The Women's Journal

Let’s Talk About Incontinence And Discuss Solutions That Work!

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Christiana_Valkili_dj13By Babak Vakili, M.D.

Babak Vakili, M.D., is the director of the Center for Urogynecology and Pelvic Surgery. Dr. Vakili is a fellow of the American College of Obstetrics and Gynecology. He completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the Louisiana State University Health Science Center in New Orleans, LA.

At one time in her life, at least one of every two women will experience incontinence, that annoying “wet” feeling, because she couldn’t make it to the bathroom in time.

Sometimes, even a good laugh — or a cough or sneeze — can result in leaking. But incontinence is no joke.

Here’s the good news. There is a highly specialized and growing subspecialty of obstetrics and gynecology called urogynecology that is devoted to pelvic floor conditions such as urinary incontinence, fecal incontinence and pelvic organs that have prolapsed, or dropped.

It’s a very fulfilling field in medicine because urogynecologists help to restore women to active, productive lives – often without surgery.

At Christiana Care Health System’s Center for Urogynecology and Pelvic Surgery, I work with Emily K. Saks, M.D., and Howard Goldstein, D.O. We have offices in three locations and are the only urogynecologists in Delaware who have completed three-year fellowships in female urology and highly specialized treatments and surgical techniques. That means we can handle complex cases, including reconstructive surgery.

One of the conditions we see often is overactive bladder, also called OAB or urge incontinence, in which the muscles in the bladder contract at the wrong time. Symptoms include an urgent feeling to go to the bathroom, heading to the bathroom many times during the day and night, and leaking urine on occasion before you make it to the toilet.

Don’t think of an overactive bladder as an inconvenience you have to endure. Instead, imagine how much better you will feel if you don’t have to worry about dashing to the ladies room.

Patients often tell us how relief from incontinence has improved their lives in very personal ways.

“It’s so nice not to have to wear black all the time.”

“I lost 100 pounds after I started exercising again.”

“I used to stay home all the time. But now I go out and meet friends.”

We encourage our patients to go out and share the good news with their friends. Frequently, they discover they are suffering from the same problem.

Often, OAB can be treated with changes in lifestyle. Even losing a modest amount of weight can make an improvement. So can pelvic floor exercises, in which you train your muscles by stopping the flow of urine in midstream, then repeat sets of contractions when you aren’t going to the bathroom.

Cutting back on caffeine and alcohol helps, too. Artificial sweeteners irritate the bladder, as well, so use them in moderation.

Can you drink a cup of morning coffee with Splenda? Yes, you can.

Can you drink 12 diet sodas a day? No, you should not.

There are a number of different medications that can reduce the urge to go if lifestyle changes don’t do the trick.

There also are techniques you can learn so that you can train yourself to go to the bathroom on a schedule, gradually increasing the time between trips. Think of it as mind over bladder.

Some cases of OAB require surgery. But most operations are much less invasive than the surgeries in the past years. Today, there are faster and more effective procedures to correct the problem, enabling patients to get back to their busy lives in just a few days.

A small percentage of cases are stubborn. But that doesn’t mean they can’t be fixed.

One treatment is neuromodulation, in which an electric stimulator is implanted next to a nerve. It’s an outpatient procedure that takes 30-minutes. The risk is extremely low; the success rate is very high, about 80 percent.

Acupuncture also is emerging as an alternative treatment to neuromodulation.

The most important thing to remember is you have      a lot of options. If you have an overactive bladder, don’t suffer in silence!

The Christiana Care Center for Urogynecology and Pelvic Surgery is located in Suite 1208 of Medical Arts Pavilion 2, on the campus of Christiana Hospital in Newark. Appointments are also available at the Christiana Care Center for Women’s Health, 3706 Kennett Pike in Greenville, or 100 S. Main Street, Suite 215 in Smyrna. For more information or to schedule an  appointment, call 302-623-4055 or visit

Dr. Saks

Emily K. Saks, M.D., MSCE, is a urogynecologist with the Christiana Care Center for Urogynecology and Pelvic Surgery. Dr. Saks completed a residency in Obstetrics and Gynecology at Pennsylvania Hospital in Philadelphia and has completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at the Hospital of the University of Pennsylvania.

Dr. Goldstein CMYK

Howard B. Goldstein, D.O., MPH, is a fellow of the American College of Obstetrics and Gynecology. He

completed a fellowship in Female Pelvic Medicine and Reconstructive Surgery at Cooper University Hospital in Camden, NJ. He currently serves as the Director of Research and Education for the Division of Urogynecology.

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