Dec 17, 2015

Interview Transcript

Dr. Jones: Wait, can we stop at the next gas station? Yes, I know we stopped at the last one but this is your bladder speaking and maybe it's time to get some help. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care and this is your bladder on The Scope.

Announcer: Covering all aspects of woman's health, this is The Seven Domains of Woman's Health with Dr. Kirtly Jones on The Scope.

Dr. Jones: Urinary incontinence is common in women, as many as 30% of women have incontinence for one reason or another. Babies moved your bladder around or you have an overactive bladder. Incontinence pads are a billion dollar business. But if your primary care provider can't help or you have more complicated medical issues maybe you need to see a urologist.

Today in The Scope Radio studio we'll be talking to Dr. Sara Lenherr. Dr. Lenherr is a urologist at the University of Utah and she's going to help us understand some of the more complicated reasons for bladder problems. She has a special interest in neurology, let's talk about how our brain and our bladder communicate.

Dr. Lenherr: The brain and the bladder have a really important communication process that needs to occur and basically the bladder is designed to store urine as a vessel until your brain tells it that it's okay to go to the bathroom, like when you're near a bathroom. And then the sphincter is designed to hold urine in place. Again, when you're able to get to the bathroom in time.

Sometimes in some medical conditions and other things that have happened with pelvic surgery or other types of vaginal deliveries with babies, that communication can get disrupted and so we need to pay special attention to that type of communication.

Dr. Jones: I always admired dogs who could put a little here and put a little there and do exactly what they wanted and when. But when that's not working I thought only men went to urologists. You know, for their prostate problems or those guy things. So urology for girls? For women?

Dr. Lenherr: So that is a really common perception and actually women have bladders too and they need to be pee too and urologists are specially trained to take care of the bladders pretty much exclusively and so we're here to help both men and women.

Dr. Jones: Great. So I'm an OBGYN and in our department we see a lot of women with urinary problems and we can fix a lot of them. But we're not very good for those women with complex medical problems. So can you talk a little bit about that?

Dr. Lenherr: So women have many different sorts of disorders that can disrupt the way the bladder works. The common ones are ones that disrupt the signals that go back and forth between the bladder and the brain. And also there are signals that make too much urine, so some women have heart disease which causes their kidneys to actually make urine and shift that around at the wrong time, and so they need to go more frequently and urgently because they're just making more urine.

There are many different types of conditions that affect the way the bladder works and really with an in-depth evaluation with a specialized urologist is really useful in order to figure out do we need to work on the bladder squeezing too much at the wrong time? Or is it a problem with the sphincter being too leaky, causing you to leak when you don't want to?

Dr. Jones: Well I can see that really takes some specialty training and you did a specialty fellowship in this area?

Dr. Lenherr: Yes, so there's a new specialty that came out a couple of years ago called, "Female Pelvic Medicine Reconstructive Urology" and we specialize in basically bladder function and how the bladder and the brain communicate. In order to evaluate how the bladder and the brain communicate frequently we perform what's called, "urodynamic evaluation" where we study the bladder pressures and the sphincter pressures, the urethral pressures, and figure out how they coordinate and communicate with different sensations.

Dr. Jones: Well we're really glad you're here at the University of Utah for all of us who are getting a little older, having a few more medical problems, and don't have the bladder that we want. Voluntary control of the bladder is a beautiful thing, but if it's not working for you, we and Dr. Lenherr can help.

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