Every female at some point in time can attest to having leaked urine when they laughed, coughed, sneezed or even as they exercised. Or getting a sudden urge to urinate, and in some instances not being able to make it to the bathroom on time, and leaking urine. And then, there are the people with overactive bladder (OAB), a collection of symptoms where they have urinary urgency or urinary incontinence, where they're leaking frequently, or plagued with nocturia and frequently have to urinate at night.
Urinary problems are many and varied, affecting young people, old people, men, women, and children, and have a horrible effect on the quality of a person's life. Despite this, urologist and laparoscopic surgeon Dr. Greggory Pinto, in an earlier interview with The Nassau Guardian, said people do not have to suffer, as he said treatment is available that will allow people to get back to their normal lifestyle.
"One in four adults — men and women — are going to have some element of a urinary problem whether it's incontinence, overactive, frequency, or incomplete bladder emptying," Pinto told The Nassau Guardian.
The doctor said many people are suffering with a problem that needs to be treated by a urologist. But that many of them don't seek medical attention, opting to suffer in silence.
"They think that as they get older in years, it's a natural progression that you have to be in adult diapers. That once you've had three children that you have to have a pad and change it five times a day. That's not the case at all. You can be pad-free. You can have that confidence of being in social circumstances without possibly smelling like urine. You can sit in church for two hours and not worry about when the next bathroom break is," said the doctor.
He said a few major causes of urinary problems and urinary incontinence, which is bladder leaking in men and women, starts first with the major topic of benign prostate hyperplasia (BPH) and its management.
"BPH is a condition that every man, once they reach 50, develops an enlargement of their prostate that causes an obstruction in their ability to empty their bladder completely, so they're going to present with a poor urinary stream, they're going to have frequency, they're going to be waking up many times throughout the night having nocturia [frequently urinating at night], they're not going to have a good night's sleep, so they're also in turn going to wake up their spouse, so it can have a horrible effect on a marriage, on a family, and just in terms of the general quality of one's life; there are so many things that can be done medically and minimally invasively as a surgical procedure to try and solve this problem."
OAB is suffered by men and women, but affects more women than men, and can have a horrible effect on a person's life, according to Pinto. He said sufferers usually avoid social interactions and their intimate life is severely affected.
Pinto said there is help and hope for sufferers, as well as those who suffer with urinary incontinence of which there are various types — stress (leaking when you cough, sneeze, lift something heavy, exercise or do anything that causes intra-abdominal pressure); urge (you get an urge, run to the toilet, but don't make it in time); transient (the result of taking drugs like diuretics and anti-hypertensive, a change in diet, infection, depression, delirium); and mixed.
Urinary incontinence and urinary problems
The classic scenario — once a female has two children, whether she's 25 years old, 35, 45, or 55 years old, the doctor said they're going to notice that every time they cough or sneeze, lift their child, that they're going to leak a little bit of urine. That situation Pinto told The Nassau Guardian could lead to social awkwardness because the person has the perception that they constantly smell like urine, which he said could lead to low self-esteem and affect their intimate life and marriage in a significant way.
"Women will avoid going out with friends, avoid exercise at all costs because it basically will initiate incontinent flow. So, these are women who will be wearing five, six pads a day, which can be very expensive and very depressing. And there are so many minimally invasive modalities that can actually solve this problem."
The broad medical term describing all urinary problems symptoms is LUTS (lower urinary tract symptoms). And the doctor said they can be obstructive symptoms and irritative symptoms, which he said means a person would urinate frequently.
"You will be up all throughout the night urinating either small amounts or large amounts. A lot of that can be contributed to by your own lifestyle, and you can be your own worst enemy," said Pinto.
"I have met so many Bahamian men and women who believe if you drink 20 gallons of water, they're going to have a healthy life and a healthy kidney. All you're doing is causing yourself suffering by running to the toilet every 10 minutes, because everyone can only drink so much in terms of fluid intake. Drinking large amounts of liquids ... whether it's water or other liquids just before you go to bed can also contribute to your problem in terms of you waking up every hour on the hour to urinate."
Hypertensive medications and diuretics he said also cause people to urinate frequently.
No matter a person's urinary problem, the urologist said there are medications that are effective that drastically reduce symptoms, and treatments that give a better quality of life. The treatments he said are all available in The Bahamas.
Indications for surgery
"If you have chronic symptoms where you're not emptying your bladder ... where you have a poor urinary stream, first thing you may have is urinary tract infections. You may develop bladder stones, you can have back pressure on your kidneys, you can even develop blood in your urine where you're visibly seeing the blood or you can just see that the medication has stopped working, or has insignificant improvements in your system. Then, you go to the next step, which is minimally invasive — endoscopy. You're put to sleep, or numbed from the waist down using a spinal anesthesia — the procedure takes about an hour, and you can go home if not that day, the very next morning. There's no recovery, no pain killers to take, no stitches; there's nothing to do in terms of healing."
Pinto said people do not need to suffer as there are a number of treatment options available from medicines to minimally invasive procedures that can be done in the urologist's office.
Treatment he said means patients can be free of cumbersome pads, pills, adult diapers, and urinary tract infections — gain control of their bladder, their life, their happiness and their self-esteem.
"The most advanced minimally invasive treatment modalities are available right here at home. You can get it done in an hour painlessly and change your life drastically," said Pinto. "Stop just tolerating urinary symptoms, especially when it's moderate or severe. You can have treatment from a urologist, get treatment and get a solution and get back to your normal lifestyle. You can get control of your bladder, control of your life and control of your happiness."
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