Do You Suffer From Symptoms of Incontinence?

Category Archives: Blog

Chronic Pelvic Pain in Women

chronic pelvic pain in womenPelvic pain affects one in four women.  Many women live in silence, not knowing it can be helped. And many women who do seek help may have unnecessary surgeries, such as hysterectomy.

What is pelvic pain?

Pelvic pain is pain or pressure felt anywhere in the abdomen below the navel. It may be intermittent or constant. Many women describe pelvic pain as a dull ache, sharp pains, “toothache” type pain, and/or burning. Other symptoms include pelvic pain/cramps that may be related to menses, or completely independent of a period, pain associated with sex, during or afterward. Women can also have painful ovulation, painful bowel movements, pain with urination, and low back or hip pain.

Pelvic pain in women is complex and can originate from different organ systems such as the female reproductive system, the gastrointestinal system, the urinary system, the musculoskeletal system, the neurological system, or some combination thereof.

Usually, temporary pelvic pain is not a cause for concern and can be treated with over the counter NSAIDS. For more chronic pain, there may be the need for further treatment options, which can include physical therapy, acupuncture, nerve stimulation, amniotic fluid allograft injections.  However, the first necessity is to have an evaluation and determine all the causes of the pain, and what organ systems are affected.  This will require a physical examination and may require cystoscopic and/or laparoscopic evaluation along with possible colonoscopy.

Here to discuss different types of pelvic pain and treatment options is Dr. Barry Jarnagin, urogynecologist with the Incontinence Institute and the Center for Pelvic Health in Franklin, TN:

What symptoms do most women mention when they come to see you for pelvic pain?

Most women complain that their quality of life is greatly diminished by their pain.  They have trouble doing their daily tasks, caring for their children, working, and having an intimate relationship with their partner.

Are there other conditions that bring women in to see you, and then you learn they have pelvic pain?

Many times, women will have urinary and/or gastrointestinal problems (urinary incontinence, urgency, frequency, constipation, and diarrhea) who, after questioning them, admit to chronic pelvic pain and/or pain with sex.

Can pelvic pain be an indicator of a more serious problem?

It certainly can, and a full evaluation is warranted.  And, while most of the time it is a quality of life issue, it needs a full evaluation.

What do you do to treat pelvic pain?

The first and main thing is to evaluate and determine what systems are affected, then develop a treatment plan that will treat all the issues. Many times, there are dietary/behavioral changes that the patient must do along with our treatment protocols. We utilize a multidisciplinary approach with physical therapists trained in the pelvic floor, along with innovative treatments to treat nerves that are affected which are difficult to treat.  We have had much success with the amniotic cell allograft in treating pudendal nerve pain. We also utilize Botox. There are times when laparoscopy with excision of endometriosis, remove a cyst or appendix is necessary. There are many treatment options, most of which are minimally invasive, or not invasive at all.

If you or a loved one are suffering from pelvic pain, schedule an appointment today with our qualified team of doctors at the Incontinence Institute in Tennessee.


Incontinence Issues? There’s an App for That!

iStock_000041888110_LargeIf you have a cellphone or a tablet, chances are you’ve downloaded a few apps. And why not? There are well over two million apps available for download for both Apple and Android devices, designed to do all sorts of tasks from playing games to counting calories to balancing your budget to saving money of goods and services – and lots more. It shouldn’t be a big surprise, then, to learn there are also apps to help people with incontinence manage their condition more effectively. From bladder diaries to apps that find the nearest restroom to videos that remind you how and when to do Kegels, there are plenty of high-tech ways to keep your incontinence under control. Here are just a few in 2018 to consider (and most are free!):

1. Sit or Squat

Available for: iPhone, Android
This app for Android and Apple is sponsored by toilet paper manufacturer Charmin and helps users find the nearest public restroom, no matter where you are in the United States.

2. BladderPal

Available for: iPhone, Android
Available for Android and Apple devices, BladderPal lets you keep track of your fluid intake and urine output, two critical measurements that are frequently used by incontinence doctors to measure your level of incontinence and track your progress with treatments.

3. UroBladderDiary

Available for: iPhone
UroBladderDiary is an iPhone only app that records liquid intake and outtake, frequency, urgency, and leakage. The app can also create a custom report that can be sent in a PDF to your doctor. This app is the perfect replacement for a paper voiding diary that is frequently recommended by physicians.

4. Kegel Trainer PFM Exercises

Available for: iPhone, Android
Also available for both types of devices, Kegel Trainer gives you 10 different exercises to practice Kegels. If you’re prone to forget, use the app to set daily reminders.

5. Tät

Available for: iPhone, Android
Tät is an Android and iPhone app with 6 basic and 6 advanced pelvic floor music training sessions. It was developed by a Swedish company who used the app in a study for stress incontinence. In the study, 9 out of 10 women who used the app improved compared to 2 out of 10 women who improved while not using the app.

