MAY 16, 2012

We aren’t talking about car seats

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dr dave“Hey, you’re in town?”

“Well the beerfest Olympics are on and …”

“No. “You’re in town” is the name of a play, a comedy. Lets go.”

And so I sashayed down to the fee-ate-her to watch WHAT??!  

“Urinetown!” A dripping saga about … well … actually it’d spoil the show if I let it leak out.
Urologists live in the real life of Urinetown, heck they live in Urineworld (not unlike Kevin Costners’ Waterworld but with more scopes and nurses, less shooting.) Poor urologists get to address not only urological problems but also must endure questions about strokes and headaches after having been introduced at the golf club social as “a neurologist.” As Dr. Pete “The Plumber” Pommerville, “an urologist” extraordinaire, sums it up “Just call us a peeologist and be done with it but quit calling me at 3 a.m. about Mrs. Hornwiggle’s nervous twitch.”

I sat down with Dr. Pommerville to discuss the world of snakes and bladders.

Me: “So big Peter, you and I hail from the same hometown of Carleton Place, Ontario, how come our paths deviated so widely and I’m a GP while you ended up in urology?”

PP: “Well I’m smarter than you. Now let’s talk about incontinence. OAB (Over Active Bladder) is a bladder matter easily identified by the OAB victim carrying a GPS with all bathrooms accurately marked within three square miles of wherever they’ll be. This dastardly drip can often be plugged quite effectively with one pill a day. But for those who don’t want to pop pills there is a new technique I’m using injecting Botox into the bladder wall.”

Me: “To relax the bladder tension?”

PP: “No, for cosmetic purposes you pecker head (classic urologist’s insult). Of course it’s to relax and soothe the spasticity of the bladder and makes life flow with ease. I do a lot of these primarily because left over Botox I get to use on my crow’s feet.  A different but often simultaneous problem is “stress incontinence” which refers to the stress the woman has each time she laughs or coughs and ends up knocking out someone’s eye. Urine leakage can get so bad that Depends are at the top of the grocery list. If Kegels exercises (which entails screaming “KEEEEGLE” every time you tighten your pelvic floor) don’t work then this condition is corrected by means of a simple bladder suspension. “The suspense is killing me, I hope it’ll last.” Willie Wonka”

ME: “What about bladder infections?”

PP: “When we as urologists say “OK girls Front-to-Back” we aren’t talking about car seats. Girls and bladder infections are like tax season or dentists – unpleasant events that come around all too often.

Men have a built in urethral defense mechanism known as length, put there deliberately by that great urologist in the sky because he knew men wouldn’t go to a doctor with a bladder infection until their kidneys were floating somewhere up by their Adams Apple.

But women have short urethras, which bacteria delight in zipping up wherein they find a huge inviting pool of urine and dive right in. 

They have a party, invite friends, make new friends (literally make them) and the poor host, irritated by all this partying, feels a sense of urgency, frequency of urination, discomfort and sometimes even blood in the urine.

As gals age they make less estrogen, a hormone that normally stands guard over the urethra like a reform school nun. It turns bacteria away when they come knocking on the urethral door. So I often give an estrogen cream to post menopausal women with recurrent bladder infections. Makes ‘em feel like an Olympic athlete, at least at the beerfest.”

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