Has your bladder betrayed you since giving birth to your children? Does urinary incontinence regularly ruin your day? Do you get the feeling your pelvic floor is no longer your friend?
Well, ladies, there’s nothing to be ashamed of if you answered in the affirmative to those questions. You are not alone. Millions of women suffer from these urogynecology conditions, and they have suffered in silence due to the stigma and embarrassment often associated with them. Let’s face it. Vaginal prolapse may not be a subject one is eager to broach, even when chatting with your BFFs over cappuccinos at your favorite coffee house.
However, it may be time to have that conversation with Sonali Raman, M.D., the energetic and expertly-trained obstetrician and gynecologist specializing in urogynecology at St. Elizabeth Physicians Urogynecology Newport/Ft. Thomas, and physician lead of robotic surgery at Ft. Thomas.
“I love my job! It’s nice to be able to do what I’ve been training for for 15 years,” Raman says. “I treat women of all ages, from the pediatric age group born with abnormalities of the genital and urinary system to women who are 100 years old.”
In fact, Raman recently operated on a 102-year-old woman who was experiencing discomfort and other difficulties related to vaginal prolapse. On Mother’s Day, no less. “She and her family were grateful that we have a service line that caters to that kind of issue,” she notes.
Relaxation of the pelvic floor due to childbirth, surgery, or genetics occurs in one out of four women,
Raman notes.
“It’s very common, but people don’t like to talk about it. They would rather ignore the problem. It’s embarrassing, and it can cause depression and affect intimacy. We have some great data that says women generally take six years before they see a urogynecologist because they have been shuffled between their doctors and their gynecologist.”
But St. Elizabeth Healthcare, Raman emphasizes, is doing a great job of responding to these disorders so women get the help they need. Treatment is customized according to each woman’s urogynecology issues.
“That’s the best part of my job. I can literally cater the type of surgery, the type of treatment, the type of counseling required once I know what each woman needs.”
She recalls one patient – a mother with three kids, a full-time career and a leaky bladder – who couldn’t jump on the trampoline with her children without experiencing incontinence. Raman recommended a bladder sling, which acts like a hammock to support the urethra and bladder, keeping the urethra closed, thus preventing leaks. The woman was back to work in four weeks and back to being a mom, jumping on the trampoline with her kids with no problems.
“A lot of women don’t realize how much they’ve suffered from these kinds of problems until they are no longer suffering,” Raman adds. For years, women have been told that vaginal prolapse, leaky bladders and the like are just a part of aging. That’s what their moms told them, and what doctors told their patients.
“It’s common, but not normal,” Raman emphasizes. “The thing I tell my patients is, they have to tell their friends about this. We’re trying to do away with the stigma. These are problems most women will go through, so let’s get in front of it so patients don’t have to deal with the negative social and personal implications of a leaky bladder. That’s the big thing – everyone is living longer and is more active. Older women are running marathons and 5Ks. Why should urinary problems be a barrier?”
Robots and Reconstruction
“When you have a breadth of tools and the skillset to do [urogynecological] reconstructive cases, you can do them in a variety of ways and customize them to fit a patient’s needs,” Raman says. “I offer vaginal and robotic options.”
Depending on your particular condition, you may be a candidate for state-of-the-art da Vinci robotic-assisted surgery, a safe, less-invasive type of surgery that is proven effective and results in less post-surgery downtime. Raman recently performed her 100th robot-assisted surgery.
“I am in full control of the robot, in control of its arms,” Raman explains. “I love it because I can decrease the amount of discomfort women experience after surgery.”
When women in the 50-plus age range come to Raman with moderate to severe vaginal prolapse, she often recommends hysterectomy with reconstruction. “With the new DaVinci Xi robot technology at St Elizabeth, I can optimize my dissection and limit unnecessary trauma to the delicate area near the bladder, vagina and rectum – all those organs that are so close together,” Raman explains. “It’s best to seek out a fellowship-trained reconstructive surgeon for these advanced procedures to set yourself up for the best outcome. You need someone who is comfortable working in small spaces and knows how to be flexible in the pelvic floor. The robot helps me have a 3D view and minimize trauma to the neighboring tissue, and oftentimes, I send patients home on the same day as their surgery.”
St. Elizabeth Physicians Urogynecology Newport/Ft. Thomas is located at 1400 N. Grand Ave., Newport, KY 41075. For more information, call 859.757.2132 or visit www.stelizabethphysicians.com/urogynecology