Improve your quality of life with incontinence treatment options close to home

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Stress incontinence can happen when pelvic support systems begin to fail. Dr. David Sheyn, of University Hospitals Geauga Medical Center, offers medication or outpatient treatment options. (Photography: Benjamin Margalit)

By Ken McEntee

For many women, urinary and fecal incontinence are embarrassing conditions that impact the quality of life. Fortunately, insists David Sheyn, MD, a urogynecologist at University Hospitals Geauga Medical Center, those conditions—and other pelvic floor disorders—are easily treatable, most often without surgery.

“Too many women continue to live with incontinence because they think that it’s just a normal part of being a woman, and don’t realize how treatable it is,” Dr. Sheyn says. “Incontinence is very common, but it isn’t normal.”

Urinary incontinence—involuntary leaking during activities like laughing, coughing, sneezing or exercising—can be caused by the weakening of the tissue that supports a woman’s pelvic organs or by an overactive bladder muscle due to a variety of causes.

The former condition, known as stress incontinence, is typically caused by pelvic organ prolapse, or vaginal tissue relaxation, Dr. Sheyn explains. “That happens when the support systems of the vagina begin to fail, resulting in descent of the bladder, uterus and rectum. Pelvic organ prolapse, he says, can be exacerbated by childbirth, but also can be caused by genetically weak pelvic tissue.

“Some women with prolapse will notice a bulge that is due to a drop in their uterus, bladder or rectum as a result of the weakened supporting tissue,” he says. “Prolapse symptoms might include leakage of urine, loose stool, painful sex or a sensation of pressure in the pelvic area.”

Stress incontinence is commonly treated with physical therapy, a pessary or the surgical implantation of a “sling” that creates additional support of pelvic organs.

The second type of urinary incontinence is urgency incontinence, or overactive bladder, which is caused by faulty signaling between the bladder and the brain, creating a sensation of needing to urinate even when the bladder isn’t full. Urgency incontinence, Dr. Sheyn says, can arise in women as they age and is typically treated with physical therapy, medication or an outpatient procedure.

“Incontinence is a quality of life issue,” he says. “More than treating the prolapse or incontinence, I am treating the bother that my patients have to go through on a continual basis. One of the most common things that I hear from my patients after treatment is that they wish they would have come to me sooner.”

The fear of surgery, Dr. Sheyn says, is one of the reasons why women don’t seek treatment for incontinence and prolapse.

“Many of my patients don’t need surgery,” he assures. “Many are treated with physical therapy. Sometimes it’s as simple as learning how to do a proper kegel exercise. University Hospitals has about a dozen physical therapists who are specially trained in pelvic floor exercises. And if surgery is needed, most patients are able to go home the same day.”

In addition to prolapse and urinary incontinence, Dr. Sheyn also treats patients who experience fecal incontinence, painful intercourse, frequent urinary tract infections, chronic abdominal pain, menopausal symptoms and bladder and bowel complaints following cancer treatment.

University Hospitals has one of the only programs in Ohio that combines urology, urogynecology and colorectal surgery for female pelvic floor disorders.

Dr. Sheyn holds office visits at the Geauga Medical Building, across the street from the hospital’s main entrance.

“Even though UH Geauga is a regional medical center, we have all of the amenities and capabilities of a tertiary medical center, including robotic surgery,” Dr. Sheyn says. “But we offer a more personalized patient experience without the hustle and bustle of larger hospitals.”

If you are experiencing incontinence issues, you can schedule an appointment with a urogynecologist by calling 440-901-6816 or visiting UH Geauga Medical Center is located at 13207 Ravenna Road, in Chardon.