Ethicon 11/30

Client Attorney Privileged/Attorney Work Product/At Request of Counsel

Online Sources

1. IS YOUR BLADDER BOSS? HERE’S WHAT YOU CAN DO TO CHANGE THAT

   Nov 27, 2015 | Madam Noire

   By Jessica Sheperd
   
   
   It’s Bladder Health Awareness Month, which means it’s time to address a common condition: stress urinary incontinence. Although more than 33 million adults in the United States, or one in six people, suffer from bladder control issues, many women tend to shy away from this topic.
2. Pelvic floor issues are common, treatable

   Nov 28, 2015 | Albany Democrat Herald

   By Dr. Linda Fox
   
   
   Women endure many uncomfortable conditions, like menstrual cramps, menopause, and childbirth. But we don’t have to tolerate the discomfort and embarrassment caused by pelvic floor disorders.

Client Attorney Privileged/Attorney Work Product/At Request of Counsel

Online Sources

1. IS YOUR BLADDER BOSS? HERE’S WHAT YOU CAN DO TO CHANGE THAT

   Nov 27, 2015 | Madam Noire

   By Jessica Sheperd

   It’s Bladder Health Awareness Month, which means it’s time to address a common condition: stress urinary incontinence. Although more than 33 million adults in the United States, or one in six people, suffer from bladder control issues, many women tend to shy away from this topic.

   
   

   Often out of embarrassment, women suffer in silence, keeping it a secret that they leak urine. Since it is not frequently discussed in the media and countless victims refrain from opening up to friends, many women assume that they are alone in suffering from this condition. Symptoms often go unreported and, therefore, untreated. Many people wait years until they finally contact their doctor. This means years of rejecting invitations to go out, hiding for fear of accidental leaks, anxiety surrounding sexual activity and feelings of isolation and embarrassment. Others who have sought medical help sometimes live frustrated and unhappy with their current treatment, unaware that other options are available.

   
   

   
   

   It is my hope to foster dialogue and bring this issue to the forefront as a topic that we can be comfortable discussing. As an OB/GYN, I see so many women struggling with urinary incontinence. I agree that living with a bladder control problem is not easy, but there is hope. Stress urinary incontinence does not have to continue to rob you of your quality of life.

   
   

   The basics:

   
   

   First, let’s talk about exactly what stress urinary incontinence, or SUI, actually is. It is caused by a weak sphincter muscle and/or pelvic floor. This weakness can cause leakage of urine during moments of physical activity that increase abdominal pressure, such as coughing, sneezing, laughing, or exercise. SUI is the most common type of urinary incontinence in women.

   
   

   Causes:

   
   

   Weakness may occur from pregnancy, childbirth, aging, or prior pelvic surgery. SUI does not discriminate; women of all ages suffer from this uncomfortable condition. Risk factors for SUI include chronic coughing or straining, obesity, and smoking.

   
   

   Treatment:

   
   

   If you believe that you are experiencing SUI, you should immediately reach out to your gynecologist so that he or she can assess your specific situation. You first want to be sure that it is SUI and not another type of incontinence.

   
   

   Fortunately, bladder conditions are usually treatable, and bladder control can be restored. Urinary incontinence can often be treated with non-surgical treatments such as bladder retraining and Kegel exercises. There are simple things that can be done to help treat SUI such as behavioral modifications like weight loss, change in diet and the consumption of excessive fluids and also, smoking cessation. This is typically the first approach, as non-invasive therapeutic interventions should be explored before attempting to treat SUI with surgery.

   
   

   Thankfully, because of increased attention to SUI, incredible progress and innovation have been made in the arena of products for everyday use. For example, the newly introduced Poise Impressa Bladder Supports – an over-the-counter internal product that helps prevent bladder leaks before they happen. The Poise Impressa is similar to a tampon and comes in various sizes that are suitable for all body types. They can be worn up to 8 hours and have been FDA approved. When it comes to SUI management, 9 out of 10 women reported that their leakage was stopped or reduced while using Impressa.

