Specialized Women’s Health Blog


2/10/14 Top 5 Myths about urinary incontinence

  1. Incontinence is a “normal” part of aging
  2. It is “normal” to wake up at night to urinate
  3. Urinary incontinence only happens to older women
  4. It can’t be prevented
  5. Incontinence usually requires surgery to be fixed.


10/2/13 Nervous to go to the Doctor? You’ll be fine

Every patient comes into the office with different expectations. It is rare that patients come to see me and are excited to be there. Nobody enjoys going to the doctor—this is the basis for what we call “white coat hypertension”, or an elevated blood pressure when people enter the office.

I’ve always prided myself on making patients feel comfortable from the moment they start their journey to our office. Our staff is extremely friendly and even on the phone are able to reassure patients that everything will be okay. Our office will make patients more comfortable, by providing services in a comfortable setting.

So what should you expect when you see the urogynecologist? Well, many of the conditions we deal with involve the female pelvis. Therefore, you’ll almost definitely be getting a pelvic exam—just like at the general gynecologist. Plan on spending about 30-45 minutes for your first visit, as it is important that we take time to evaluate you and interview you.

We expect that you will have an enjoyable and educational experience in our office. If we don’t meet your expectations, then please let us know.

9/3/13 FDA Approves Botox for Overactive Bladder

The U.S. Food and Drug Administration today expanded the approved use of Botox (onabotulinumtoxinA) to treat adults with overactive bladder who cannot use or do not adequately respond to a class of medications known as anticholinergics.

Overactive bladder is a condition in which the bladder squeezes too often or squeezes without warning. Symptoms include leaking urine (urinary incontinence), feeling the sudden and urgent need to urinate, and frequent urination.

When Botox is injected into the bladder muscle, it causes the bladder to relax, increasing the bladder’s storage capacity and reducing episodes of urinary incontinence. Injecting the bladder with Botox is performed using cystoscopy, a procedure that allows a doctor to visualize the interior of the bladder while Botox is being injected.

“Clinical studies have demonstrated Botox’s ability to significantly reduce the frequency of urinary incontinence,” said Hylton V. Joffe, M.D., director of the Division of Reproductive and Urologic Products in FDA’s Center for Drug Evaluation and Research. “Today’s approval provides an important additional treatment option for patients with overactive bladder, a condition that affects an estimated 33 million men and women in the United States.”

Botox’s safety and effectiveness for this new indication were established in two clinical trials of 1,105 patients with symptoms of overactive bladder. Patients were randomly assigned to receive injections of 100 units of Botox (20 injections of 5 units each) or placebo.

Results after 12 weeks showed that patients treated with Botox experienced urinary incontinence an average of 1.6 to 1.9 times less per day than patients treated with placebo. Botox-treated patients also needed to urinate on average 1.0 to 1.7 times less per day and expelled an average of about 30 milliliters more urine than those treated with placebo.

Treatment with Botox can be repeated when the benefits from the previous treatment have decreased, but there should be at least 12 weeks between treatments.

Common side effects reported during clinical trials included urinary tract infections, painful urination, and incomplete emptying of the bladder (urinary retention). Patients who develop urinary retention may need to use a catheter until the urinary retention resolves. Patients being treated for overactive bladder with Botox should not have a urinary tract infection and should take antibiotics before, during, and for a few days after Botox treatment to lower the chance of developing an infection from the procedure.

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