Do you suffer from urinary incontinence or know someone who has suffered in silence for decades thinking it’s a normal part of aging? You may be surprised to know that bladder issues can affect anyone at any age, especially those who have given birth vaginally. While many women may be embarrassed or ashamed to speak to loved ones or even their physician about their symptoms, which can affect their social, physical and sex life, and affects on in three women, there is help out there. With November being National Bladder Awareness month Dr. Karen Noblett, a renowned urogynecologist at University of California Irvine joined me recently to discuss everything from what pelvic floor dysfunction is to the symptoms, risk factors and treatment options.
Candace Rose: Dr. Noblett, can you tell us a little about yourself and the Pelvic Floor Disorders Alliance?
Dr. Karen Noblett: I’m a urogynecologist at University California Irvine. We treat women with pelvic floor dysfunction and pelvic floor disorders. That is sort of a broad umbrella term that a covers a myriad of conditions that really affect women’s pelvic floor functioning and those include urinary incontinence, fecal incontinence and pelvic organ prolapse. Our specialty is all about evaluating and treating women with these disorders.
We formed a group called the Pelvic Floor Disorders Alliance, and the Pelvic Floor Disorders Alliance was actually created in September of 2011, and it’s a public -private partnership that brings expertise and resources to various partners including the medical organizations like the American Urogynecologic Society, patient advocacy groups, and even industry with the primary focus of bringing public awareness about pelvic floor dysfunction, about pelvic floor disorders and to really help empower women to know that this is a common condition and there are treatment options available.
The first really effort out of this group came a consumer based survey, where we were just trying to get a feel for what the knowledge base was for these disorders. It was quite surprising that 90% of the respondents really underestimated the prevalence of the condition and many of the people didn’t really understand what pelvic floor disorders were- almost half. And of those that did, they thought it was just a normal part of aging. About 40% said they would just manage it with pads and diapers.
Our goal is to let them know they don’t have to live in diapers and they don’t have to manage it with pads. We’ve developed a campaign which is called Break Free From Pelvic Floor Disorders, and we have a website that is specifically for women called VoicesforPFD.org. This is a really nice resource for women that really provides them with more information on pelvic floor disorders, it has interactive tools to help them to understand what there symptoms are and the process of what’s occurring with their body. It gives them a fact sheet to download so they can check off things they may want to talk to their physician, and also references so they can find a physician who has expertise in this area that they can seek out in their community to get a consultation with.”
Candace Rose: What is pelvic organ prolapse?
Dr. Karen Noblett: “Pelvic organ prolapse is a weakening of the pelvic floor muscles or a tearing of the connective tissues. It can occur with childbirth or chronic exercise/chronic straining and it weakens the support structures in the pelvic area. When those support structures are weakened, parts of the vagina can prolapse to the outside of the body. The bladder might be behind that. The rectum might be behind it or the uterus can come completely out of the body. Women will start to notice the prolapse when the prolapse sort of dips to the opening of the vagina. They may be in the shower washing themselves, and all of a sudden noticing some tissue there. Or they may have some sensations of heaviness or swelling, or vague discomfort. And then when the prolapse continues to advance you may have some significant irritation in the tissues and even ulceration of the tissue. But there’s generally not a lot of pain, it’s more of a discomfort.”
Candace Rose: Who is most susceptible to bladder issues?
Dr. Karen Noblett: “All women, in fact one in three women will experience some type of pelvic floor dysfunction. That’s a huge number, so all women are at risk for developing pelvic floor dysfunction but there are certain risk factors, so those women who have had vaginal deliveries are at higher risk, and then other risk factors would include aging, going through menopause, and these conditions do increase with age. But we also see it in 30 year olds, and 40 year olds as well.”