Female Urology Conditions & Treatment—Dr. Jonathan Jay

I am Dr. Jonathan Jay, a board certified urologist with Advanced Urology Institute. While I am board certified in general urology, I also did fellowship in female urology, voiding dysfunction and pelvic floor dysfunction.

Dr. Jonathan Jay of Naples, FLOne of the inevitable consequences of aging in women is urinary problems. With increasing age, the pelvic floor muscles—a group of muscles that support the bladder, vagina and rectum—face the risk of damage. Since these muscles need to relax in order to pass urine well or have smooth bowel movement, their disruption may result in urinary problems, such as incontinence, overactive bladder, pelvic organ prolapse or pelvic floor dysfunction. Tension in these muscles may also lead to pain during sexual intercourse, painful or frequent urination and lower back pain.

Aging and urinary problems

As women age, they may develop and overactive bladder, which means they urinate at all hours and with little warning. Many women suffer from incontinence after childbirth, a condition characterized by unintentional leakage of urine when coughing, sneezing, laughing or jumping. Childbirth may also cause injury to the pelvic floor muscles leading to weak spots in the walls and muscles of the vagina when adjacent organs move from their normal positions resulting in pelvic organ prolapse.

Informed decision-making

Unlike other specialties, such as neurology and oncology, urology offers a range of treatments that deliver great results for these conditions. Actually, most patients do get better after intervention by a urologist.

In fact, one of the reasons I chose this profession is that there are so many ways to help rectify problems and restore normalcy to people’s lives. As a urologist, I get the opportunity to care for patients in their declining years when urologic problems are so common. I care about both their medical and emotional challenges.

As urologists, we have the ability to find your problem when you present with symptoms. Once the problem is identified, we educate you on what you need to do and talk with you about the different treatment options available. I like counseling patients; talking to them about the bigger picture and helping them make informed decisions.

And as we define these problems, educate patients and talk about the different treatment options available, especially the positives and negatives, we help our patients to make choices that they are comfortable with. Still, because we understand that these choices have risks, we ensure that we provide enough information to minimize the risks.

Most urinary problems are not life-threatening, but are quality of life issues. That means that by resolving them, we restore confidence, meaning and hope into our patients’ lives.

What does the treatment involve?

When we make choices for treating urinary problems, we prioritize the least invasive procedures in order to minimize the risks. Typical treatment begins with a physical examination and evaluation followed by a discussion of options such as physical and behavioral therapies–including exercises to build strength in pelvic floor muscles–and reducing water, alcohol and caffeine intake.

As an option for treating overactive bladder, we may recommend nerve therapy, a procedure which involves placing a needle in the ankle to transmit electric stimulation to the nerves that control bladder function. We may also recommend more invasive options for overactive bladder such as Botox injections and an implantable bladder pacemaker.

Depending on the symptoms, we may choose to manage pelvic organ prolapse using silicon or rubber diaphragm called a pessary, which is inserted into the vagina to support the pelvic floor. We may also recommend vaginal medications or muscle injections to help with pelvic floor dysfunction. But if the problem persists or worsens even with these interventions, we may explore surgery as a last resort.

Remarkable outcomes

In urology, we are fortunate that most of the problems are clearly defined, the treatment path is clear, and the results are usually good. At Advanced Urology Institute, we offer everything, from observation, pessaries and medications to surgery. Fortunately, most of our patients do well and get better after we apply minimally invasive procedures.

We understand that many women with urological problems might not know how common and treatable these problems are—a fact that keeps them from seeking proper care. So at AUI, we try to provide information to the public so that people are aware that there are solutions for even the most awkward and uncomfortable urinary problems. For more information on female urology conditions and their treatment, visit the Advanced Urology Institute website.

How are Urinary Problems Treated?

Because urinary problems can be a sensitive and potentially embarrassing subject, many people are nervous about discussing these issues with their medical provider, even though they are very common conditions. Experts estimate that around a third of the U.S. population suffers from urinary incontinence. Luckily, these issues are treatable, according to Luis Camacho, PA, a physician assistant with the Advanced Urology Institute.

“If the patient has prostate problems, bladder problems, for the most part, the patient can be treated with oral medications,” Camacho explains. “If that is not effective, then we can incorporate different procedures or surgeries in order to improve the patient’s symptoms.”

Urinary Incontinence

Urinary incontinence is the most common problem. There are five different types of incontinence, but one of the most common types is stress urinary incontinence, or SUI. SUI occurs when a patient’s pelvic muscles are weakened, allowing urine to escape during normal everyday movements, such as sneezing, coughing or bending over. This condition is particularly common with older women, especially those who have had children. SUI can be managed with lifestyle changes or pelvic floor strengthening exercises like kegels.

Another common type of incontinence is overactive bladder, or OAB. Patients dealing with OAB feel an urge to go to the bathroom frequently throughout the day and night, even though their bladder isn’t full. This urge can be difficult to ignore and can lead to a lot of stress for patients in their daily lives. OAB and SUI can occur together in a condition known as mixed incontinence.

Other Urinary Problems

Other common urinary problems that should be discussed with a doctor include urinary tract infections, also known as UTIs; hematuria, or blood in the urine; and urinary retention or frequent urination. These problems are often signs of a larger issue that should not be ignored, such as diabetes, kidney stones, or prostate or bladder cancer. It’s important to bring up any issues like these with a doctor to ensure that the underlying issues can be treated promptly.

Getting Help

Although urinary problems are common, that does not mean they should be ignored, especially when they could potentially be signs of a more serious problem. Medical professionals know how wide-ranging both the symptoms and causes of urinary problems can be. “It’s important to listen to the patient and then establish a course of assessments, so we can help the patient effectively,” Camacho says. He and the other experts at the Advanced Urology Institute understand the sensitive nature of urinary problems and are well-prepared to help patients deal with these issues and get back to living their lives with confidence. For more information, visit the Advanced Urology Institute website.