HCA East Florida - October 15, 2020

Ask a Doctor: About Dr. Jeffrey Schachar, MD, FACOG

As women, it’s important to be aware of and communicate changes in your health to maintain your well-being and prevent disease. As your partner in health, your doctor can answer any questions you may have - no question is too small or embarrassing. From planning to have a baby to the treatment of cancer, specialized care is required throughout a woman’s lifetime to maintain long-term health.

An important area of women's health is urogynecology, focusing on conditions that affect the urinary system and pelvic area. Read on as Dr. Jeffrey Schachar, a female pelvic medicine and reconstructive surgery specialist at Plantation General Hospital, provides helpful answers to six common questions many patients are too nervous to ask.

To learn more about the women's health services offered at Plantation General Hospital, please call our Consult-A-Nurse® team at (954) 321-4099.

Q. Do all women experience urinary incontinence after having a baby?

  • Urinary incontinence, or accidental leakage of urine, is fairly common among women, but not everyone has it. Urinary incontinence is more common as women get older, but it does occur in younger women as well. Roughly 10-15% of women over the age of 20 experience incontinence, whereas more than half of all women over 65 years old experience incontinence. There are many reasons why some women are at higher risk than others, and pregnancy is such a factor. However, there are many women who have never been pregnant who have urinary incontinence as well. Urinary incontinence is also fairly common during and shortly after pregnancy but usually resolves a few months after delivery. If you are suffering from bothersome urinary incontinence you should speak to your doctor about what can be done and consider making an appointment with a Urogynecologist – a gynecologist specializing in these types of urinary issues.

Q. Sometimes I leak when I run or do high-impact activities. Why?

  • Leakage of urine associated with activities such as running, jumping, coughing, laughing, or sex is called Stress Urinary Incontinence. This typically results from increased pressure in the abdomen, and the muscles that generally keep the urine in the bladder aren’t strong enough to hold the urine when there is increased pressure. This lack of support results in urine leakage during these activities.

Q. What is the purpose of Kegel exercises? Do they work?

  • Kegel exercises are important for strengthening the muscles in the pelvic floor. They can help to prevent or treat mild cases of urinary incontinence or pelvic organ prolapse. Pelvic organ prolapse is when the pelvic organs (bladder, uterus, bowel) push into the vagina, and many women feel a pressure or bulge sensation in the vagina. Some women can easily perform Kegel exercises, whereas others need guidance on how to perform them correctly. When instruction is needed, either your Gynecologist or Urogynecologist can provide some guidance. Still, some women benefit from seeing a Pelvic Floor Physical Therapist who can help to teach them how to perform the Kegel exercises properly.

Q. When should I talk to a doctor about female incontinence issues?

  • You should always feel comfortable talking to your doctor about any issues that you may be experiencing. We can’t help if we don’t know that there is an issue. Depending on the leakage level and how bothersome it may be, there are many causes and a wide range of treatment options. While urinary incontinence is common, it is not “normal”. At the end of the day, I review all of the treatment options with my patients, and we discuss which option is the best fit for them and their specific situation. Talking to your doctor is the first step, and it is a critical one. Ultimately the treatments or therapies we decide to proceed with is completely up to you as the patient.

Q. As I get older, I notice I sometimes urinate when I laugh. Is there a treatment option for this?

  • Yes, there are many different treatment options for Stress Urinary Incontinence. Depending on the evaluation of the severity of the leakage, some options may work better than others. We always start the discussion with the most minimal therapies, basically lifestyle changes that you can do without medications, surgery/procedures to improve your symptoms. If those don’t work at all or are inadequately treating the issue, there are office procedures and minor outpatient surgeries (same-day) that can be performed to improve your symptoms significantly

Q. As a woman, what are questions I should be asking my doctor?

  • Always ask your doctor about scheduling general health and wellness exams or needs, such as an annual physical, immunizations, breast exam, pelvic exam, and Pap test. You should also consult with your doctor before making lifestyle changes, such as diet or exercise.

Other questions you can ask may include:

  • What does this test involve?
  • Does this test or medication have side effects or dangers I should know of?
  • What has caused this condition? Is my condition permanent?
  • What long-term effects will this treatment have on my life? Are there other treatments available?
  • How much does this test cost? Are there any other options?
  • What do I do if I miss a dose of medication? Are there generic brands of my medication available?
  • Is there anything I should be aware of while taking this medication?

 

Women’s Care at Plantation General Hospital

Whether you are in adolescence or menopause, seeking preventive care or treatment, your individual needs come first. Plantation General Hospital is committed to supporting women through every stage of life. 

About Dr. Jeffrey Schachar, MD FACOG

Dr. Jeffrey Schachar is board certified in the field of obstetrics and gynecology with a subspecialty in the field of Female Pelvic Medicine and Reconstructive Surgery (Urogynecology), practicing at Florida Robotic and Minimally Invasive Urogynecology (FRMIU) in Plantation, Florida. He provides individualized medical and surgical care for women with pelvic organ prolapse, urinary and fecal incontinence, interstitial cystitis, recurrent urinary tract infections, mesh complications, fistulas, and pelvic floor dysfunction. Dr. Schachar is proficient in minimally invasive and robotic surgeries, as well as advanced vaginal surgery techniques.