What are Hemorrhoids?

Published on Jul 21, 2016

Hemorrhoids are painful varicose veins in the anal area, which can get inflamed and cause significant pain and discomfort.

Traditional surgical treatment involves excision of the hemorrhoids that can be very painful with a long recovery time. Using radiofrequency and electrocautery, we are able to treat a large number of hemorrhoids, under local anesthesia, as an out-patient procedure.

An office evaluation of the anal area is necessary to qualify for this treatment and rule out other causes of pain and discomfort such as anal fissures, tumors, infection, abscess, polyps or cancer. Once hemorrhoids are identified, in most cases local treatment involving emollients and steroids are sufficient to relieve the pain. However, if the hemorrhoids are recurrent, treatment using these outpatient techniques are employed.

Treatment requires a duration of less than 15 minutes. Local anesthesia is used. With no down time, in most cases, the patient may return to his or her normal activities subsequent to the procedure. Multiple treatments may be necessary to allow for complete resolution of the hemorrhoids.

For patients that qualify for this treatment, this may be a solution much more tolerable than the traditional excisional treatment.

Postpartum Urinary Incontinence

Published on Jul 7, 2016

Postpartum urinary incontinence is post-baby urine leakage no one wants to talk about.

My patient and her friend who recently had children were in the gym trying to get back into shape. It was a routine that involved jumping, dance moves, and exercises aimed at building their core. Even though the moves were fun and they were getting a lot of good exercise, they suddenly noticed they were leaking urine with workout moves that required any type of straining. They now wear black and stand near the exit closest to the bathroom and buy panty liners by the bulk.

Why some have this issue and others do not?

During pregnancy and labor, muscles that support the pelvis and the pelvic floor muscles come under significant stress. During pregnancy, the weight of the baby causes stretching and pressure. During labor, tearing and damage to the muscle fibers and nerves can cause changes in the support they provide.

In ordinary circumstances, when we sneeze the pelvic floor muscles squeeze and stop the flow of urine. After the damage, the squeeze is a lot less effective and sometimes beyond their body’s ability to repair itself.

What can be done to fix it?

The good news is much can be done to help you with this problem. Pelvic floor exercises during and post-delivery can strengthen the muscles and help reduce the damage and encourage repair. Kegels are one such exercise. Kegels can be augmented with physical therapy to involve the internal and external abdominal muscles and back muscles that contribute to the functioning of pelvic floor muscles.

Weight loss is also crucial to regaining control. Studies show 10% weight reduction reduces incontinence by 40%. A healthy weight loss program is crucial to a healthy pelvic floor.

Surgical and non-surgical options include injection of bulking agents, repair of the defects, injection of Botox, and placement of nerve stimulators and are reserved for patients that do not respond well to conservative management.