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Wesley Hilger, M.D., FACOGWesley Hilger, M.D., FACOGUrogynecologistSutter Medical Center, Sacramento
Wesley Hilger, M.D., FACOGUrogynecologistSutter Medical Center, Sacramento

Dr. Wesley Hilger’s surgical practice goal is to improve a woman’s quality of life. After finishing a residency in Obstetrics and Gynecology he entered a three year fellowship program at the Mayo Clinic in Female Pelvic Medicine and Reconstructive Surgery. The program was unique in its emphasis on using minimally invasive techniques such as laparoscopy and the da Vinci Robotic System to address gynecologic issues such as urinary incontinence, vaginal relaxation or pelvic organ prolapse, endometriosis and uterine fibroids. Dr. Hilger utilizes the skills he gained in his fellowship training to help women get over often embarrassing and activity limiting problems and get on with the lives they want to live. His ability to use minimally invasive techniques means patients are out of the hospital in a day, have minimal pain and recover faster. Dr. Hilger strives to stay up to date with the latest technology by attending and teaching at national and international meetings.

See Dr. Hilger's profile

Question of the Week

I had a partial hysterectomy at 29. Now, at 43, I have bladder control problems with coughing or sneezing, and not making it to the restroom. This is not a small amount, even if I have recently gone. Is this related to the hysterectomy?

Wesley Hilger, M.D., FACOG answered: Urinary incontinence can be very troubling and have a negative impact on quality of life. It should never be accepted as “just part of getting older”. Developing urinary incontinence is not necessarily associated with a hysterectomy. Depending on the cause of incontinence, there are typically several options to treat the problem and reduce or cure the incontinence.

The symptoms you describe, leaking a large volume with increased pressure put on the bladder with coughing, sneezing, etc. is consistent with Stress Urinary Incontinence. However, you also describe not being able to make it to the bathroom without leaking which is consistent with Urinary Urge Incontinence (also called an Overactive Bladder). When these two types of incontinence are present in the same patient, it is called Mixed Urinary Incontinence.

The key to optimizing treatment for Mixed Urinary Incontinence is to have an appropriate assessment that determines why the bladder is not functioning properly. A physician with experience in treating women with bladder issues will be able to perform such an assessment and then tailor the treatment to your specific symptoms and goals.

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