Women’s Health
Conditions We Address
Bladder Pain
Bladder Pain
Persistent bladder discomfort can severely impact your quality of life. At Bradenton Women’s Care, we specialize in alleviating the symptoms of bladder pain and discomfort in women, employing cutting-edge techniques and procedures. By carefully assessing your symptoms and identifying the root cause of your discomfort, we strive to provide effective relief, allowing you to resume your daily activities.
Conditions we address include interstitial cystitis and recurrent urinary tract infections (UTIs).
At Bradenton Women’s Care, Dr. Socas employs advanced diagnostic tools such as urodynamic testing and cystoscopy. Our approach to treatment involves a collaborative effort, incorporating behavioral and dietary counseling, pelvic floor therapy, medication management (including oral and intravesical options), and, when necessary, surgical intervention.
Female Urinary Disorders
Understanding Female Urinary Issues
If you're among the many women grappling with bladder control challenges, it's crucial not to let embarrassment hinder you from seeking assistance. Whether it's leaking urine, frequent urination, or other symptoms of urinary incontinence, these issues shouldn't be dismissed as trivial consequences of childbirth or aging.
Not all healthcare providers routinely inquire about urinary function during examinations. Taking the initiative is key. If you're experiencing bladder control problems, communicate them to your doctor and request assistance.
Why seek help?
Bladder control issues necessitate medical attention for various reasons. Reduced bladder control might:
- Limit your physical activities
- Cause social withdrawal
- Heighten the risk of falls, particularly if balance issues prompt rushing to the bathroom
Sometimes indicate an underlying medical condition like diabetes or kidney disease
When to seek assistance?
A few sporadic incidents of urinary incontinence may not demand immediate medical attention. Additionally, it's common for individuals, particularly as they age, to experience nocturia. However, if these problems significantly affect your quality of life, consider having your symptoms evaluated.
Schedule an appointment with a healthcare provider if:
- You're embarrassed by urine leakage, leading you to avoid important activities
- You frequently experience urgency to urinate, rushing to the bathroom but sometimes not making it in time
- You frequently feel the need to urinate but can't pass urine
- You notice a weakening urine stream or feel unable to empty your bladder thoroughly
What is Female Voiding Dysfunction?
It is estimated that up to 25 million Americans experience bladder control issues. Voiding dysfunction refers to a condition where the bladder fails to function properly.
The lower urinary tract, comprising the bladder and urethra, is responsible for storing and releasing urine appropriately. Voiding dysfunction encompasses various conditions characterized by poor coordination between the bladder muscle and the urethra. This can lead to inadequate relaxation or excessive activity of the pelvic floor muscles during urination.
There are several specific definitions of voiding dysfunction; the International Continence Society and International Urogynecological Association define it in females as "abnormally slow and/or incomplete voiding based on symptoms and urodynamic investigations."
Voiding dysfunction can present with a range of symptoms, including difficulty emptying the bladder, urinary hesitancy, a weak or slow urine stream, urgency, frequent urination, or urine dribbling.
The underlying causes of voiding dysfunction may involve nerve dysfunction, non-relaxing pelvic floor muscles, or a combination of both. It can also result from either bladder (detrusor) underactivity or outflow (urethra) issues.
Clinical evaluation often includes tests such as uroflowmetry, post-void residual measurements, and pressure flow studies.
Treatment approaches are tailored to individual patients based on their specific conditions. Options may include pelvic floor therapy, intermittent self-catheterization, muscle relaxants, or the placement of a neuromodulation device.
Interstim Therapy
Many individuals find it challenging to discuss bladder control issues with their loved ones and healthcare providers. However, if you're experiencing symptoms of overactive bladder (OAB), you're not alone. Over 33 million Americans grapple with OAB, characterized by urgency, frequency, and urge incontinence. InterStim therapy offers a treatment option for OAB.
What is InterStim therapy?
