Dr. Dawn D. Dewitt, MD

Collectively, anxiety disorders are the most common mental health issues diagnosed in the United States -- even more common than depression. Women are more likely than men to be diagnosed with anxiety, and it is extremely common for a person with anxiety to have another illness at the same time, such as depression, a physical illness, or substance abuse.

Treatment for anxiety usually involves medication and psychotherapy together. Medications used may include antidepressants (which also work for anxiety), anti-anxiety medications, or beta blockers (which can be used to control the physical symptoms of anxiety). Psychotherapy can be useful to teach patients new ways of thinking and reacting so that they can manage their feelings of worry and fear. Support groups can also be very effective for anxiety, and they can be a form of treatment themselves for social phobias. Stress management, relaxation techniques, and meditation all help reduce feelings of anxiety or of being out of control. Finally, having a strong support network of family and friends is an excellent way to help manage the difficulties of life with anxiety.

More and more, gynecologic surgery is moving towards the use of minimally invasive surgery. Minimally invasive surgery uses several small incisions and tiny tools and scopes to perform the operation, rather than one large opening. While it is not appropriate in every case, minimally invasive surgery can lead to less scarring, less blood loss, faster recovery, and a lower chance for infection. Minimally invasive gynecologic surgery may be performed with a laparoscope, a thin tube with a camera on the end that allows the surgeon to see inside the body. It may also be performed robotically, using even smaller tools and cameras that a surgeon controls from a computer. Robotic surgery allows even better vision, precision, and control than laparoscopic surgery.

Over the course of a lifetime, many women need pelvic surgery to stay healthy. Qualified gynecologic surgeons will have the right tools at their disposal to provide care with a minimum of discomfort.

Treatments vary based on the severity of the incontinence. Mild to moderate leakage may be controlled by doing pelvic floor exercises, avoiding foods that can irritate the bladder, or taking medication. For severe incontinence, however, surgery may be necessary. The most common procedures for stress urinary incontinence are bladder suspension, artificial urinary sphincter surgery, and sling surgery.

Each of these procedures takes about an hour to an hour and a half. Patients will likely wake up with a catheter, a tube that drains urine, as swelling after surgery makes it difficult to urinate. Taking slow, short walks to keep the blood flow moving is usually encouraged within hours of the surgery. Although patients may return to work within seven to ten days after certain procedures, strenuous activities such as running and working out are not recommended for at least four to six weeks. In addition, patients should avoid lifting objects over 15 pounds for three months after any of these operations.