Tag Archives: Urinary Incontinence

The ABC’s of Urinary Tract Infections | Fullerton, CA

Every year, over 11 million women develop a urinary tract infection, (also known as a UTI, a bladder infection or acute cystitis). These infections are more common in women than men, primarily due to the normal female anatomy, with the urethra (tube leading from the bladder to the outside), located very close to the vaginal opening. This allows bacteria from the vagina, and especially the rectum, to enter the bladder, and subsequently cause an infection. Sexual activity is the most common cause for developing a UTI, but pregnancy, advancing age, lack of estrogen, and diabetes are common contributing factors for developing these infections. For women who are more prone to bladder infections, prevention is key:

  • Women who are sexually active should void both before and after intercourse to limit the amounts of bacteria in the bladder. Also, some lubricants, oils and spermicidal jelly may also make an infection more likely.
  • Drinking an adequate amount of liquids will continually wash out the bladder. Water is preferred, as soda, coffee and tea may make it more likely to get an infection.
  • After a bowel movement or urinating, wipe from the front of the vagina to the back toward the rectum, away from the urethra.
  • Frequent changing of sanitary napkins or tampons can limit infections.
  • Avoiding hot tubs or highly chlorinated pools, as well as removing your wet swimsuit as soon as possible, can also limit bacterial exposure.
  • Cranberry juice and cranberry pills (no calories) have been proven to reduce UTI’s.

If you would like more information on urinary tract infections, contact Dr. Gordon C. Gunn MD in Fullerton, CA at 714-912-2211 to schedule an appointment today. Or visit www.gordongunnmd.com for additional information regarding women’s health. 

Dr. Gordon Gunn proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut and all surrounding Orange County areas.

Do you suffer from Urinary Incontinence? | Fullerton, CA

Branch of dogwood blossoms against a dark background

An estimated 10 Million people -85% which are women- suffer from urinary incontinence. Urinary incontinence, also known as bladder incontinence, is the loss of bladder control. In some cases, individuals suffer from a total loss of bladder contents or it may just cause minor leakage. This issue is more than just medical problem; it can affect emotional, psychological and social life as well.

There are many people who think urinary incontinence comes with age, but it is actually a symptom that can be caused by many conditions. The causes of urinary incontinence differs between men and women. Urinary incontinence is separated into three different types, and some may experience a mix of the types or all three. The following includes the three different types of urinary incontinence:

  • Stress Incontinence- This type of incontinence occurs when you apply pressure on your bladder by exercising, laughing, sneezing, coughing or lifting something heavy. The activity causes the sphincter to weaken and release urine.
  • Urge Incontinence- Urge incontinence occurs when you feel the sudden, intense urge or need to urinate. Often times, after feeling the urge to go you won’t have time between the urge and the loss of urine to make it to the restroom.
  • Overflow Incontinence- This type occurs when you experience frequent dribbling or urine, due to the fact that your bladder doesn’t empty completely.

If you think you may be suffering from urinary incontinence, contact Dr. Gordon Gunn in Fullerton, CA at 714-912-2211 to schedule an appointment today or visit our website at www.gordongunnmd.com for more information.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and all surrounding areas.

Do you suffer from an Overactive Bladder? | Fullerton, CA

 overactive bladder, fullerton

Do you have to get up more than once in the middle of the night to use the bathroom? When you are in public do you find yourself always looking for the restroom? Having an overactive bladder can make daily life hard. However, there is hope. With dietary changes and therapy, overactive bladder can be treated.

Dietary Changes can help manage your overactive bladder. Avoiding caffeine, alcohol and artificial sweeteners can help decrease bladder activity.

Other treatments include:

Pelvic Muscle Exercises

These type of exercises help prevent and/or alleviate symptoms, since they strengthen the pelvic floor. They send a signal to the bladder to relax and resume filling. Through regular exercises you can build strength and endurance to help regain and maintain bladder control.

InterStim Therapy

The process of delivering electrical stimulation directly to the sacral nerves. It is shown to be successful in 4 out of 5 patients. InterStim therapy involves two stages. First, a test. Second, a permanent implant. The implant delivers electrical stimulation without having to revisit the doctor. It is an outpatient procedure. The implant is surgically placed under the skin in the upper buttock or abdomen. It stimulates the sacral nerve using electric pulses.