InterStim therapy is a reversible treatment used for urinary incontinence, frequency, and incomplete bladder emptying. It involves the use of an implantable device that delivers mild electrical pulses to the sacral nerves. Located near the tailbone, these nerves regulate bladder function and related muscles. When there's a communication issue between the brain and sacral nerves, the bladder may not function correctly, leading to OAB symptoms.
What types of bladder control problems does InterStim therapy address?
InterStim therapy can help with:
Urge Incontinence: involuntary loss of urine when feeling a strong urge to urinate.
Urinary retention: inability to empty the bladder completely, requiring the use of a catheter.
Urgency and frequency: sensation of incomplete bladder emptying, frequent urination, and passing only small amounts of urine.
How do I determine if InterStim Therapy is suitable for me?
Your healthcare provider can assist in making this decision and may suggest trying InterStim Therapy temporarily to evaluate its effectiveness, known as test stimulation. InterStim therapy is typically recommended for patients who have previously attempted medications and behavioral modifications without success or who cannot tolerate these treatments.
Mid-Urethral Sling
Mid-urethral sling procedures are operations designed to help women with stress incontinence. Stress incontinence is leakage of urine with every day activities such as coughing, sneezing or exercise. It is a very common problem that affects 1 in 3 women. Stress incontinence may be improved with pelvic floor exercise and lifestyle modifications, but if these strategies fail then surgery may be recommended for you. The mid-urethral sling is the most offered procedure.
The operation involves placing a sling of polypropylene mesh about 1 cm wide between the middle portion urethra and the skin of the vagina. The urethra is the pipe through which the bladder empties. Normally, muscles and ligaments cost firmly when straining or exercising to prevent leakage. Damage or weakening of these ligaments from childbirth or aging can result in urine leakage. Placing a sling underneath the urethra improves the support and reduces or stops the leaking.
Monalisa Touch
What is vaginal and vulvar atrophy?
Atrophy is a condition characterized by thinning and dryness of the vaginal and vulvar walls due to a decline in estrogen levels. It affects approximately 40 percent of women, particularly after menopause, and can lead to painful intercourse, vaginal dryness, burning, and reduced urinary tract health, resulting in discomfort with urinary frequency and even recurrent urinary tract infections.
What treatments are available for vaginal atrophy?
Traditional therapies for vaginal atrophy have included hormone administration, such as estrogen, an oral medication known as Osphena, and various vaginal moisturizers or lubricants. However, many women, including breast cancer survivors, cannot take hormones or have found hormone therapy to be minimally effective. Fortunately, a new non-hormonal treatment called the MonaLisa Touch™ has emerged as a highly successful option for addressing this issue.
What is the MonaLisa Touch™ Therapy?
The MonaLisa Touch™ is a minimally-invasive treatment aimed at improving the health and elasticity of the vaginal mucosa, or inner lining of the vagina. This procedure utilizes a specially designed CO2 fractional laser in an office setting to target the atrophic or thin and sensitive vaginal wall. The laser penetrates deep into the layers of the vaginal wall, stimulating collagen production and restoring the vaginal tissue to a pre-menopausal state.
How many treatments are necessary?
The recommended treatment cycle consists of three sessions spaced six weeks apart. This typically provides significant or complete relief of symptoms for approximately one year, after which additional treatment sessions may be required.
Most women experience minimal to no pain during the therapy; however, some may notice slight localized discomfort. Full activity can usually be resumed within 24 to 48 hours post-treatment.
Are there any side effects or complications?
Although this therapy is relatively new to the United States, patients in Europe have reported no long-term side effects. Similarly, patients treated at The Christ Hospital have not reported any serious side effects or adverse events.
MonaLisa Touch can address:
Key features of MonaLisa Touch:
Novasure
Quick – Simple – Safe and Effective
QUICK: The procedure takes just five minutes.
SIMPLE: No pre-treatment is necessary, and it can be performed at any point in your menstrual cycle, even during menstruation. Plus, it can be done right in your doctor's office.
SAFE AND EFFECTIVE: FDA-approved since 2001 with over 15 years of clinical experience.
