Godiwalla Shirley Y MD Sc

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Shirley Y. Godiwalla, MD SC offers solutions and treatments to urological conditions.
Dr. Godiwalla works closely with patients to find urological solutions to fit the patients lifestyle. A recent publication was written about how bladder pacemakers inserted into patients offer hope to patients with incontinence problems.

Story by JoAnn Petaschnick
More than 13 million American men and women suffer from urinary control problems, with an estimated one million new cases diagnosed each year. Problems range from urge incontinence to retention to frequency. People with these conditions often face devastating challenges in their everyday lives, including constant trips to the bathroom, sleepless nights and just plain fear of loss of control. In fact, some individuals become so apprehensive about the problem that they become prisoners in their own homes.
It is true that treatments are available to help relieve the symptoms of urinary incontinence, but studies show that they dont necessarily bring satisfactory results. Treatments include behavioral modification techniques such as bladder retraining, pelvic muscle exercises and biofeedback, as well as medications such as antispasmodics, or even antidepressants.
Dr. Shirley Godiwalla, an urologist on staff at Community Memorial Hospital in Menomonee Falls, has been studying the difficult problems associated with incontinence. She has dealt first hand with many patients suffering the debilitating effects of this illness, and she has genuine concern and sympathy for their suffering. Imagine having to plan trips away from your home around knowing where every restroom is along the way. And imagine having to devise tricks that can help you escape work or social situations on a moments notice, said Godiwalla.
There are many people for whom this is not an imaginary problem or just an occasional bother. These are people who cannot leave their homes because they have to urinate as often as every 15 minutes, according to Godiwalla. They have to make drastic lifestyle adjustments. To top it off, approximately 85 percent of those who suffer are women between the ages of 30 and 59 those in the most active years of their lives.
Fortunately, there is hope for people who have found behavioral and drug treatments unsuccessful. The Sacral Nerve Stimulation System, also known as InterStim Therapy or the bladder pacemaker is available to patients with serious urge incontinence, as well as significant symptoms of urgency-frequency and non-obstructive urinary retention. The device, developed by Medtronic, Inc. looks very much like a heart pacemaker (also manufactured by Medtronic), and like the heart pacemaker, it provides a more normal life for individuals with a serious illness.
InterStim Therapy is mild electrical stimulation of a sacral nerve in the lower portion of the spine. The pacemaker, which consists of a lead, neurostimulator and an extension, is surgically implanted in the patients lower back and, if successful, should help regulate the urge to urinate. But while other surgical procedures are available (bladder augmentation, bladder denervation or removal) they are not reversible and InterStim Therapy is reversible, Godiwalla explained.
Obviously, not every person with urinary incontinence is a candidate for InterStim Therapy. When a patient comes to Dr. Godiwalla with incontinence, she performs a series of tests and then tries a variety of therapies, depending upon the type of problem the individual has. This is not for every patient, especially older patients in their seventies or beyond, she said, primarily because the nerves usually dont respond as well as they do in younger patients.
InterStim Therapy is recommended only after other, more conservative therapies have been tested because the problem could be caused by other conditions. We have to show that we have tried other things, Godiwalla noted. Usually, she will perform an internal examination acystoscopy to rule out organic problems such as infections or tumors.
The results speak for themselves. Patients who have had the implant are running their own lives again. They are finding they will urinate every two to three hours instead of 15 minutes, Godiwalla said. The satisfaction of the patient the smile on the patients face is what is important.
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