In addition, YouTube has plenty of videos for Kegels and other pelvic strengthening exercises for men and women, as well as yoga videos to ease the stress and anxiety that can accompany the condition and even contribute to it.

Before beginning any at-home treatment, it’s critical you have your symptoms evaluated by an incontinence specialist. In some cases, incontinence can be a sign of a serious underlying medical condition, and having an evaluation is the best way to be sure you get the right care, right away. If you live in Tennessee, the Incontinence Institute can help! Call our discrete concierge today at 615-525-5253 to schedule your own evaluation and consultation.

Are Reusable Incontinence Pads Right for You?

The Cost of Incontinence

For sufferers of urinary incontinence, making sure you are always prepared and protected can be a costly job. The average individual with moderate urinary incontinence will use around two disposables a day. With each going for $1.30-1.50, they can expect to spend around $80 per month. However, if you are using more than two disposable incontinence pads per day or you require more expensive products with better absorption and performance, those numbers can quickly climb. In fact, if we project those numbers to a year’s time, it comes out to a total of nearly $1000 – money that could have been spent treating this problem.

What is my alternative?

Various disposable solutions exist for incontinence sufferers. Reusable incontinence pads can be purchased for a larger upfront investment but long-term cost effectiveness. Pads are made of various washable materials, some of the most popular including cloth, organic cotton and hemp.

Why reusable?

  • Health- While disposable pads are largely comprised of cotton, manufacturers of washable incontinence products frequently use cloth in its place. However, you also have the option of choosing chemical-free organic products. By choosing organic products, you protect your body from materials that may have been treated with herbicides, fungicides, and pesticides. Additionally, you don’t run the risk of exposing yourself to toxic chemical residue.
  • Environmental – Using and discarding countless disposable pads puts a real burden on the environment. By switching to reusable incontinence pads, you’re keeping plastic out of landfills and pollutants out of the environment.
  • Quality- One large benefit of reusable products is that they can be created with custom sizing. Some cloth reusable products are created to be both self-sanitizing and also fast drying. Higher quality also translates to higher comfort, with a better fit and thus better performing product.
  • Cost- Incontinence products are on average 6x more expensive than baby diapers or menstrual pads. Unlike menstrual pads which may be used a couple days out of the month, many incontinence sufferers have to wear them 24/7. It is suggested that incontinence sufferers purchase at least 6 reusable pads or briefs. While they cost about $20 each, reusable incontinence products are generally advertised to last for 300 uses. The yearly savings on reusable incontinence pads compared to disposables averages eight hundred dollars! Plus, they can be quickly and easily sanitized in your home, using just your washer and dryer.

By switching to washable incontinence products, you’ll have extra money to treat what is causing your incontinence. While incontinence issues are common, they are not just a normal part of aging – there are treatments that can help. To start treating the root cause of your incontinence, contact one of our professionals today for a consultation.

How Common is Urinary Incontinence After Childbirth?

It is not uncommon to hear of pregnant women having trouble holding their bladders. In fact, up to 53% of women report some degree of urinary incontinence during pregnancy. But what happens if at one, three, or even five years after childbirth, a mother is still struggling with the involuntary loss of urine? She may be suffering from postpartum incontinence.

What is Postpartum Incontinence?

  • There are two main categories of postpartum incontinence. Many women experience both. The first is referred to as stress incontinence, in which the loss of urine is caused by increases in pressure or stress in the body. It is frequently correlated with a weakening of the pelvic floor muscles or pelvic muscles that have lost normal function due to overuse. If running, jumping, or a sneeze, cough, or laugh sends you to the restroom, you may be experiencing stress incontinence.
  • The second category of postpartum incontinence is called urge incontinence. It is most often caused by nerve damage sustained while pregnant or delivering, which impairs the bladder’s ability to communicate with one’s brain. As a result, the bladder may signal a need to use the restroom too soon or too often. Women with urge incontinence may suddenly feel like they’ve “got to go”, even when their bladders are nearly empty. The onset of these feelings may be quick and intense, and leaks may happen before they can make it to the restroom.

Could I be Experiencing Postpartum Incontinence?

  • Women who had a vaginal delivery are most likely to be affected, with up to 25% experiencing symptoms that persist for at least 1 year postpartum. In contrast, it affects up to 16% of women having had a caesarian section delivery.
  • Furthermore, obese or women over the age of 35 are at an increased risk of postpartum urinary incontinence. Likewise, the use of forceps in delivery, smoking, and incontinence during pregnancy predict a higher likelihood of postpartum incontinence.
  • Unfortunately, even though urinary incontinence after childbirth is extremely common, 77% of women who have postpartum incontinence either do not know or never seek a formal diagnosis, and as a result never receive treatment.