NovaSure endometrial ablation—a one-time, five-minute procedure!
This single, five-minute procedure is designed to remove only the uterine lining—the endometrium—which is the source of heavy bleeding. No incisions are required, preserving the integrity of your uterus.
How the NovaSure procedure works:
Step 1: Your doctor slightly opens your cervix, inserts a slender wand, and extends a triangular-shaped netted device into your uterus.
Step 2: The netting expands to fit the size and shape of your uterus.
Step 3: Precisely measured radiofrequency energy is delivered through the netting for about 90 seconds.
Step 4: The netted device is retracted into the wand, and both are removed from your uterus.
Important Safety Information:
NovaSure endometrial ablation is intended for premenopausal women with heavy periods due to benign causes who have completed childbearing. Pregnancy after the NovaSure procedure can be risky. It is not suitable for individuals with or suspected of having uterine cancer, active genital, urinary, or pelvic infections, or those with an IUD. NovaSure endometrial ablation is not a sterilization procedure. Rare but serious risks include thermal injury, perforation, and infection. Temporary side effects may include cramping, nausea, vomiting, discharge, and spotting. If you or someone you know experiences a potential side effect, please consult your physician.
Overactive Bladder
What is OAB and Who Experiences It?
Overactive bladder (OAB) refers to a collection of bladder symptoms characterized by three main issues:
Urgency: A strong sensation of needing to urinate urgently.
Incontinence: Occasional leakage of urine, often associated with the urgent need to urinate.
Frequency: The frequent need to urinate throughout the day and night.
Individuals with OAB often feel the urge to empty their bladder even when it's not full, leading to an urgent need for the restroom that cannot be ignored or controlled. If you find yourself needing to urinate eight or more times per day and night, or experiencing fear of urine leakage before reaching the restroom, you may be dealing with OAB.
OAB affects approximately 33 million Americans and is not considered a normal aspect of aging. It is a persistent health issue that requires treatment. Both men (30%) and women (40%) commonly experience OAB symptoms as they age. However, many individuals are unaware of available treatments or feel hesitant to seek help.
It's important to note that stress urinary incontinence (SUI) is a separate bladder problem where urine leakage occurs during activities such as sneezing, laughing, or physical exertion. Unlike the sudden urgency associated with OAB, SUI is triggered by external factors. For more information on SUI, visit http://www.urologymanagement.org/sui/.
This guide provides comprehensive information on managing OAB. Don't hesitate to seek assistance, even if you feel embarrassed. There are numerous effective treatments available for OAB, and your healthcare provider is trained to discuss and address your symptoms with sensitivity and professionalism.
Pelvic Floor Therapy
Pelvic floor disorders are prevalent among women, and it's essential to recognize that these issues should not be endured but treated. At Bradenton Women’s Care, we offer a range of comprehensive services to address pelvic floor disorders effectively. These disorders occur when the muscles or connective tissues in the pelvic region weaken or sustain injury, leading to various conditions. The most common pelvic floor disorders include urinary incontinence, fecal incontinence, and pelvic organ prolapse, with a higher prevalence among older women.
Our pelvic floor therapy program is designed to alleviate or eliminate the symptoms associated with pelvic floor dysfunction. We offer targeted treatment to alleviate symptoms such as:
- Increased urinary frequency or leakage during coughing, sneezing, or exercise
- Strong urge to urinate
- Pain during sexual activity
- Difficulty with urination or defecation
- Pelvic or genital pain
- Bladder discomfort
- Pelvic organ prolapse
Pelvic Prolapse
Pelvic prolapse occurs when the supportive connective tissue of the pelvic organs weakens or tears, leading to a loss of pelvic support. It's a prevalent disorder, especially among older women, and can be caused by various factors such as aging, muscle tone loss, menopause, and obesity.
The condition often results from strain during childbirth, where weakened or stretched muscles fail to adequately support the pelvic organs. Additionally, surgeries like hysterectomy can leave pelvic organs with reduced support, exacerbating prolapse symptoms.
