine), suffered the same condition?

While Mr. Hogestyn can’t move or speak, he nevertheless pursues his passions. He finds ways to communicate — spelling out words by blinking, and connecting with others via a special computer system that allows him to type, manage an inspirational website, and explore the internet.

More impressively — the part that interested our local sportswriter — is that he has found a way to use adaptive hunting gear and an all-terrain wheelchair to nab five deer since 2006.

This story is a humbling testament to the power of hope and resilience in the face of a life-changing diagnosis. It’s also a beautiful tribute to at-home caregivers (like Larry’s wife, Pam) and the role they play in people’s lives. You can read the column, here.

(Photo courtesy of Jen Rynda, Democrat & Chronicle)