What can I do about Postpartum Urinary Incontinence?

Postpartum incontinence greatly affects the daily lives of those who have it. Many women resort to always wearing pads, visiting the restroom frequently, and even drinking less to minimize fluid in the bladder. Yet none of these methods offer a permanent solution.

If you are experiencing any or all of the above symptoms and are ready to find relief, the Incontinence Institute offers cutting-edge therapies and restores confidence to women affected by this condition. Some of our treatment options include Botox®, a bladder sling, and InterStim® Therapy. In every case, our board-certified physicians work closely with patients to create customized plans that cater directly to your unique needs. Contact us today to schedule an appointment and regain control – because no one should have to live with leaks.

Urology association honors Incontinence Institute’s Dr. Kaufman

Melissa Kaufman, MD. PhD Uro. Surgery resident nf

Melissa Kaufman, M.D., Ph.D., associate professor of Urologic Surgery, received the 2017 Zimskind Award at the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) Winter Meeting in Scottsdale, Arizona.

The Zimskind Award, established in 1979, is awarded to an individual who, within 10 years of completing residency or fellowship, has made significant contributions to the field, primarily through basic and clinical research, and has shown great potential for continuing and progressive scholarship.

“The Zimskind award represents the highest possible achievement for a mid-career specialist in lower urinary tract and female pelvic floor dysfunction. This is a singular recognition of an outstanding individual,” said Roger Dmochowski, M.D., professor of Urologic Surgery.

Dmochowski, who serves on the SUFU board, received the Zimskind Award in 1999.

Kaufman completed her Ph.D. in Biology at the University of Tennessee and obtained her medical degree from the University of Arkansas College of Medicine.

She completed her general urology residency at Vanderbilt and a Female Pelvic Medicine and Reconstructive Surgery fellowship under the direction of Dmochowski.

She is also a past president of the Society of Women in Urology (SWUI).

Provided by Vanderbilt University Medical Center’s Reporter

Top 10 Incontinence Triggers

If you find your incontinence worsening due to increased urination, something you are consuming regularly may be having a negative effect on your bladder. Try to avoid this list of 10 things that can contribute to incontinence symptoms.

  1. Alcohol
    To help prevent incontinence, try to avoid or limit alcohol consumption.It is a diuretic and can irritate the bladder.
  2. Carbonated drinks
    The bladder does not respond well to carbonation and caffeine so limiting your intake of fizzy drinks will help minimize symptoms.
  3. Chocolate
    The small amount of caffeine found in this popular treat can also worsen your symptoms.
  4. Citrus fruits
    Grapefruits, oranges, limes, lemons and tomatoes contain acid that aggravates the bladder.
  5. Coffee or tea
    Both of these liquids contain caffeine, which is a diuretic and bladder irritant.
  6. Fluids
    If you struggle with nighttime incontinence, make sure to reduce your fluid intake well before you go to bed.
  7. Frozen foods
    Artificial foods and colorings, chemicals and caffeine contained in frozen or packaged meals contribute to increased urination.
  8. Medication
    Heart medications, blood pressure-lowering drugs, muscle relaxants, sedatives, and other drugs are often diuretics; removing fluid allows the heart and other organs to work more efficiently, but can cause increased urges to urinate in those with incontinence.
  9. Spicy food
    Meals containing curry powder, chili powder and cayenne pepper can trigger incontinence in people who struggle with it, especially women.
  10. Sugar
    Foods containing honey, corn syrup and fructose can also aggravate your bladder.

If you are concerned about your symptoms or interested in more information about incontinence, call our discreet, dedicated medical concierge at 1.888.741.6403.


Six Myths about Incontinence

Urinary incontinence affects about 25 million Americans but there are plenty of myths out there about the condition. The first step to treating incontinence is getting educated on the facts. Here are six myths about incontinence:

  1. Myth:It’s only for old people.
    Fact: One in four women over 18 leak urine involuntarily.
  2. Myth: You should drink as little as possible.
    Fact: It is vital to stay hydrated, just try to not overdrink.
  3. Myth: It’s uncommon.
    Fact: Urinary incontinence affects 200 million people worldwide.
  4. Myth: Men don’t experience incontinence often.
    Fact: About 20% to 25% of Americans with incontinence are men.
  5. Myth: It’s just embarrassing.
    Fact: It’s a serious condition that severely affects a person’s quality of life.
  6. Myth: You just have to live with it.
    Fact: There are many ways urinary incontinence can be greatly reduced or eliminated with proper treatment.

For more information on treatment options or to speak with a dedicated medical concierge, call 1.800.771.1953.

Five Signs You Need to See a Urologist

How do you know when your little leak is a big problem? If incontinence is affecting your daily life, it may be time to seek help. Here are five symptoms that it’s time to see a urologist.