   
   

   Of course, if other non-invasive treatments don’t seem to do the trick, surgery is still an option. The most successful surgery to date is the sling procedure, which offers support and stability. The Mayo Clinic explains:

   
   

   During a sling procedure, your surgeon uses strips of synthetic mesh, your own tissue or sometimes animal or donor tissue to create a sling or ‘hammock’ under your urethra or bladder neck. The bladder neck is the area of thickened muscle where the bladder connects to the urethra—the tube that carries urine from the bladder. The sling supports the urethra and helps keep it closed–especially when you cough or sneeze — so that you don’t leak urine.

   
   

   If you’re suffering from SUI, please realize that you are not alone and that you have options. Singer Marie Osmond once let out a noticeable puddle during the farewell night of the Donny & Marie Cruise, and after laughing hysterically went on with the show! I encourage women to discuss this issue with their practitioners. They can provide the help that you so desperately need and want. Talking with your doctor about options, and also making changes to your routine, can help you get the control you need to become more confident and sure of yourself. It’s time for you to get back to enjoying your life.

   Return to headline | Return to top

2. Pelvic floor issues are common, treatable

   Nov 28, 2015 | Albany Democrat Herald

   By Dr. Linda Fox

   Women endure many uncomfortable conditions, like menstrual cramps, menopause, and childbirth. But we don’t have to tolerate the discomfort and embarrassment caused by pelvic floor disorders.

   Aging increases the likelihood of pelvic floor disorders, but they are not a normal part of aging.

   Symptoms include accidentally leaking urine when you exercise, laugh, cough or sneeze, having to go all the time, difficulty emptying the bladder, problems having a bowel movement, accidental bowel incontinence or pain or discomfort in the pelvis.

   Fewer than half of women with these symptoms seek treatment within a year. But there is no need to be embarrassed and help is available.

   Start by talking to your physician and ask to see a specialist who specializes in treating female pelvic problems. Incontinence can be greatly improved in most cases, and treatment is available to improve the quality of life for women with prolapse.Anatomy

   The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis. The pelvic floor supports the bladder, uterus, rectum and vagina. Weakened pelvic muscles or connective tissue supporting the pelvic floor can cause problems with bladder or bowel incontinence and uterine prolapse.

   In addition to aging, pregnancy and childbirth may also increase the risk of pelvic floor conditions. Many risk factors can be controlled, such as being physically active but cautious with extreme sports, and limiting caffeine or excessive intake of fluids. Weight loss and smoking cessation have also been shown to decrease symptoms.

   Pelvic floor conditions require specialized treatment, and recently I have undertaken extra training to meet the requirements of the American Board of Obstetrics and Gynecology and become board certified in female pelvic medicine and reconstructive surgery.Incontinence

   There are different types of incontinence. Stress incontinence occurs during exercise, coughing, sneezing, laughing or body movement that puts pressure on the bladder. Urge incontinence is the strong, sudden need to urinate due to bladder spasms or contractions. People may experience one or the other type, or both.

   To better understand what’s causing your symptoms, we may recommend urodynamic testing to assess how your bladder and urethra are working. Our goal with treatment is to start with the least invasive method first. Some treatments work well for one patient, but not for others. And all treatments take time to work.Advertisement (1 of 1): 0:19Prolapse

   About half of all women will experience a form of pelvic organ prolapse when the tissues become too weak or stretched to hold the pelvic organs in the correct position. Risk factors include pregnancy, childbirth, menopause, previous surgery, obesity, aging and genetics.

   There are different types of prolapse, and women may experience different symptoms, such as a bulge or lump in the vagina, a pulling or stretching feeling in the groin, vaginal pain, pressure, irritation, bleeding or spotting, difficulty with bowel movements, delayed or slow urinary stream and difficult or painful sexual intercourse.

   Treatment for prolapse depends on how much the symptoms are bothering you. A conservative approach is to watch and see how things go, making dietary changes, and doing pelvic floor exercises or physical therapy. Other non-surgical and surgical treatments are also available to help you experience a better quality of life.

   You can learn more about these conditions and treatments, and get your questions answered at a free seminar I am offering at Good Samaritan Regional Medical Center at 6 p.m. on Dec. 8. For more information and to register call 1-855-873-0647 or visit samhealth.org/BeHealthy.

   Return to headline | Return to top