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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.

Your No-Stress Summer — Managing Stress Incontinence Away from Home

Summer is all about being spontaneous — jogging, biking, hiking, dinners al fresco and, of course, laughing — which it what makes it such fun!


Not so much if you’re one of the 25 million people in North America people who are coping with stress bladder incontinence . As a result of weakened pelvic muscles, stress incontinence occurs when urine leaks out involuntarily due to unexpected pressure on the bladder. But worrying about these unpredictable incidents shouldn’t ruin your otherwise carefree and happy summer. These tips from the Incontinence Institute™ can help you manage stress bladder incontinence while away from home.

At the Gym

Fitness is a key to feeling great and strengthening muscles, but so many of the typical routines can trigger an accident. Try these things instead:

  • Swap exercises that cause you to bear down (crunches, double leg raises, weight training) for core-strengthening sets
  • Add workouts that target the transverse abdominis — a muscle group that wraps around your belly and helps you to draw your belly button up and into your abdomen (such as when you’re doing Kegels)
  • Wear triathlon shorts to add compression around your core and support for your pelvic floor (added bonus: this workout wear has a light, built-in pad to absorb moisture)

On Vacation

The beach, the mountains and a new city all have one thing in common — bathrooms that can be few and far between. Don’t let the possibility of an accident keep you from exploring new places:

  • Stay hydrated with foods as well as fluids; watermelon, cucumbers, radishes and bell peppers are summer staples packed with water that give your bladder a break
  • Say no to overly spicy and acidic foods (like citrus, pineapple and tomatoes) which can irritate your bladder
  • Download a toilet locator app for your smartphone, like the “Flush – Public Toilet Finder, that scans your immediate surroundings for bathrooms that are clean and safe

At a Sleepover

Being (and having) a houseguest can be wonderful, like staying in a hotel filled with your favorite people who get every inside joke and share your intense dislike of that weird, wrinkly fruit. Relax with these tips:

  • Pack dark pants, flowy skirts, patterned dresses and tunic-style tops — these pieces are fashionable, comfortable and great at hiding stains
  • Bring plenty of absorbent pads and disposable bags to avoid having to ask your host for a spare
  • Use white vinegar (from the pantry) or rubbing alcohol (from the medicine cabinet) to kill bacteria and dilute urine odors without damaging the upholstery or mattress

While the possibility of an unexpected incident from stress bladder incontinence can certainly make you anxious, a little planning can help you manage your symptoms easily. If you have questions or are interested in discussing a permanent solution with an Incontinence Institute doctor, contact us online  or call our discreet, dedicated Medical Concierge at (800) 771–1953.

Is It Urge Incontinence? What You and Your Doctor Should Know

iStock_000048988048_SmallUrge incontinence , more commonly referred to as “overactive bladder syndrome” or OAB, is identified as sudden and sporadic bladder contractions. What that actually means is that you may need to urinate without warning, oftentimes when there is no restroom nearby, or that urine leakage could occur when laughing, exercising, or sneezing. Diagnosing OAB can frequently be delayed or entirely missed due to embarrassment, misinformation, and a number of other underlying conditions. Take an anonymous self-assesment  offered by the Incontinence Institute™ and read on for tips on when to seek treatment.

Say It Out Loud

Embarrassment and depression are just two of the emotional pitfalls  associated with any type of incontinence. Because we’re all “potty-trained” from a very early age, having to admit that you’ve had an accident or don’t feel like you’re in control of your bladder can result in simply ignoring the situation. That denial only leads to a worsened condition and deprives you from the support network  that’s millions-strong.

“It’s Only Natural” and Other Misinformation

The aging process, childbirth , and other normal bodily functions make for convenient scapegoats. While  older women are statistically more likely to be diagnosed with urge incontinence, it can develop into a neuromuscular condition affecting any age and gender. Avoiding things that can cause bladder irritation, such as caffeine and “holding it”, are just a couple of ways to help decrease the spasms that lead to uncontrollable urination.

Another common mistake is assuming your intense urge to urinate is caused by a Urinary Tract Infection  (UTI). Caused by the common bacteria E. coli and accounting for approximately 4 million clinic visits per year in the U.S.1, the UTI is another way to shift focus away from possibility of urge incontinence. Because UTIs are treated with antibiotics, it can be very dangerous to repeatedly misdiagnose chronic incontinence for this temporary infection.

Underlying Health Issues

Prostate issues such as an enlargement of the gland or surgery for prostate cancer , as well as obesity , can also obscure your urge incontinence symptoms. If fluid management, consciously urinating when you first feel the need, and cutting out irritants such as caffeine and smoking haven’t provided any relief, it may be time to seek treatment .

There are number of treatment options , some non-invasive as well as other highly-effective medical procedures, that can help put your bladder back in your control.  But the first step is talk with an expert, like doctors Barry Jarnagin and Melissa Kaufman at the Incontinence Institute. To set up an appointment or discuss your concerns, contact us online  or call our discreet, professional Medical Concierge at (800) 771–1953.


