For 10 seasons, The Doctors have helped hundreds of people overcome a multitude of sensitive medical issues. Some too embarrassed to even appear on camera. For the next hour, we're going to do a deep dive into stories that captivated viewers in a show we're calling Most Embarrassing. In our first story, we meet Nicole, who's looking for help with an incontinence issue. Nicole's gonna start us off today with a question.
Nicole: Okay, so, after I had my son about eight years ago, my second child, I had noticed I started peeing a little bit every time I would sneeze, or jump, or run, and I'm a nurse, and I work 12 hour shifts, and it's embarrassing, but I know it's very common. Yes. I just don't understand, I've tried the kegels and all those exercises, I've looked into all kinds of procedures, I don't know which ones are effective and which ones aren't.
So, in addition to the kegels, have you tried changing your diet, have you tried any other therapies at all?
Nicole: Well, I eat pretty healthy, and you know, but I try to drink more water, and sometimes that makes it even worse, so, kind of counterproductive.
And this is so common after pregnancy. Those pelvic floor muscles can weaken, and so, we're gonna go with a little tag team approach, 'cause we have our gynecologist here, but we also have, joining us via Skype Dr. Aaron Spitz, who is a urologist. You've been hearing Nicole's story, what are your thoughts?
Dr. Aaron Spitz: Urinary incontinence is very common, particularly after childbirth. Because the baby and the delivery itself puts such a strain and stretch on the pelvic floor. The pelvic floor is a hammock of muscles that hold up the vagina, the uterus, the bladder, and the urethra. And when they get stretched out, those things shift out of proper position, and now what can happen is the particular alignment that allowed the bladder to hold the urine even when you jump, cough, laugh, strain, is now thrown out of kilter and even slight movements can cause you to leak urine.
I'm curious because you mentioned trying the kegel exercises, which are things people can do at home. How often will that be effective with someone who's having some of this urinary incontinence, say after pregnancy?
Dr. Aaron Spitz: You know, kegel exercises can be very effective if the incontinence is mild to moderate, if they're started early, and the person sticks with it. But it really does take a lot of commitment and dedication, and some cases are just simply too severe. The change in the architecture is too much just to override with tightening up those muscles more.
They actually have to be surgically lifted back up into an alignment. In a case like this one, I suspect that what really needs to be done is realign the pelvic floor, and that's gonna be best done by a surgical approach, such as a sling, where a little hammock of either graft material, or the patient's own tissue is brought underneath the urethra, cinched up, and now when the person coughs or strains, that pressure can't push everything down and it stays nice and tight and keeps that urine where it should be in the bladder.
But Nicole, what I'd like to do is extend our practice's services to you and my partner, Dr. Leah Nakamura, who is a specialist in female incontinence, has agreed to see you, evaluate you, and find out what the best treatment would be for you, and then get you fixed up.
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