Contact Dr. Gordon C. Gunn, M.D., a specialist in female urology. Don’t continue to suffer with overactive bladder. Call his office today for an appointment 714-912-2211 or visit his website at www.gordongunnmd.com.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut and surrounding areas.

Urinary Incontinence in Women | Fullerton, CA

iStock_000000705315MediumFor a conservatively estimated 10 million Americans (85% of whom are women), incontinence of urine is socially embarrassing, physically limiting, or a significant disability. In fact, after psychiatric and neurological disorders, the uncontrollable or accidental loss of urine is the second most common reason individuals are placed in nursing home facilities. The true number of non-institutionalized women who have quietly altered their lives because of accidental loss of urine is actually unknown because they are reluctant to discuss their disability. Women are frequently embarrassed and hesitant to admit their problem to their family, friends or even to their personal physician. Among women, between ages of 45-64, 40% are estimated to have experienced incontinence of urine. Women often perceive that their problem is a normal result of bearing children and getting older, and therefore just cope with it. However, they also limit exercising, dancing, traveling and other activities, which would otherwise require them to be away from nearby toilet facilities. They frequently will change the style of clothes they wear to avoid embarrassment. I want my patients to know that urinary incontinence is a symptom of a condition, which is not normal and usually can be successfully treated to restore normal bladder function.

The U.S. Department of Health and Human Services estimates the annual direct cost of care for persons with urinary incontinence to exceed $10 Billion, 70% of which is spent for persons who are not in nursing home facilities. Over one-third of the female sanitary pad market is for coping with incontinence of urine and not menstruation. Product advertising frequently focuses on coping or hiding the problem rather than education and treatment. Regardless of the cause of urinary incontinence, this problem can be cured or significantly improved in most cases.

In women, the most common type of urinary incontinence is called urinary stress incontinence or USI. USI occurs when there is a sudden increase in abdominal pressure during certain activities such as laughing, coughing, sneezing, running, bending, lifting, etc. The primary cause of the problem is a weakness of the pelvic tissues (called prolapse), which normally supports the bladder (called cystocele) and its sphincter. The amount of urine loss with each episode of stress, varies with the degree of weakness, the volume of urine in the bladder, and the intensity of the abdominal pressure. The correction of USI is usually surgical restoration of the prolapse supporting pelvic tissues to a normal position so the bladder sphincter mechanism can function properly.

Another type of urinary incontinence is urge incontinence, in which women perceive the urgent need to urinate, rush to the bathroom, and fail to get there in time. The amount of urine loss can vary with the cause of the urge, the volume of urine in the bladder, and the strength of the pelvic tissue. Urgency and urge incontinence are often associated with frequent urination (called frequency) and getting up at night to urinate (called nocturia). Women who regularly experience urgency and frequency, with or without nocturia, have what is called urinary urgency syndrome, with or without incontinence.

The causes of urinary urgency syndrome can be both physical and non-physical. The most common physical cause is infection of the bladder (cystitis) and/or urethra (urethritis), and it is corrected with treatment of the infection. There are other causes such as chronic inflammation of the bladder, polyps or tumors and certain medications. When no physical cause can be found after a complete medical evaluation, the cause is usually a result of a learned habit. Treatment may include medications, bladder retraining programs and pelvic floor muscle exercises (Kegel Exercises).

Mixed urinary incontinence is a combination of both stress and urge incontinence. Often a woman experiencing USI “learns” that if she empties her bladder more frequently, she will be less likely to leak as much urine. Unfortunately, over time the awareness of having a “full bladder” occurs with an ever-decreasing capacity of urine, and she will urinate at more frequent intervals. When the stress component of her incontinence is surgically corrected, she can then retrain her bladder so she will choose when to go to the bathroom. In postmenopausal women, Estrogen replacement therapy will improve the elasticity of the vagina, bladder and urethral tissues, and improve both stress and urgency symptoms.

There are other less common, but important types of urinary incontinence:

Overflow incontinence is a frequent spilling of small amount of urine when the bladder is over-distended, and can occur with certain medications, after pelvic surgery or trauma.

