Urinary Leakage: Main Symptom Of Pelvic Floor Defects Urodynamics Diagnostic Tests Help Counter Tragedy, Myths, Misunderstanding of Stress Urinary Incontinence(SUI)

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Endoscopic pioneer Thomas L. Lyons, MD, introduced the Laparoscopic Supracervical Hysterectomy (LSH) 15 years ago, and now combines this procedure with complex repair of pelvic floor defects, often diagnosed using urodynamics. All are performed using minimally invasive procedures. Myths abound re causes of urine leakage, the main symptom of pelvic floor defects.

Endoscopic pioneer Thomas L. Lyons, MD, introduced the Laparoscopic Supracervical Hysterectomy (LSH) 15 years ago, and now combines this procedure with complex repair of pelvic floor defects, often diagnosed using urodynamics. All are performed using minimally invasive procedures. Myths abound re causes of urine leakage, the main symptom of pelvic floor defects.

“More than 1/3 of women with Stress Urinary Incontinence (SUI) who have given birth do not believe that childbirth increases the risk of involuntary urine leakage,” said Thomas L. Lyons, MD, of the Center for Women’s Care & Reproductive Surgery in Atlanta at http://www.thomasllyons.com.

“This is a myth. Childbirth and loss of estrogen associated with menopause are main causes of SUI,” he added.

“Regrettably, many women also believe loss of bladder control is a disease, and that it’s a natural consequence of aging. It’s not. But without proper diagnosis using urodynamics testing, women may suffer unnecessarily,” he said.

According to a 2002 landmark study by the National Association for Continence, approximately 14% of American women ages 30-70 suffer from stress urinary incontinence (as opposed to urge incontinence) at a cost of billions of dollars annually. Forty-two percent believe that drinking a lot of liquid puts them at risk, and nearly 1/3 of women age 25-34 with SUI symptoms believe too much sex puts women at risk. These are also myths.

A leading national cause of disability and dependency, stress urinary incontinence is the involuntary loss of urine severe enough to have social or hygienic consequences.

Laparoscopic Pioneer Introduced Minimally-Invasive Pelvic Floor Repairs

More than a decade ago, Dr. Lyons introduced the Laparoscopic Burch Procedure for Stress Urinary Incontinence, and in 1990 he pioneered the Laparoscopic Supracervical Hysterectomy (LSH), which leaves the cervix intact for better pelvic support and sexual function post surgery. Since then he has trained hundreds of surgeons worldwide on the endoscopic procedures he developed. http://www.thomasllyons.com

However, not everyone is capable of performing these procedures, including LSH. Some surgeons refuse to do laparoscopic procedures on a large uterus. The size of the problem is not an issue for Dr. Lyons.

“It’s especially important that patients choose a surgeon who is experienced in working with lasers and laparoscopy. LSH requires more skill than open abdominal hysterectomy. LSH is easier on the patient, but more challenging for the surgeon,” explained Dr. Lyons.

Endoscopic surgery is a minimally invasive surgical approach that utilizes between three and five small incisions to gain access to internal organs and tissues. Conventional, traditional, open surgery requires a large incision.

SUI: A Common and Treatable Health Problem for Millions

“Urine leakage is the most common symptom of pelvic floor defects, many of which can be fixed surgically using minimally-invasive procedures. Unfortunately, many women experience symptoms for more than six years before being diagnosed,” said Dr. Lyons. “This is a tragedy because of the negative effects leakage has on lifestyle.”

Stress urinary incontinence usually occurs with some form of physical activity, lifting, sneezing, laughing, jogging, bending or stooping. Many sufferers said they abstained from some type of social and physical activity, while others said the condition caused them to refrain from sexual intercourse.

“Despite the emotional and physical costs of this disability, very few women seek treatment for incontinence—often because of their embarrassment,” said Dr. Lyons. Surgical therapy is indicated after conservative therapies have proven ineffective, or if SUI is greatly interfering with a patient's daily activities.

Initial management of the problem can include weight reduction to help lessen intra-abdominal pressure, behavior modification (e.g. changing posture), estrogen replacement therapy in menopausal and postmenopausal women, Kegel exercises, and electrostimulation to strengthen the pelvic floor. Medication to help constrict the muscles in the bladder may also be prescribed.

"Most patients recommended for surgical therapy are wearing incontinence pads due to the severity of their condition, or are candidates for gynecologic surgery for other conditions, such as fibroid tumors, abnormal bleeding or rectocele," said Dr. Lyons. "In those cases, the gynecologic surgeon may recommend that the patient undergo several procedures and pelvic floor reconstruction during the same operation."

Most patients undergoing outpatient endoscopic surgery for SUI are back to work or normal activities within a week--as compared with between five and seven hospital days, and up to eight weeks out of work required with conventional surgery. Other advantages of the endoscopic surgical approach include fewer hospital charges, less blood loss and reduced postoperative pain.

Not All Surgeons Created Equal

Kathy Droze is an active mother of two who experienced urine leakage and was told by both her urologist and GYN that she’d need eight weeks to recuperate after surgical repairs. See video clip http://www.thomasllyons.com

“I knew their information was totally erroneous,” she said. Even though he wasn’t on her medical plan she opted for Dr. Lyons to perform LSH, complete pelvic floor reconstruction and rectocele repair. “I’d actually have lost much more money if I’d had it done the old way because of time lost from my sales job,” she said.

She advises others not to believe everything they hear on their first or even second medical opinion. Her procedure was done on Wednesday and she was back to work on Monday.

“People don’t do enough investigation. They need to be their own advocates to get beyond the misinformation,” she said.

One thing to be aware of: many surgeons will attempt a laparoscopic procedure and find it necessary to convert to an open surgery with a long incision during the procedure. Make sure to ask your surgeon about his or her conversion ratio.    Dr. Lyons’ conversion ratio is less than one percent.

For more information contact:

Toll-free 1-888-545-0400 or 770-352-0037

http://www.thomasllyons.com http://www.EndoCenters.org

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