Factors such as obesity, chronic cough, and pelvic organ tumors can further worsen pelvic prolapse by exerting pressure on the abdominal region.
Symptoms of pelvic prolapse may include pressure against the vaginal wall, lower belly fullness, sensations of pelvic heaviness, and urinary or bowel issues.
Diagnosis involves a thorough physical examination, including a pelvic exam, to assess symptoms and potential causes.
Treatment options vary depending on the severity of prolapse and symptoms. Non-surgical interventions like estrogen therapy, physical therapy, and the use of devices called pessaries can help manage symptoms. For severe cases, corrective surgery may be necessary, which can be performed vaginally, laparoscopically, or with robotic assistance. Various surgical techniques are employed based on the type of prolapse, aiming to restore pelvic support and alleviate symptoms effectively.
Percutaneous Tibial Neuromodulation
Percutaneous Tibial Neuromodulation (PTNM) via the Medtronic NURO™ system presents a safe, minimally-invasive, and efficient treatment avenue for Overactive Bladder (OAB), aiming to restore bladder function and enhance quality of life.
The NURO™ device, developed by Medtronic, offers PTNS (Percutaneous Tibial Nerve Stimulation), a recognized method for OAB treatment. Additionally, Urgent PC is another PTNS system available in the market.
Research indicates PTNS, or PTNM, as an effective OAB treatment for both genders, irrespective of age or prior medication use. A full course typically involves twelve weekly PTNM sessions to maximize treatment benefits for individuals grappling with OAB symptoms.
Safety assessments of PTNM are well-documented in literature, with numerous studies attesting to its safety profile. Clinical trials have demonstrated statistically significant improvements in OAB symptoms post-PTNM, comparable to traditional pharmacotherapy.
Studies have examined the efficacy of PTNM up to a span of three years, with reported reductions of up to 60% in urinary incontinence linked to OAB, as observed by experts like Dr. Socas.
PTNM is a brief, non-invasive office procedure lasting approximately 30 minutes. It is virtually painless and devoid of associated risks, offering a convenient and safe treatment option for individuals dealing with OAB symptoms.
Recurrent Urinary Tract Infections
Overview of Recurrent UTIs
Urinary Tract Infections (UTIs) are bacterial infections that affect the urethra, bladder, ureters, and kidneys.
UTIs are recurrent if they happen two or more times in six months, or three or more times in a year.
Typical symptoms include a strong urge to urinate, frequent urination in small amounts, often accompanied by a burning sensation.
Primary care physicians or urologists commonly treat UTIs, with preventive antibiotics being a common treatment approach, either taken continuously in low doses or as needed when UTI symptoms or triggers are present.
In severe cases, hospital treatment may be necessary, especially if the infection spreads to the kidneys.
Causes of Recurrent UTIs
Recurrent UTIs, affecting 20% to 30% of women, occur when gastrointestinal bacteria migrate from the anus to the urethra and urinary tract, potentially infecting these areas.
Diagnosis of recurrent UTIs is made if a person experiences two or more UTIs in six months or three or more within a year.
Sexual intercourse and catheter use increase the risk of recurrent UTIs.
Symptoms of Recurrent UTIs
Symptoms vary depending on which part of the urinary tract is affected.
Common symptoms include pain or burning during urination, pelvic discomfort, strong urge to urinate, frequent urination in small amounts, cloudy or discolored urine, and a foul odor.
A UTI spreading to the kidneys is a serious condition requiring immediate medical attention, characterized by nausea, vomiting, fever, chills, and back pain below the ribs.
Treatment of Recurrent UTIs
Most UTIs resolve with a short course of antibiotics, alongside home remedies like increased water intake, frequent urination, and cranberry supplements.
Recurrent UTIs may require preventive antibiotics, tailored to the frequency or triggers of infections.
For women experiencing UTIs after intercourse, post-coital antibiotics may be beneficial. Others may receive prescriptions to fill when symptoms arise or take a low dose of antibiotics regularly to prevent infections, particularly those with spinal cord injuries, multiple sclerosis, or diabetes.