Reflex incontinence is the loss of urine when the person is completely unaware of the need to urinate, such as while sleeping or washing their hands. This type of incontinence may indicate an underlying neurological disorder.

The first step in correcting urinary incontinence is sharing the problem with your physician. Before your visit, you will be given a “Patient History for Urinary Function”. This form should be completed prior to your office consultation. You may also be given a two-day “Voiding Diary” to record the amount of liquids you drink and the number of times and amount you urinate during the day and night. You will also list the circumstances under which you regularly experience urinary urgency or incontinence. After your patient history, physical examination and voiding diary is completed and reviewed, simple office tests are performed which will further identify the primary cause of your incontinence. Once the cause (or causes) is determined, the proper treatment and alternative will be recommended and explained.

Treatment begins with having a thorough understanding of normal urinary function, the cause of your urinary problem, and your treatment alternatives. Successful treatment is a patient-physician team mission, and is an achievable goal.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

 

Timed Voiding Bladder Program | Overactive Bladder | Fullerton, CA

iStock_000005142700SmallThis is an important part of your bladder-retraining program. When followed consistently you will have significantly improved control over your urgency symptoms, including any urge incontinence. This program started when you monitored the amount and the type of fluids you consumed each day in your Voiding Diary. A normal fluid intake is between 1500-2000 cc (50-70 oz.) per day, which should produce 1200-1500 cc (40-50 oz.) of urine output. The normal bladder capacity before you feel any sensation of urge is about 300 cc (10 oz.). Normal voiding volumes are 210-300 cc (7-10 oz.) with the first morning voiding usually being the largest at 400-500 cc. Your Voiding Diary record will have indicated if any modification is required in the volume or type of fluids you drink.

Your goal with the Timed Voiding Program is to increase your bladder’s capacity and prolong the time interval between urinating up to a minimum of three or more hours. The initial time interval between urinating will be determined by the frequency of urination as recorded in your Voiding Diary.

Attached is a “Voiding Chart for Bladder Retraining” on which you will chart your daily progress for the first week. [Please make five additional blank copies of the Voiding Chart to insure you have a total of six weekly charts.] The Chart is a daily record of your Scheduled (predetermined voiding interval), Unscheduled (when you are unable to suppress the urge without the risk of accidentally urinating), and accidental.

Follow the instructions on the chart as indicated: (incontinence) urinating episodes.

  • Fill in the following on each sheet: Your Name, Date, and Voiding Interval (Hrs.) at the beginning of each
  • Fill in the time for any of the types of urinating (Scheduled, Unscheduled, or Accidental) and place a check mark in one of the three columns:
  • Dark Gray Column: Urinating at the Scheduled Time.
  • Light Gray Column: Urinating at any Unscheduled Time. (when you cannot suppress the urge)
  • White Column: If you Accidentally urinate (incontinence incident), place a checkmark at the time it occurred and add a “D” for Damp or “W” for Wet beside the check mark to indicate the relative amount of urine loss.

Keep your Chart nearby along with a pencil and a clock or timer. Most importantly, maintain your determination to stay with this six-week program.

For more information on overactive bladder or any bladder or bowel incontinence problems you may have, Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Control your Bladder Incontinence with Kegel Exercises | Fullerton, CA

Pure, Natural, BeautyAn obstetrician named Dr. Arnold Kegel originally described pelvic floor muscle exercises. Their purpose is to strengthen the pelvic floor muscle supporting the urethra in order to control the accidental loss of urine during physical exertion (i.e. sneezing, coughing, laughing, running, or exercising). This type of loss of urinary control is called Urinary Stress Incontinence, and can have a considerable impact on the overall quality of life and well-being.

The pelvic floor muscle is called the ‘levator’ muscle and when contracted helps to stop urination, prevent passing gas or a bowel movement, and to tighten the vagina during intercourse. The levator muscle forms the floor of the pelvis and supports the urethra, vagina, and rectum. It consists of two types of muscle fibers: “slow-twitch” (70%) and “fast-twitch” (30%). Both muscle fiber types should be exercised to improve the muscle’s tone and ability to rapidly contract when ‘stressed’. The muscle can be identified by placing two fingers inside the vagina, tightening your levator muscle, and feeling the squeeze. You do not need to squeeze your abdominal, thigh, or buttocks muscles. Just focus on squeezing or tightening your urethra, vagina, and anus. If you can slow or stop the flow of urine, you are using the levator muscle.

