Armor Men's Health Show

Bonus Episode: Dr. Voves on Urinary Incontinence and How to Lose Your Leak with Pelvic Floor PT

January 20, 2023 Dr. Sandeep Mistry and Donna Lee
Armor Men's Health Show
Bonus Episode: Dr. Voves on Urinary Incontinence and How to Lose Your Leak with Pelvic Floor PT
Show Notes Transcript

In this bonus episode, Donna Lee is joined by NAU Urology Specialists' very own Dr. Mary Voves to discuss urinary incontinence. Bladder leakage caused by stressors like sneezing, jumping, or running is called stress incontinence, while urge incontinence is leakage that occurs during urgent trips to the restroom. Dr. Voves explains that both men and women can suffer from urinary incontinence, and both can benefit greatly from exercises that strengthen the pelvic floor. Listen in to learn how pelvic floor physical therapy treatment can significantly improve or eliminate incontinence. Give us a call today to start losing your leaking! 

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Speaker 1:

Welcome back to the Armor Men's Health Show with Dr. Mystery and Donnel Lee.

Speaker 2:

Welcome to the Armor Men's Health Show with Dr. Mystery and Donnel Lee. And sometimes you lucky listeners are so fortunate that you hit me by myself. Reach out to us if you'd like with any questions you have for the show. And Dr. Mystery will answer them anonymously at armor men's health.com. And you can send us questions, um, there to our inquiry button there that you'll see in our phone number is(512) 238-0762. We are located in Round Rock, north Austin, south Austin and Dripping Springs, Texas. Every episode now we're trying to bring on a special guest, especially some of our N A U Urology specialists and Armor men's health family members. And today we have our lovely newest to the family, pelvic floor physical therapist. Mary Bovis. Welcome to the show, Dr. Bovis.

Speaker 3:

Thank you Donna. I'm so happy to be

Speaker 2:

Here. First, congratulations on your, your marriage. You just got married. Thank

Speaker 3:

You. Yes.

Speaker 2:

That's so exciting. Your pictures were beautiful. So everybody I want you to get to know Dr. Bovis, we call her Mary. She's the sweetest thing in the world. Dr. Collette Rodin is also with us and you've heard her on other podcasts, but I thought we'd bring on Dr. Bovis today to talk about some pelvic floor physical therapy stuffs and things that she does because she does see a lot of men. And so most of the listeners to the show are men, but we also have a ton of ladies. And you're also treating ladies, is that correct? Correct. So seating seeing mostly men, but um, by 60 40%, maybe 60% men, 40% women in the clinic,

Speaker 3:

About 60% men.

Speaker 2:

Gotcha. So you guys, you need to take care of your pelvic floors. But first let's learn a little bit more about Dr. Bovis. Where were you before or what did you do before you joined us at Urology

Speaker 3:

Specialist? Yeah, so before I joined y'all here, I um, was in Chicago. That's where I was born and raised and I was working there, um, at a private practice. And then I was also in Raleigh before I came here too, seeing, um, pelvic health at a hospital system out there. Nice. And I came here in March and have been very happy settling into Austin and very happy here at au.

Speaker 2:

Okay. Are you super happy as in Austin night? I

Speaker 3:

Am happy as in Austin Night

Speaker 2:

<laugh>. So you and your husband are hitting all the parks and the the restaurants and the fun things?

Speaker 3:

Yes. We love the energy of the city and there's so much to do and we love being able to be outside all year round because that is not something you can do in the Midwest. Oh,

Speaker 2:

That's true. I mean, depending on when you're listening to this podcast, whether it's cold or hot outside, um, we're about to go through some serious cold, but you're probably used to the cold. Oh yes. We are all gonna freak out in a day or two when the temperature drops. So just just don't mind us crying around the clinic.<laugh>, it's, it's gonna be fine. But I thought we'd talk a little bit about a patient specific patient type of issues. And we've talked about this in the past with our previous pelvic floor physical therapist, Dr. Treadway who retired, who we missed greatly. But we had a podcast, I think it was probably a couple years ago. But I'd like to tell the patients or the listeners what is the difference between stress incontinence and urg incontinence. Because in my head it's just all incontinence, but they're obviously, they're two different things and there's two different treatments for those.

