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My experience with female urinary incontinence and pelvic prolapse

I am an OB/GYN who has been in practice now for 20 years in Seattle. My early training had a strong emphasis on vaginal reconstructive surgery, but I was always frustrated with our poor success rate in repair of pelvic prolapsed and urinary incontinence. As my practice has evolved I have continued to focus on urinary incontinence and new techniques for treating pelvic prolapse. In the recent years there have been some very exciting new changes.

Urinary incontinence in women

Many women are bothered by urinary incontinence. Recent studies have shown that this is worse if you have had a vaginal delivery, but some of women have either wide pelvic openings or poor tissue elasticity that can lead to this without ever having had a vaginal delivery. This is an embarrassing problem and can be very inconvenient, with many women carrying a change of clothes or wearing daily pads. In the elderly this can lead to slips or falls and even broken hips. For women who have had children, this may keep them from exercising or playing with their children for fear of leakage. Many women suffer in silence because this is too embarrassing to share even with their doctors.

Today we have several ways ....

Activity after open or laparoscopic abdominal surgery

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after ..

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