A strong levator muscle improves bladder function in two important ways:

1. Improves stress incontinence: During a sudden cough or sneeze, the pelvic floor muscles contract, supporting the bladder and decreasing the accidental loss of urine. The stronger the muscle, the better the control.

2. Suppresses the ‘urge’ to urinate: When you feel an inconvenient urge to urinate contract your levator muscle (slow-twitch exercise). There is an immediate nerve impulse sent to the bladder to relax

Two types of exercise are necessary to adequately strengthen the levator muscle and should be performed the sense of urgency. The stronger your levator muscle, the greater the nerve stimulation to relieve the urge sensation.

Two types of exercise are necessary to adequately strengthen the levator muscle and should be performed every time you finish urinating. These should be used on alternating days’

‘Slow-Twitch’ Muscle Exercise

Squeeze your levator muscle and hold it tight for a slow count of five seconds, relax, and repeat again for a total of five (5) contractions. (Remember, do not tighten your thigh, abdominal, or buttocks muscles; tighten only your levator muscle). As you gradually strengthen your pelvic muscle, work your way up to twenty (20) contractions.

‘Fast-Twitch’ Muscle Exercise

Quickly contract and relax your levator muscle 30 to 50 times, relax for ten seconds, and repeat again for a total of two to three sets. You may only be able to start out with a total of 30 “quick flicks”. Over a period of a few weeks you will be able to increase the number up to a total of 200.

Within 6-8 weeks of consistently performing these exercises you will notice a definite improvement. Don’t quit. Every time you go to the bathroom and after you finish urinating (before you stand up), perform either one of the above levator muscle exercises (switch each time or each day). Remember, this is now part of your normal urinating routine. It is what you do every time you go to the bathroom. It is like any isometric exercise. If you don’t exercise this muscle regularly, it will become weak again and your symptoms will return. Many patients with urinary stress incontinence have cured their symptoms completely by performing these exercises.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

FAQ’s About Urinary Incontinence | Fullerton, CA

iStock_000005142700SmallWhat is Female Urology?

Female Urology (referred to as Urogynecology) is a subspecialty within Obstetrics and Gynecology that focuses on disorders of the female pelvic floor such as pelvic organ prolapse (bulging out of the uterus and/or vagina), urinary incontinence and fecal incontinence.

How common is urinary incontinence among women?

It is estimated that 11 million American women currently suffer from leakage of urine. However, that estimate may be low. A study of 2800 postmenopausal women funded by the National Institute on Aging found that 56% of women experienced urinary incontinence at least weekly. Many women incorrectly assume that urine leakage is normal. While this problem may be very common, it should not be considered normal.

What causes urinary incontinence?

Urinary incontinence is the involuntary discharge of urine. There are many possible causes of urinary incontinence. The key to treatment is identifying the specific type of the incontinence a woman is experiencing through a careful medical interview and a focused physical exam. Frequently, a special test called urodynamics is recommended to accurately diagnose the problem. Urodynamics studies should always be performed when a woman is considering surgery to correct her incontinence.

The two most common types of urinary incontinence are “stress incontinence” and “urge incontinence”. Stress incontinence is accidental urine leakage that occurs during physical activities that cause a sudden pressure (or “stress”) on the bladder such as laughing, lifting, coughing, or sneezing. Urge incontinence is urine leakage that occurs before a woman has a chance to get to the bathroom in response to urge to urinate. Women with this type of leakage may also experience frequent urges to urinate, the inability to suppress the urge and frequent nighttime waking to urinate.

What treatment options are available?

Treatment for urinary incontinence varies on the type and severity of incontinence. The first step in treating the problem is determining an accurate diagnosis.

Stress incontinence can be effectively treated with pelvic floor exercises, devices that “block” the loss of urine, or surgery.

Urge incontinence is commonly treated with medication, biofeedback, or electrical stimulation to the nerves that control the bladder.

There is a wide variety of non-surgical and surgical treatment options available for all kinds of urinary incontinence.

