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There are factors that increase a woman's risk for incontinence. One big one is weight, so that extra abdominal pressure on your bladder with abdominal weight is something big that we try to work with our patients of just encouraging them in healthy weight loss programs. Don't have to be super skinny, but just getting off those extra few pounds can really get you a far ways. Another reason why women have a risk of leaking urine is through chronic bearing down and straining. Sometimes you can't help that with your job, you're lifting heavy things throughout the day, you work in a factory, you're moving heavy things, but we try to help our women realize that asking for help is not always bad. If something feels heavy, you can ask for help and help to move.

Number of vaginal births are also a big contributor for urinary incontinence. That pushing, vaginal trauma during delivery can definitely increase your risk. Other things: Diet, artificial sweeteners, that Diet Coke that everyone wants to drink, really can be detrimental to that bladder, cause inflammation, that extra coffee in the afternoon that everyone wants to have can cause that as well. If you're not drinking the right amount of fluids throughout the day, we recommend our patients drink about 50-60 ounces of water a day. If you're having issues with incontinence, it can really decrease your risk of leaking. And if you're leaking at night and getting up a lot at night, stopping to drink fluids about four hours before bedtime really helps with that.

Other factors, things that you can't always help are chronic disease states such as diabetes, chronic back pain, nerve injuries to your back and your spine, those are things that you can't help that you have, but trying to treat those properly and keeping your diabetes well controlled, keeping your A1C down can really help those things as well. Getting off certain medications that can increase your risk of leaking are things as well. There are certain depression medications that can increase your risk, so talking to your doctor about maybe changing medication or seeking counseling and trying to get off a medication can help as well.

A woman should talk to her doctor about incontinence when she ... When it's affecting her daily life and her everyday living. If it's something that you go, "No, it's every now and then and it's really not changing the way I'm living my life," it's okay to watch it, keep an eye on it. We have people come in when they're afraid to go out for a walk with their friends because they're afraid they're going to leak, or they don't want to go out to dinner with their family because they're constantly having to go to the restroom and it's embarrassing for them. We want you to live a happy and healthy lifestyle. Most incontinence is not life threatening, but it's bothersome and it can be embarrassing and keep you from doing those healthy things and those things that keep you happy throughout your life. So that's the time to talk to your doctor and to really start getting treatments so that you can do those things that make you healthy and happy.

Female incontinence, saying it's curable is a very strong word. It's manageable and treatable. It's not like another disease state where you can cure it overnight with a medication, but you can manage it. If you stop some things, that could come back. So it's manageable is the way to say that. We talked about different types of incontinence before, stress incontinence is that weakness of the urethra, that's the tube you pee out of, you lose that muscle strength underneath there, and that urine drops out.

We have different treatment options for that that we offer to patients. One's always do nothing. We have patients do expectant management, see how much it's bothering you. Once it becomes bothersome, we can offer you further treatment. Other treatment options is physical therapy, pelvic floor muscle therapy is offered, talked about that well. It's a student-teacher relationship, they teach you how to control those pelvic floor muscles, strengthening those underneath the urethra so all that urine not to leak out. That gives you some good success at times, especially at the beginning of some incontinence and it's just started, it can really help you get some strength back.

Thirdly, there is an option for placing a support underneath the urethra. That is an out-patient procedure and a minor procedure that you can talk about with your physician at a later date. For urge incontinence, that's the bladder spasms, that bladder has a big muscle around it that spasms and makes you go urgently, leak on the way to the restroom, get up at night, we have options for that as well. One is that physical therapy, again. Those physical therapists can teach you how to control those bladder muscles, give you more time between urinations, and give you more time to get to the restroom. So when you get that urge, they can teach you some breathing and abdominal exercises to give you more time to get there, and that can be very helpful for your daytime symptoms.

InterStim is a implantable device that we use to treat refractory overactive bladder patients. Those are patients that have urinary incontinence, they have an urge to go to the bathroom but before they make it to the restroom they leak. It's also approved for women and men, for that matter, who have urinary urgency frequency and also urinary retention. So, it's a device that we implant to treat urinary incontinence.

InterStim basically is what's a category called neuro-modulation which has been out there for a long time and basically in order for our bladder to work properly our brain has to communicate to our bladder through certain nerves and in the bladder it's the sacral nerves that communicate with the bladder.

So, what this InterStim device does is we place a lead down there that sends small electrical impulses to that nerve, basically allowing the brain to communicate better to the bladder and inhibiting a person from leaking urine when they don't want to leak urine. For most people they don't urinate unless their brain says, you know, I want to urinate. So it increases the communication between, that's probably the best way to explain it.

The ideal candidate for InterStim therapy is anybody that has urinary urge incontinence, frequency, urgency or non-obstructive urinary retention who has failed conservative therapy, whether that be pelvic floor therapy or medical therapy and there's really no other medical...and they're medically stable to have the device implanted.

You know, we probably get on average 80% reduction. Rarely is it a complete cure but for most patients an 80% reduction is a huge deal. They can go from maybe going from three or four incontinence episodes a day to maybe three or four a week which you can imagine is a huge change, a huge change.

Polycystic ovarian syndrome is a hormonal imbalance, pretty much. It is characterized by ovulation dysfunction, and, also increased male hormone in a female. It affects about, I would say about five to 15 percent of female population, depending on which demographic you go to.

Polycystic ovarian syndrome is a hormonal imbalance, pretty much. It is characterized by ovulation dysfunction, and, also increased male hormone in a female. It affects about, I would say about five to 15 percent of female population, depending on which demographic you go to.

There is no cure for polycystic ovarian syndrome that we know of, but if the obesity is the cause, then, yes. You know, losing weight can actually regress it back to normal. So, there's that, but other than that not really a cure for polycystic ovarian syndrome. What we actually do is we take care of the symptoms pretty much. If the increased male hormone is the issue, then you treat that with medication. If period being irregular is the issue, then we treat that with the medication. Or if the other thing is if you ... lifestyle changes, eating healthy, exercise. Those can actually help to cure, I would say. Or to make it better, improve the symptoms of polycystic ovarian syndrome. But there's no exact cure for polycystic ovarian syndrome.

So for the infertile lady, what we do is there are ... You have to realize that these patients are not ovulating all the time, right? You are supposed to ovulate once a month, you know, eggs come out, and it's like the body is trying to get pregnant every month. But people with polycystic ovarian syndrome they're not ovulating all the time. So, that's the problem. That's where the infertile lady come in. However, you have to realize they do ovulate every once in a while, so they do need actually protection with birth control if they do not want to get pregnant. However, if they're trying and not getting pregnant, then yes, there are some ovulation induction agents we can use to help them get pregnant.