Tuesday, January 31, 2012

Book Launch! Female Urinary Incontinence

I am proud to announce the launch and availability of my new book on Female Urinary Incontinence. It is immediately available at www.BladderBook.com

It is informative, concise, well illustrated, and not too heavy with medical jargon. It will inform and improve your life if you experience Urinary Incontinence, no matter how long you've had it or what causes it to occur.

In 10 minutes you can change your life dramatically and regain lost confidence.

It is only available at www.BladderBook.com  You will find it is shorter (60 pages), less expensive, and as comprehesive as any comparable book at Amazon or B&N. And it fits conveniently in your purse or pocket.

To preview the chapters go to www.BladderBook.com. We can ship to all 50 states, and worldwide.



Wednesday, January 25, 2012

Are There Racial Differences Among Those That Have Overactive Bladder?


A very common condition, Overactive Bladder (OAB) is a syndrome that consists of abnormal urinary urgency (uncontrollable or painful), with or without urge incontinence (leaking with the urge prior to getting to the bathroom), urinary frequency, and often nocturia (waking up with the urge to void urine), when no other bladder disorder is present (such as infection, tumors, etc). The prevalence of OAB in Europe and the US ranges between 11-16% of the adult population, with similar rates between men and women. Of the large trials, none looked at whether there are racial differences when it comes to who develops OAB.

An enormous internet based survey was conducted in the US among over 62,000 participants from the US, UK and Sweden. Over 36,000 responded and a random sample of 20,000 men and women were chosen. There were very interesting findings:

White and Hispanic men and women perceived worse bladder condition than black and Asian men and women. Women experienced greater impact than men.

Black men were most affected by OAB compared to Hispanic, Asian or white men, while for women there was no racial difference. Among women of all races the prevalence of OAB was between 27-46%, the lowest were Asians, the highest were black women.

Significant predictors for developing OAB in women were:

History of bedwetting as a child, high BMI, being a current smoker, history of recurrent UTIs, uterine prolapse, hysterectomy, arthritis, depression, hypertension, IBS, previously given birth, and sleep disorder.

For men, predictors of OAB were also arthritis, hypertension, diabetes, heart disease, prostatitis, prostate cancer, IBS and BMI.

Many of the health conditions that are predictors of OAB are shared between men and women, and these are usually age related changes, where an aging bladder itself as well as underlying vascular disease can contribute to OAB symptoms. Pelvic floor surgery or weakness is a risk factor in women for OAB as well.

Though race is not predictive among women for who may develop OAB, it is a common condition that can affect quality of life and can be exacerbated by lifestyle habits and poor health.

Sunday, January 1, 2012

Does Pelvic Radiation for Cancer Affect Female Sexuality?


Sexuality is a complex synthesis of the physical, psychological, and social interaction. Cancers that develop in the pelvis, such as uterine, cervical, anal or rectal cancer may require surgery, radiation or both. How does radiation affect women and their sexuality? Often, sexuality is neglected after treatment, or considered secondary in terms of importance related to overall survival. But in women who survive, can they resume sexual activity, and how are they affected by radiation to the pelvis? Survival rates for cancers are increasing and as such, more attention is then paid to quality of life.

Ionizing radiation destroys cancer cells due to their more rapid proliferation compared to normal tissue, but radiation can lead to anatomic changes resulting in bowel and bladder symptoms, pelvic pain, loss of hair to irradiated skin, vaginal narrowing, vaginal dryness, higher infection risk and pain with intercourse, vaginal bleeding and premature menopause. At the same time, women will often feel isolated, or develop anxiety and depression from their diagnosis and throughout or after treatment.

A large study recently reviewed the common complaints and changes that women reported as a result of pelvic radiation for uterine, rectal or anal cancer. Women reported more fatigue, lack of strength, vaginal discharge, diarrhea, skin redness and psychological stress. Of all the sexual dysfunctions, sexual desire was affected more than other sexual domains such as arousal, orgasm, etc. The most common reason for avoiding sex was limitation from the cancer diagnosis and treatment itself, reported by 66% of women. Sexual function was not a function of overall radiation dose received.

Interestingly, 25% of the female patients reported that their doctors questioned them about their sexual function, while 17% reported that they were the ones who prompted the doctor with questions about sexuality. These topics may sometimes be perceived as trivial and may be dismissed in light of the overall health concerns.

No less important is the quality of the relationship the woman has with her spouse/partner, who may withdraw for fear of the cancer itself, or fear causing harm to their loved one, or fear of the unknown if sexuality is explored. Overtime, the stress on the body, whether physical or psychological can increase, thereby worsening sexuality with time as well. In the end, intimacy may be avoided in order to avoid anxiety that may be provoked with sexual activity.

Reviewing such a topic with women who are dealing with cancer may be encouraging and inspire hope and strength throughout treatment.