  1. You lie down to relieve a constant, heavy pressure.
  2. You routinely wear sanitary pads.
  3. You experience leakage when you laugh or cough.
  4. You experience recurrent urinary tract infections.
  5. You frequently have a need to urinate.

Here are a few additional incontinence resources that may be helpful:

  • National Association for Continence (NAFC)
    An organization dedicated to improving the quality of life of people with incontinence, voiding dysfunction and related pelvic floor disorders.
  • Senior Directory
    A comprehensive directory of over 70 categories of services for aging adults.
  • The Simon Foundation for Continence
    A foundation that aims to bring the topic of incontinence out into the open, remove the stigma surrounding incontinence, and provide help and hope to people with incontinence.

Take the first step with our Online Self Assessment here. For more information on treatment options or to speak with a dedicated medical concierge, call 1.615.547.2938.

8 Things That Can Make Incontinence Worse

When you’re living with incontinence, you’ll try anything to lighten the burden of frequent bathroom visits. But, are you sabotaging yourself? Here are 8 things that make incontinence worse, as suggested by

1. Make fewer trips to the water cooler
It makes sense that consuming too much liquid is a problem for those who suffer from incontinence. However, it’s important to keep hydrated. Generally, doctors recommend drinking about two liters of fluid a day.

2. Dial back the morning pick-me-ups
Love your morning cup of joe? Caffeine, like alcohol, is both a diuretic and a bladder irritant. Decaf and tea can do just as much damage so wean yourself off of the caffeine addiction.

3. Put away the pop
Containing both caffeine and carbonation, carbonated drinks have been shown to worsen incontinence symptoms. The more you can stick to a natural diet without colorings and chemicals, the better.

4. Stop the sweet tooth
Sugary foods including those that contain honey, corn syrup and fructose have been shown to aggravate your bladder. Put away the Splenda, artificial sweeteners may be no better. Research has shown that even the substitute stuff contributes to urge incontinence.

5. No more hot tamales
Studies suggest that spicy foods can be a trigger for overactive bladders. If you notice a problem, cut back on the curry and hot sauce.

6. Cut back on the booze.
Alcohol is a diuretic. It causes you to produce more urine, which can contribute to urge incontinence. Try to limit yourself to one drink a day.

7. OJ is “Oh no!”
The age-old cure of orange juice may be a curse for those with incontinence. Acidic foods and beverages can irritate your bladder and possibly worsen incontinence symptoms.

8. Monitor your medication
Certain heart medications such as blood pressure-lowering drugs, muscle relaxants and sedatives tend to worsen incontinence. Talk to your doctor about whether your prescription medications might be contributing to your bladder problems.

A Runner’s Guide to Incontinence

Are you running to the bathroom instead of running the trails? If so, you’re not alone! Researchers have found that as many as 30 percent of female runners have experienced incontinence while running. The median age for women marathon runners is 35, which also is a prime age for urinary incontinence to emerge.

Urinary leakage during running is due to what is often called “stress incontinence.” The jarring impact of your legs hitting the pavement causes the organs in the pelvic cavity to be continuously pulled in a downward motion, sometimes resulting in pelvic organ prolapse issues. The most frequent form of incontinence, stress incontinence can be triggered by running, jumping or even sneezing.

Are you at risk? Weakened pelvic muscles happen after childbirth, surgeries, diabetes, obesity and even some medications. Also, as women age their likelihood of experiencing incontinence issues increases.

What can women do to lessen the symptoms?

  • Strengthen the muscles of the pelvic floor using Kegel exercises or Pilates.
  • Wear support garments like absorbent pads while running to absorb any leakage.
  • Time your fluid intake, use the restroom before running or plan on having a bathroom or two along your route.
  • Keep a bladder diary to determine the best times to go to the restroom.
  • Discuss treatment options – including minimally invasive surgery – with a doctor.

Most importantly, don’t let incontinence limit you from participating in something you love. Whether you dream of running marathons or simply running after your kids at the park, we’re here to help. For more information or to speak with a dedicated medical concierge, call 1.800.771.1953.

About The Incontinence Institute

At the Incontinence Institute, our team of healthcare providers understand the physical and mental trials that accompany living with urinary or bowel incontinence. Because of this, we are sensitive to your situation and treat all of our patients with the utmost respect and concern for discretion.

Individual incontinence conditions, treatment and recovery times may vary. Each patient's experience with incontinence procedures and / or surgery will differ. All surgical procedures involve some level of risk. If directed to pursue surgery by your physician, prompt action is advised, as waiting may reduce the efficacy of surgical treatment. The opinions expressed in patient testimonials are by patients only; they are not qualified medical professionals. These opinions should not be relied upon as, or in place of, the medical advice of a licensed doctor, etc.

Contact Us

Incontinence Institute 2009 Mallory Lane, Suite 100 Franklin, Tennessee 37067