Speaker 3:

You're correct. Those are two different types of incontinence. Stress incontinence is when you're having leaking, um, usually due to some sort of stress. So coughing, sneezing, laughing, jumping, running, um, when something puts like a lot of pressure on the pelvic floor. Mm-hmm.<affirmative>, that's why it's called stress incontinence. When you overstress the pelvic floor where the muscles just aren't strong enough to hold back the urine and so you leak mm-hmm.<affirmative> and then urg incontinence is when you get an urge you have to go to the bathroom and then you're leaking on the way to the bathroom and don't make it in time. So it's, it's different. So it's not, it's still stress on the pelvic floor but in a way of like you can't hold it back and you're kind of running to the bathroom when like a little bit's dripping out as you're on the way there.

Speaker 2:

Oh, so that's the word urge?

Speaker 3:

Urge.

Speaker 2:

Yes. Urgent. Urgent. I never put those together in my head. That makes so much sense. Yes. So with the stress incontinence, I know what causes that for women a lot of times is having had babies or getting a little older and I know that, yeah, I, I would see a trampoline after I was with my child. I'd be scared to death cuz I'm like crap I need to go get a pat or something.<laugh>, I'm sure that's FYI for listeners, but tell us what do causes men to have stress incontinence? Cuz obviously they're not having babies but what do they go through to have that same sensation that they're, they're, you know, need to

Speaker 3:

Go? Yeah, so the biggest thing that would cause that would be after having a prostatectomy mm-hmm<affirmative>. So after having the prostate removed, they will frequently experience the stress incontinence because they haven't been relying on those pelvic floor muscles as much to control the leaking. So they'll notice it with those stressful activities. That's usually the biggest thing. Otherwise it's not super common for men. Right. Um, men will get urgency and like feeling like they have to go. Um, it's just not the same as women. But men also can get leaking like after they go to the bathroom, if they don't get it all out they might have a little bit of dribbling that's not stress or urge incontinence but that's a more common form of incontinence in men. Gotcha.

Speaker 2:

And how do you, what treatment plan or what do you go through with the patient? Let's say I'm a male patient seeing you for the first time and I have urge incontinence where, where do you normally start?

Speaker 3:

Yeah, great question. So urge incontinence, it's treated differently than stress incontinence but it can be due to a number of different factors. Um, certain things that can increase urgent incontinence would be weakness in the pelvic floor. So we'd check the pelvic floor strength and then if the muscles are weak we can teach you how to strengthen them. It can also be due to um, pelvic floor muscles that are too tense or have too much tightness giving you sense that you have to go to the bathroom more often so you have a lot of urgency and feeling like you have to go. And then it could also be due to other things like certain dietary or dietary really influences uhhuh<affirmative> like certain drinks or bladder irritants. Like if you're really only hydrating or drinking sodas or coffee or tea or caffeinated beverages all day and not really drinking a lot of plain water, that can increase your urge and urgency and that can contribute to the urgent incontinence too. So

Speaker 2:

You're saying diet cokes are

Speaker 3:

Bad? I am<laugh>,

Speaker 2:

I

Speaker 3:

Unfortunately yes. Not great on your pelvic

Speaker 2:

Floor. I never thought about that connection with pelvic floor and, and mm-hmm.<affirmative> bad sodas but yeah, I know people out there are like what? I can't have my bad sodas anymore. Really quick question though. Going back to pelvic floor, how do you test the pelvic floor strength in a man?

Speaker 3:

We can do an external and an internal assessment so externally we can check to see how much they're activating the muscles. Mm-hmm.<affirmative>. So we'll press on the perineum area, which is right underneath the genitals, see how well they can squeeze and relax the muscles. And then for a more accurate picture we can also do an internal assessment that's an internal rectal assessment where we'll see how much they can squeeze the muscles and also relax. But don't fear these aren't things that are required, they're just ways we can test the strength and

Speaker 2:

They certainly don't hurt. Yeah, right. I mean I know men are scared to death of their booty holes being violated. Yes.<laugh>, we talk a lot about that with Dr. Mystery.

Speaker 3:

Oh yes. It's just good information to have and it's not something, not something that everyone has to do if you're uncomfortable, but it's great to know so you can actually know, okay, are the muscles tight? Do I need to work on relaxing them, are they weak? Do we have to work on strengthening them? And then see where you're at because ultimately we're here to help you reach your goals, which is not having any leaking. So we want to figure out where you're at so we can get you there as soon as possible.

Speaker 2:

Gotcha. And what type of exercises do men can they expect or even women with? Um, either of the incontinence, like let's talk about both urge and stress. What um, type of activities or yoga positions or what do you tell them to do or what do you instruct them to do in the room?