What Are the Options for Incontinence Treatment?

Male hand writing phrase It's all about you on virtual screen.Incontinence is one of the most difficult conditions to face. You may not know why it happens, how to control it, or how to feel comfortable going out in public. However, what many people don’t realize is that there are treatment options available. If you have symptoms or a diagnosis of incontinence, treatment may be available to you in a variety of forms. With the help of experienced, specialized doctors, you may get the help you need to overcome this condition for good.

What Are the Incontinence Treatment Options?

Everyone’s needs are very different. When you come in for a consultation and examination, you’ll learn more about the treatment options that are available to you specifically. These are some of the treatments for incontinence.

• Botox is one of the best solutions for most people. It involves an injection into the bladder muscle, which then helps to provide improved control. The procedure takes just 15 minutes to perform. It can last up to nine months.

• InterStim is a device that is about the size of a silver dollar that’s placed in the skin near the pelvis. It works as a modulator for neurological signals. In short, it works to improve communications with the bladder and brain reducing your risks of problems.

• Medications may help some people. Some prescription medications include estrogen, imipramine, anticholinergics, and desmopressin. Not all medications will work for all patients, which is why a specialized examination is necessary for each individual. Medications work in various ways to help improve control.

• Physical therapy and biofeedback are additional options. In some situations, this condition occurs due to a weakened muscle or nerve-related concerns. If this is the case, physical therapy may be helpful. Biofeedback uses sensors attached to the body to improve mental and physical exercises that can improve control.

• Urethral sling treatment is another option that works for 8 out of 10 women – leading to a cure. This is a form of surgery that addresses a sagging urethra or bladder neck, which often happens from complications of other surgeries. The treatment can work in men as well. In this procedure, a sling is connected to the abdominal wall. This works to lift the urethra to the proper position.

Which treatment option can work for you?

This depends on a number of factors. What you should know, though, is that many people struggle with this type of health condition. It is not something you should feel embarrassed to discuss with your doctor. When you come in to learn more about incontinence treatment options, we’ll discuss what can work for your specific needs. In many cases, patients can benefit from more than one option, giving you the ability to find the best solution for your individual needs. This means improved quality of life and health. Give the Incontinence Institute a call to discuss options tailored to your specific needs!

Hemorrhoid Care,Treatment and Prevention

If you suffer from bowel incontinence, there is a good chance that have suffered or may suffer from hemorrhoids. These internal or external anal protuberances can cause pain, itching, and bleeding — adding insult to injury when you’re already dealing with another bowel-related issue. The good news is that you can receive treatment to help you reduce your hemorrhoid symptoms — or even eliminate the hemorrhoids themselves — and prevent recurrences.

Take our Fecal Incontinence Self-Assessment

The Link Between Incontinence and Hemorrhoids

A hemorrhoid is an enlarged blood vessel that arises in the anus. There are two main categories of hemorrhoids, both of which can develop simultaneously. The more common variety, internal hemorrhoids, form small lumps just inside the anus, although sometimes they can prolapse and extend into the anal opening, or sphincter. External hemorrhoids originate at the anal sphincter. Both types can cause maddening discomfort; they also produce bleeding that might alarm you into thinking you have another, more serious condition.

Hemorrhoids can have many possible causes, including obesity, pregnancy, lack of dietary fiber or exercise, and they may even show up for no known reason. But bowel incontinence is another direct cause of hemorrhoids. That’s because changes of pressure in the anal canal place extra stress on the delicate blood vessels there. Both constipation and diarrhea can trigger hemorrhoids. The irony there is that people worried about constipation-related hemorrhoids take laxatives, which can be a little too successful and create diarrhea, causing them to experience hemorrhoids all the same. If you have an untreated bowel incontinence condition, it’s no wonder that you might be dealing with constant hemorrhoid symptoms as a result.

Treatment and Prevention Strategies

If you suffer from mild to moderate hemorrhoids, recommended treatment usually starts by addressing the underlying bowel behavior causing or aggravating the problem. For example, if certain foods or spices as the cause of recurring diarrhea or constipation, you can simply remove those items from from your menu. If weak pelvic muscles are leading to too many trips to the bathroom, we can prescribe exercises and other forms of therapy to help you strengthen these muscles. Once we have successfully treated your incontinence problem, we’re well on the way to eliminating your hemorrhoid problem.

Some hemorrhoids can become so large or painful that we recommend their removal. The simplest method for accomplishing this is banding. Our skilled team ties off the blood supply to the hemorrhoid with tiny rubber bands, causing the hemorrhoid to die. Better yet, the scar tissue that replaces it is tough enough to discourage future hemorrhoid development at that spot. This outpatient procedure heals completely within 10 days or less, and it can work on both internal and external hemorrhoids. Contact the Incontinence Institute today, and take the first step toward a more comfortable life.

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.

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