What are the surgical options to treat stress incontinence?

When it comes to treating stress incontinence, not all surgical procedures are equal. There are many variations of anti-incontinence surgery, but the two surgical procedures that have the best results are retropubic urethropexy (Burch Procedure) and the trans-vaginal sub-urethral sling. The tension free vaginal tape (TVT) has rapidly replaced most other surgeries for stress incontinence. The TVT procedure involves the placement of synthetic sling material at the mid-urethra. The procedure takes approximately 45 minutes and may be performed on an outpatient basis. Although no surgery for incontinence has a 100% cure rate, the retropubic urethropexy or suburethral sling permanently cure 75-95% of women suffering with stress incontinence.

What are the risks of surgery to correct stress urinary incontinence?

All surgical procedures present some risks. Although rare, potential complications may include difficulty emptying the bladder and development of urge incontinence.

How can I prevent this problem?

All the factors that cause urinary incontinence are not fully understood, so it is difficult to recommend ways to prevent the problem. Pelvic muscle exercises, also known as “Kegel” exercises, help strengthen the pelvic floor and are probably the best thing you can do to help prevent stress incontinence. Refer to: Health Topics for Women, Bladder Problems on this website.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Treatment Options for an Overactive Bladder | Fullerton, CA

Grandparent and daughterSuffering from an Overactive Bladder can be life altering. The good news is an Overactive Bladder can be treated. Some of the treatment options are as follows:

  • Dietary changes
  • Fluid management
  • Pelvic muscle exercises
  • Drug therapy
  • Sacral nerve stimulation

Dietary Changes

Some symptoms of overactive bladder can be managed by changing your diet. Keeping a diary of what foods you eat and how much fluids you consume can possible help you form a correlation between consumption and urination.

Some foods and drinks to avoid are:

  • Caffeine – Increases bladder activity.
  • Alcohol – It has been shown to act as a bladder stimulant. It triggers symptoms of overactive bladder and acts as a diuretic, increasing the frequency of urination.
  • Artificial Sweeteners – Studies have shown sweeteners negatively affect bladder function. Frequency and urgency of urination were increased after consuming drinks with artificial sweeteners.

The best thing for you to drink is plenty of water. Water is a great beverage for your bladder. Some people think by not drinking water they will help their overactive bladder. However, not enough water intake leads to urine that is highly concentrated. Dark yellow and strong smelling urine actually makes you go to the bathroom more often and causes bacteria to grow.

Pelvic Muscle Exercises

These type of exercises help prevent and/or alleviate symptoms, since they strengthen the pelvic floor. They send a signal to the bladder to relax and resume filling. Through regular exercises you can build strength and endurance to help regain and maintain bladder control.

InterStim Therapy

The InterStim Therapy process works by delivering electrical stimulation directly to the sacral nerves. It is shown to be successful in 4 out of 5 patients. InterStim therapy involves two stages. First, there is a test. Then second, a permanent implant. The implant delivers electrical stimulation without having to revisit the doctor. It is an outpatient procedure. The implant is surgically placed under the skin in the upper buttock or abdomen. It stimulates the sacral nerve using electric pulses.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.

Bladder Incontinence, you are not alone | Fullerton, CA

mature woman blonde greyBladder incontinence or the unintentional loss of urine, is a problem for more than 13 million Americans—85 percent of them women. Even though around half of the elderly population has bladder incontinence, it is not usually a consequence of age.
Several factors cause bladder incontinence. Women are most likely to develop it during pregnancy and childbirth, or after the hormonal changes of menopause, because of weakened pelvic muscles. Older men can become incontinent as the result of prostate surgery. Pelvic trauma, spinal cord damage, caffeine, or medications including cold or over-the-counter diet tablets also can cause incontinence.

But even though urinary incontinence can be improved in 8 out of 10 cases, fewer than half of those with bladder problems ever discuss the condition with their health care professional. The condition often goes untreated.

Contact Dr. Gordon Gunn today at (714) 912-2211 to schedule an appointment.

Dr. Gordon Gunn also proudly serves Buena Park, La Mirada, Yorba Linda, Diamond Bar, Walnut, and surrounding areas.