Getting to the bottom of an uncomfortable issue — Bayhealth

Bayhealth—The Drive is Here®

Incontinence is difficult to deal with. For many women, it makes life complicated. They know every bathroom in the mall or every rest area on the highway. And many are just too embarrassed to talk to their doctors about it. “While many women are afraid to open up, the truth is, this is a very common problem and there are treatment options available,” says Elsa Goldstein, MD, of Bayhealth Colon Rectal Surgery with offices in Milford and Lewes.

Patients experiencing problems with urinary or fecal incontinence can now make an appointment at the Pelvic Floor Center. The Pelvic Floor Center has state-of-the-art diagnostic capabilities to accurately diagnose incontinence disorders. Dr. Goldstein sheds some light on pelvic floor disorders and the options available for treating urinary and fecal incontinence.


WHAT IS THE PELVIC FLOOR?
The pelvic floor is a muscular structure that supports the pelvic organs of the bladder, uterus, vagina, and rectum.

WHAT ARE PELVIC DISORDERS?
The most common pelvic disorders involve the weakening of the pelvic floor. That’s when you have bladder, rectal, or uterine prolapse. Prolapse is when the body parts essentially fall out of position. This prolapse causes incontinence with urine or stool. More rarely, some people have pelvic floor problems because the muscles are too tight, but this is not very common.

WHO TENDS TO HAVE PELVIC FLOOR DISORDERS?
Women are far more likely to have pelvic floor problems. The most common age group is women over 50. Men can have problems as well, but women are far more likely. Some younger women may also experience pelvic floor disorders if they had a large baby.

WHAT CAUSES PELVIC FLOOR DISORDERS?
The main cause of pelvic floor disorders is a combination of childbirth and aging. That’s why women are more likely to have issues. Nearly one third of women will sustain a tear during childbirth. Once you get older and the aging process is underway, women tend to notice the symptoms.

WHEN SHOULD I SEEK HELP FOR PELVIC FLOOR DISORDERS?
People should seek treatment when they become symptomatic. Once the problems begin impacting your life, it’s time to look for help. Women will many times make adjustments to their lifestyle to accommodate the symptoms rather than seeking help. Some women will stop traveling or going out because of bathroom concerns. Others won’t eat all day if they know they have to go out.

WHAT ARE THE SYMPTOMS OF PELVIC FLOOR DISORDERS?
The most common symptoms are urine or fecal leakage. Some women will experience leakage when they cough, sneeze or exercise. Other women will have leakage no matter the circumstances. With fecal incontinence, some women may leak gas or stool. There’s also an increased urgency, where you may have limited or no warning that you need to use the bathroom.

WHAT ARE THE TREATMENT OPTIONS?
The most common treatment is pelvic floor therapy. Most people respond well to the therapy and do not need any further intervention, such as surgery. We create an individualized plan for all of our patients. It’s not a one-size-fits-all model. We tailor the plan to the patient to ensure they have the best results. We also work with patients on dietary management, as many people respond well with it too.

HOW LONG DOES TREATMENT TAKE?
For many people, treatment is once a week for a few months. It’s very similar to going to physical therapy. There’s nothing preventive that can be done, so it’s important women seek treatment when they notice symptoms.

ARE THERE ANY RISK FACTORS?
Women who have given birth are at a higher risk of developing pelvic floor problems. Additionally, anyone who is diabetic, people taking certain medications, and anyone who has undergone radiation treatment to the pelvis are at a higher risk. Those with neurological disorders and a history of rectal surgery are also at a greater risk of developing pelvic floor problems.

HOW COMMON ARE PELVIC FLOOR PROBLEMS?
This is a very common problem and women should not be embarrassed. Nearly 20 percent of the population has pelvic floor problems. This is a silent affliction. Women suffer in silence and aren’t telling their doctors or family members. They don’t seek treatment and instead just make lifestyle adjustments. But it doesn’t have to be that way. We work with women to create a specific treatment plan and restore lifestyle and dignity. There’s no longer a reason to suffer in silence.


Dr. Goldstein treats patients at Bayhealth Colon and Rectal Surgery in Milford and Lewes. To make an appointment call 302-503-2700 or learn at Bayhealth’s website.

Bayhealth—The Drive is Here®