Stress Urinary Incontinence
Understanding Stress Urinary Incontinence (SUI)
If you've experienced the distress of involuntary urine loss, particularly during coughing, laughing, sneezing, or exercise, you're not alone. Stress urinary incontinence (SUI) affects millions of women, especially after childbirth. It often occurs due to weakened pelvic diaphragm support and a fragile urethra.
What are the Risk Factors?
- Childbirth: Pregnancy and childbirth can weaken pelvic floor muscles, leading to urine leakage.
- Menopause: Estrogen deficiency during menopause can thin the urethra lining and weaken bladder muscles.
- Urinary Tract Infections
- Illnesses causing excessive coughing or sneezing
- Obesity
- Smoking-induced coughing
- Diabetes-related urine production and nerve damage
- Excessive caffeine or alcohol consumption
- Medications promoting urine production
- Certain athletic activities pressuring the bladder
Though SUI can disrupt daily life, medical solutions exist. For women silently suffering from SUI symptoms, scheduling a consultation with a specialist is the first step toward identifying the cause and finding relief.
Urethral Bulking
Urethral bulking is a procedure utilized to address stress incontinence, a condition characterized by the unintentional leakage of urine during activities such as coughing, sneezing, or laughing. This minimally invasive procedure involves injecting a bulking agent into the walls of the urethra, assisting in the formation of a tight seal to prevent urine leakage.
Stress urinary incontinence commonly affects women and can result from weakened pelvic floor muscles, the urethra itself, or the supporting ligaments. Symptoms include urine leakage triggered by activities that increase abdominal pressure.
For further details on stress urinary incontinence or urethral bulking, feel free to reach out to us today.
Urge Urinary Incontinence
What is urge incontinence?
Urge incontinence is characterized by a sudden and compelling urge to urinate, often leading to leakage before reaching the toilet. It is commonly associated with an overactive or unstable bladder, medically known as detrusor instability, where the bladder muscle contracts unexpectedly.
Individuals experiencing urgency or urge incontinence often also exhibit increased urinary frequency, including frequent urination during the night, and may experience urine leakage during sexual activity, particularly during orgasm.
How common is urge incontinence?
Urge incontinence ranks as the second most prevalent cause of incontinence, accounting for approximately three out of ten cases. While it can affect individuals of any age, onset typically occurs in early adulthood, with a higher prevalence among women compared to men.
What causes urge incontinence?
The underlying cause of urge incontinence is often attributed to an overactive bladder muscle, known as the detrusor muscle, which contracts prematurely. This premature contraction sends signals to the brain, indicating a full bladder when it's not, leading to the urgent need to urinate.
The exact cause of an overactive bladder remains unclear in most cases, termed idiopathic urge incontinence or overactive bladder syndrome. Factors such as stress and certain dietary components like caffeine and alcohol may exacerbate symptoms. Additionally, postmenopausal women may experience urge incontinence due to vaginal atrophy resulting from decreased estrogen levels.
In some instances, neurological conditions like stroke, spinal cord injury, Parkinson's disease, or multiple sclerosis can lead to an overactive bladder. Bladder irritation caused by urinary tract infections or bladder stones can also contribute to symptoms.
What are the treatments for urge incontinence?
Treatment options for urge incontinence encompass various approaches:
- Lifestyle modifications may offer relief.
- Bladder retraining techniques are often effective and commonly recommended.
- Medications may be prescribed, typically in conjunction with bladder retraining.
- Pelvic floor exercises may be beneficial in certain cases.
- Surgery is considered a last resort and is rarely employed for urge incontinence treatment.
For postmenopausal women with urge incontinence related to vaginal atrophy, topical estrogen cream applied inside the vagina may be beneficial. However, oral estrogen tablets may exacerbate symptoms, necessitating further research on their effects.
For detailed information on urge incontinence treatments, refer to the section on overactive bladder syndrome.
