Ask the Clinician: Common Urology Problems in Women

David H. Lamb, MD, FACS, is a urologist at Lexington Urology, a Lexington Medical Center physician practice that provides comprehensive urologic care and advanced treatment for urologic conditions.

Q: What are the most common problems you see in female patients?
A: I see two urologic problems on a daily basis. The first is recurrent urinary tract infections. They occur when bacteria is not cleared from the bladder regularly. Any activity with the potential to introduce bacteria into the bladder is a risk factor, including sex. Treatments include antibiotics or preventative therapy. UTIs that recur often may require low-dose nightly or post-intercourse antibiotics if they infections are associated with sex. And, cranberry juice can decrease adherence of bacteria inside the bladder.

Dr. David Lamb

The second problem is overactive bladder, which is an urgent and frequent need to urinate and frequent urination. I think of it as the bladder in control of the person instead of the person in control of the bladder. It can be debilitating, but it’s treatable. Urologists look for infections, introduce behavioral and physical therapy to improve bladder control, use bladder relaxation medicine and even a Botox® injection to decrease unwanted muscle activity.

We have effective strategies to treat these problems, and there is no need to suffer in silence.

A Labor Day Story: 43 Years of Delivering Babies

A snapshot of Pam Padula, RNC, from 1986 reveals a smiling young nurse in scrubs showing off a newborn. Several decades and thousands of babies later, Pam still radiates joy with every new birth she witnesses at Lexington Medical Center.

Labor and Delivery nurse Pam Padula at Lexington Medical Center in 1986 and 2019.

“It’s more of a gift to be present at a birth than a job,” said Pam, who has delivered more babies than any other nurse at Lexington Medical Center. “People remember their birth experience their whole lives.”

She recently received a note from a patient who thanked her for her experience and enthusiasm. “They can still see my excitement after doing this job for so many years.”

Pam first came to work at Lexington Medical Center in 1976 as a nurse technician in the postpartum unit. A short while later, her husband’s job moved the family to Greenwood, where she worked in a hospital maternity unit there. When Pam and her family returned to Lexington in 1983, she was excited to land a job in Lexington Medical Center’s Labor and Delivery department.

“I was an Army brat and moved a lot growing up, but this community feels like home,” she said. “I bonded with the original group of nurses who were here when I started. We had a close relationship with the physicians, too, which I wouldn’t trade for anything.”

Pam has been an eyewitness to many changes in childbirth over the years. Back in 1983, Lexington Medical Center was a community hospital with just two rooms for women in labor. When labor progressed, patients were wheeled into the hospital’s only delivery room.

Despite this small setting, Lexington Medical Center broke ground as the first hospital in South Carolina to allow husbands in the delivery room.

Pam recalled the Lamaze movement in the 1980s brought a new trend – natural childbirth. Instead of delivering babies under a pain-alleviating sedative, mothers embraced natural methods.

“No one wanted pain medicine,” she said. “But it got a lot quieter in labor and delivery a few years later in the late 1980s when we introduced the epidural.”

Over the years, Pam has developed some distinct capabilities.

“I’m pretty famous for knowing when a baby will come,” she said. She predicted a recent delivery would occur at 1:00 p.m. The actual time of delivery was 1:01 p.m. “It was only because we had to wait for the doctor,” she quipped.

Pam’s years of dedication to expectant families have earned her accolades. In 2002, she received the prestigious Palmetto Gold award for excellence in nursing.

These days, she encounters several generations of her patients in Labor and Delivery. She met a grandmother who recognized Pam as the nurse who delivered her daughter, and now her daughter’s child.

“One time I was working with a new nurse at a delivery and I said, ‘I’ve probably been birthing babies since before you were born.’ She didn’t believe it, but then she said she was born at Lexington Medical Center, so we went through the logs and, sure enough, I delivered her.”

To find physicians who deliver babies at Lexington Medical Center, visit

Feeling the Burn? New Treatment Ends Acid Reflux Disease

Patti Williams woke up in the middle of the night and thought she was having a heart attack.

“I had pain in my chest, back, jaw, neck and down my left arm,” she said. “It was the worst pain I’ve ever felt in my life. And I was terrified.”

Patti Williams inside Lexington Medical Center

Patti’s husband took her from their home in Gilbert to the Emergency department at Lexington Medical Center. Doctors performed a series of tests that ruled out cardiac problems. But they saw something else on an ultrasound that caught their attention.

Patti had a hiatal hernia, which occurs when the upper part of the stomach bulges through the diaphragm. A hiatal hernia may cause acid reflux or gastroesophageal reflux (GERD), where stomach acid backs up into the esophagus. In some cases, that can cause the type of pain Patti felt.

Patti went to see James D. Givens, MD, FACS, at Riverside Surgical Group, a Lexington Medical Center physician practice.

Patti told Dr. Givens she’d been experiencing acid reflux symptoms for about two years. She noticed that when she ate certain things – including onions and fried foods – she would experience indigestion, heartburn and even a nagging cough. Sometimes, it would get so bad that she broke out in a sweat and felt nauseated. She treated it with medications, but it always came back.

“Medications can suppress acid reflux symptoms, but they don’t take away the core of the problem. Acid reflux continues to damage your esophagus,” Dr. Givens said. “The only way Patti was going to get relief was with surgery.”

Dr. Jim Givens

Dr. Givens told Patti about a new surgical option called LINX®. During this laparoscopic procedure, doctors implant a small, flexible band of magnetic beads around the esophageal valve. The string of beads opens and closes to allow patients to swallow food and liquids, but it doesn’t allow contents back up into the esophagus. The magnetic attraction between the titanium-coated beads keeps the valve closed to prevent reflux.

“LINX is the most important change in anti-reflux surgery in the last 70 years,” Dr. Givens said.

The procedure takes about an hour. Patients can go home within a day and are typically back to work and their regular routine in a week. According to Dr. Givens, someone who needs to take acid reflux medications every day to ease their symptoms should consider a surgical option such as LINX.

Patti underwent the procedure in February. During the operation, Dr. Givens also repaired her hiatal hernia.

After the surgery, Patti noticed clear differences and felt better. “I don’t have to take medication anymore for acid reflux,” she said. “Before the surgery, if I didn’t take medicine, I’d have bad indigestion and chest pain. That doesn’t happen anymore.”

For more information on surgical solutions for acid reflux disease, visit