‘Ask the Expert’ – A Urologist Answers Readers’ Questions

Chief or urology weighs in on reader questions

1) Is wearing a pantyliner daily harmful in any way?

Wearing a panty liner daily has been proven through multiple studies to be safe and is not associated with vaginal yeast infections or urinary tract infections.

(Eur J Obstet Gynecol Reprod Biol. 2007 May;132(1):8-19. E-pub 2007 Jan 3)

 

2) Natural treatment of mild incontinence in a postpartum young female?

Typically, the type of urinary incontinence that postpartum women develop is stress urinary incontinence. This refers to abdominal stress exerted on the bladder during coughing, laughing, sneezing, jumping, or other forms of exercise.

The best form of treatment is performing Kegel exercises. Medications or supplements do not help since it is a mechanical weakness of the bladder support muscles that are at fault. There are several ways to know if you are doing a Kegel exercise properly. One way is to try to stop your urine stream when urinating. If you are able to do so, then you’re likely using the correct muscles. However, do NOT practice Kegels that way. If you routinely stop your urine stream as a form of regular practice, you may develop a voiding dysfunction.

Another way to know if you’re doing it right is to place your finger inside the vagina and try to squeeze your finger using just your vaginal muscles. Avoid contracting your gluteal muscles, inner thigh muscles or abdominal muscles. If you have a hard time isolating these vaginal muscles, then ask your doctor about pelvic floor physical therapy. There, a female physical therapist can use biofeedback to help you hone in on the correct muscles to exercise. Once you know how to do it, it’s recommended that you start with 20 Kegel contractions daily and work up to 60 contractions daily over time. A way to remember to do them is when you see a commercial on TV or when you’re stopped at a red light.

The chief of urology weighs in with her answers to reader questions

 

3) Age at which prostate exam is done and is it only done by a urologist?

The AUA (American Urological Association) recommends that prostate exams and a PSA blood test be performed as part of screening of healthy men between the ages of 55-70 once every 2 years. For men with a first-degree relative who has prostate cancer or African-American men, it is advisable to start at age 40 and perform the testing annually. This does not have to be done by Urologist. Primary care physicians are able to do screening as well.

 

4) Other than meds- which my child was taking for about six months – what options are there for an overactive bladder, if medications stop working and the parent prefers no medications moving forward?

For overactive bladder (at any age), it is important to monitor diet and behavior. Avoid bladder irritants in the diet such as spicy food, citrus, carbonated drinks, caffeinated drinks, tomatoes, (and for adults) wine and beer.

Often urinary frequency in children may be psychological from nervousness/anxiety rather than physiologic. If the child is not having incontinence, bladder training can be very helpful. Bladder training involves encouraging the child to hold their bladder a little longer via distraction techniques. There are helpful guidelines online on how to do this. Seeing a pediatric urologist to rule out incomplete bladder emptying would also be important.

 

5) Is it typical for female toddlers to get frequent UTIs if they aren’t getting the wiping thing down?

Unfortunately, there are no research studies in my search of the literature that looked at your exact question, but my opinion is that wiping incorrectly is not a common cause. Pediatric UTIs generally require a work up involving a kidney ultrasound to rule out obstruction or kidney stones and something called a VCUG (voiding cystourethrogram) which helps rule out if the ureters are refluxing urine upwards towards the kidneys. These tests are often ordered by a Pediatric Urologist. If a child gets frequent UTIs, prophylactic daily antibiotics may be necessary to help prevent damage from the repeat infections.

 

Remember to discuss this and any other medical advice you read online with your doctor, as it may differ based on your individual case and specifics.

 


Dr. Kashefi answers questions in urology

Carol Kashefi, MD is the Chief of Urology at Scripps Clinic Medical Group in La Jolla, CA. 

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