Speaker 3:

Yeah, that's a great question. After we evaluate, we'll see what's really going on with the muscles. So we first wanna see if the muscles are a little bit, have a little more tension and tightness and they need to work on relaxing, then you can expect to get exercises more focused on stretching. So things like pulling your knees to your chest or like cat cow stretches, child's post stretches, things to start relaxing and opening the pelvic floor. If after we do the assessment we find the muscles are weak but they don't have that tension problem, we'll do exercises like strengthening. So think of like kele exercises that um, some people might be familiar with mm-hmm<affirmative> where you're squeezing the pelvic floor muscles and relaxing them. And then over time we always wanna start incorporating just other strength exercises to like squats and bridges and maybe some lunges overhead things so that the pelvic floor muscles are working with the rest of your body. Mm-hmm<affirmative> your core, your legs, your glutes, because most people are gonna have these issues when they're upright and moving like on the way to the bathroom or when they're standing. So we wanna make sure that we're training your pelvic floor in all positions. And

Speaker 2:

In men, other than having a prostatectomy, what are the things had they gone through to get to you to where they needed pelvic floor physical therapy

Speaker 3:

For leaking? Like incontinence

Speaker 2:

Specifically? Mm-hmm.<affirmative>. Yeah. Are there other procedures or, or maybe have they had been in like a car accident? Like what are, isn't there more other traumatic events that they could have gone through?

Speaker 3:

Yeah, really any sort of like trauma to the pelvis or any sort of accident or any procedure where they do anything more internally in the bladder, in the prostate, sometimes those procedures where they're working on if people having a large prostate kind of like trying to improve how they, um, urinate. People can have some leaking after that too. Really any type of like surgery procedure, sometimes even abdominal surgeries can kind of trigger some of these things you didn't

Speaker 2:

Even think about that. That makes sense because your

Speaker 3:

Pelvic floor is a core muscle. Right. And it works with your abdominal core too, so some people can have some symptoms after that.

Speaker 2:

Oh that makes sense. Cuz they're down and they're cutting things and they might have maybe cut a little too much or, or your body's like, no, no thank you.

Speaker 3:

Really your body, your body tends to, when you have any sort of surgery kind of tighten up in the area cuz it wants to protect you. Too much tension, too much tightness. The pelvic floor can't work the way it needs to. Mm-hmm.<affirmative> and so we have to reteach the pelvic floor how to do what we want it to do.

Speaker 2:

Gotcha. And other than, um, the urgency, stress incontinence and urgent incontinence, what other, you know, really quickly, what other type patients are you seeing type of patients?

Speaker 3:

Yep. We see a lot of people, people, um, a lot of men will come in with pain like testicular pain or penile pain. Mm-hmm.<affirmative>. Um, that's also, again a lot of times due to tightness and muscles in our sedentary jobs and sitting and not moving a lot. Um, we'll also see people for um, see some people for kind of like abdominal pains that kind of falls along with pelvic pain too. Um, the incontinence leaking after urination, um, erectile dysfunction, having difficulties getting or maintaining erections. Um, ejaculatory dysfunctions, having a hard time with and um, or premature too. So any of the sexual or bladder or bowel dysfunctions is really what we see. Wow.

Speaker 2:

We're busy.

Speaker 3:

We are. Yes.

Speaker 2:

<laugh>, we, we need another one of y'all actually. Yes. So if you're listening and your appellate floor physical therapist<laugh>, please give us a call at(512) 238-0762. And you are also though a yoga instructor in Pilates, is that

Speaker 3:

Correct? Yes, I'm a Pilates instructor and I'm just an avid yogi. Oh, gotcha. Um, yeah, I've been teaching Pilates for going on five years and I've been doing it for like, even longer than that. Um, and I love that. I definitely incorporate that kind of style into the exercises we do. And, um, pelvic floor PT too, it's very catered to you as an individual, so we'll see where you're at. Don't feel like we're just gonna give you like a cookie cutter program like everybody else gets like mm-hmm.<affirmative>, I wanna know what your specific goals are. So if you're leaking and you want to be running, we're gonna work on things related to that. Or if you're leaking when you're picking up, you know, the dog food, we're gonna work on things related to that. So it's always gonna be focused on, um, your goals mm-hmm.<affirmative> and your daily life and how we can get you back to doing those things you wanna do.

Speaker 2:

Awesome. Well it's super specialized, uh, super specific. So if you have questions for Dr. Voz, call us at(512) 238-0762 and check out our podcasts wherever you listen to free

Speaker 1:

Podcasts. The Armor Men's Health Hour is brought to you by urology Specialists. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.