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Hold it! How to Stop Urinary Incontinence

By John Moore, MD of Vista Women’s Healthcare

Can you imagine getting up to deliver a talk to your PTA or employees and having to worry about leaking urine if you happen to cough, sneeze or laugh? Do you know where every bathroom is at your favorite store? These are daily worries for millions of women. Urinary incontinence—the involuntary leakage of urine—is treatable in the majority of cases and should be discussed with your physician any time that it is a concern for you. Your primary care physician will either initiate treatment or make an appropriate referral, usually to a gynecologist or urologist, if necessary.
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The two most common types of incontinence are stress incontinence and urge incontinence. Stress incontinence occurs with sneezing, laughing, coughing or exercising. It is usually caused by a weakening of the tissues that support the bladder or the muscles of the urethra. This weakening can be caused by pregnancy, childbirth or even just normal wear and tear from aging. Urge incontinence occurs when there is a strong, sudden urge to urinate and there is leakage before you can get to the restroom. It is also called overactive bladder and occurs when the muscles in the wall of the bladder contract too easily. The two types also frequently occur together, a situation referred to as mixed urinary incontinence. Incontinence may be associated with other symptoms such as frequent strong urges to urinate even if the bladder is not full, urinating much more frequently than normal and bed-wetting.

Identifying the cause of incontinence is essential to enable your physician to prescribe appropriate treatment for you. A thorough history and physical exam may identify treatable causes of incontinence such as bladder infections or medication side effects. A pelvic exam is necessary to detect loss of support of the bladder and urethra. In cases where the cause is not certain, your physician may ask you to keep track of how often and how much you urinate over several days. You may also be asked to undergo bladder, or urodynamic, testing to more adequately evaluate bladder function. Cystoscopy, where a thin lighted tube with a camera on it is inserted into the bladder is sometimes needed as well. These tests allow a very accurate diagnosis and help your physician determine what treatments will work for your incontinence and, maybe more importantly, which ones won’t!

Dr. John Moore of Vista Women's Healthcare

Dr. John Moore of Vista Women’s Healthcare

There are many options for treating urinary incontinence. Lifestyle changes such as weight loss, smoking cessation, reducing caffeine intake and treating a chronic cough may help. Bladder training by voiding on a more frequent “timed” schedule, whether you need to go or not, may reduce urge incontinence. Kegel exercises tone the muscles around the urethra and vaginal opening and often reduce both urge and stress incontinence symptoms. Physical therapy and biofeedback are sometimes used to help you learn which muscles to contract. Medications in pill, patch or gel form are often prescribed for urge incontinence and can help immensely. They may, however, have side effects such as dry mouth and constipation which are bothersome. Surgical therapy is usually reserved for stress incontinence and takes several forms. A bulking agent may be injected into the tissue around your urethra to help it stay closed, a procedure that is usually performed in the office. More invasive surgery to support the bladder and urethra is performed in the hospital and requires incisions in the vagina or abdomen. These surgeries include placing slings underneath the urethra or supporting the bladder neck and urethra with sutures placed lateral to them and tied to higher tissue to give support.

Finally, in cases where surgery is not an option, a pessary may be prescribed. This device is placed in the vagina to provide bladder support.

Incontinence can be an embarrassing problem but definitely a treatable one. Plan a visit with your physician today to discuss your concerns and regain your control!

Healthy Breakfasts

This week on WIS News 10 Sunrsie, Health Directions personal trainer Jennifer Mangum was a guest with news anchor Len Kiese and weather forecaster Tim Miller to talk about healthy breakfast choices. Before you take a bite of that sugary, carb-filled cereal, watch below to hear Jennifer’s advice for starting your day right.

LMC Expanding Mammography to Vista Women’s Healthcare

You might feel like there just aren’t enough hours in the day. While working, going to school, running a household and raising children, our health can often take a back seat. Trying to get to appointments for doctor visits, radiologic studies, and lab services all over town can make it even more challenging to stay up-to-date with routine care.

Mammography Technologist Lisa Wymer performs a mammogram at Vista Women's Healthcare in Columbia's Vista

Mammography Technologist Lisa Wymer performs a mammogram at Vista Women’s Healthcare in Columbia’s Vista

Lexington Medical Center is working to make taking care of ourselves easier and more convenient. Vista Women’s Healthcare, a Lexington Medical Center practice, has begun offering on-site screening mammography at their Gervais Street location, in the heart of Columbia’s Vista.

One in eight women will be diagnosed with breast cancer in her lifetime, most with no family history or notable risk factors. As with all cancers, an early diagnosis can be the key to surviving a dreaded disease.

“Mammography remains our most effective screening tool for breast cancer,” said Dr. John Moore, a gynecologist at Vista Women’s Healthcare. “We hope that by adding this service, we will increase the number of patients who are able to adhere to the screening guidelines.”

Women should begin yearly mammograms at age 40. Earlier studies are often recommended if there is a significant family history of breast cancer. Your health care provider can assist you in determining when your screening should begin.

Vista Women’s Healthcare becomes the sixth site in the Lexington Medical Center’s network of care to offer mammography. Other locations include the main hospital campus in West Columbia, LMC’s community medical centers in Chapin, Irmo, and Lexington, and a mobile mammography van that travels throughout the Midlands.

Vista Women’s Healthcare’s location and accessible, dedicated parking in the Vista makes it a convenient stop for women who work, go to school, or spend time in the downtown Columbia area.

A full-time, certified mammography technologist will conduct the state-of-the-art digital screening study in the practice’s spacious, comfortable radiology suite. A team of radiologists at Lexington Medical Center will promptly read the images and report the results to you and your ordering physician. If your study shows anything of concern, you will be contacted by Lexington Medical Center to arrange additional diagnostic studies or testing at the facility on the main hospital campus. The hospital’s Women’s Imaging Center is rated as a Breast Imaging Center of Excellence by the American College of Radiology and is an American College of Radiology Accredited Facility.

At Vista Women’s Healthcare, creating an environment that serves all of the health care needs of women in one location is a primary goal and part of the larger picture for the practice—one they hope represents the future of well visits for women.

“We are dedicated to creating a medical home for women in the Columbia and Lexington area,” said Dr. Moore. “If you make obtaining care easier and faster, patients are more likely to go get the care they need. That will help women live healthier and longer lives.”

Vista Women's Healthcare: Standing L to R: Abigail Smith, MD; Harold Moore, MD; Beverly Summer, NP. Sitting L to R: Kathryn Moore, MD; John Moore, MD

Vista Women’s Healthcare: Standing L to R: Abigail Smith, MD; Harold Moore, MD; Beverly Summer, NP. Sitting L to R: Kathryn Moore, MD; John Moore, MD

The practice currently includes four gynecologists and a nurse practitioner. They provide complete gynecologic and many primary care services for women in all stages of life. This includes well women preventive exams with pap smears, evaluation of abnormal pap smears and in office treatment of cervical abnormalities. Adolescent gynecology, all forms of contraception, as well as treatment options for menopausal symptoms and incontinence are also available. The physicians are well versed in minimally invasive surgical techniques and offer treatment options for fibroids, abnormal bleeding, endometriosis and pelvic pain. For patients’ convenience, ultrasound, urodynamics testing, bone density, and laboratory services are all on-site.

In addition to Dr. John Moore, the practice includes Dr. Harold Moore, Dr. Kathryn Moore, Dr. Abigail Smith, and nurse practitioner Beverly Summer.

Patients, or their providers, may schedule a screening mammogram with Lexington Medical Center by calling (803) 791-2486 and reviewing appointment options. Patients may schedule an appointment with Vista Women’s Healthcare by calling (803) 254-3230.