‘Dropped uterus’ frequent cause of incontinence

Dear Dr. Gott: I have a dropped uterus. When I need to go to the bathroom, I must go or it will come out on my panties. If you have an answer to this problem I would appreciate it.

Dear Reader: Your problem, which you have well expressed in two short sentences, is common. Female urinary incontinence has many causes, the most frequent one being a “dropped uterus,” a weakness of the suspensory tissue of the womb, a consequence of multiple pregnancies.

When the uterus is “mobile,” it can interfere with bladder control and lead to incontinence, both dribbling and outright urination.

You should start with your gynecologist, who may urge you to consider an operation to stabilize your uterus (or remove it). If his or her recommendations are not acceptable, your next step is to be examined by a urologist, especially one who has an incontinence nurse in the office. Such a professional will teach you certain control exercises and techniques that could delay your need for a hysterectomy.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: My questions pertain to tetanus shots. I’m getting conflicting reports. How long is a shot good for? Also, should it be updated after an injury or surgery? And, finally, is there a difference between a tetanus shot and a booster shot?

Dear Reader: Childhood immunizations consist, in part, of three spaced tetanus injections. Booster shots are recommended every 10 years. In the presence of a severe injury or a puncture wound, experts advise booster shots regardless of the timing of a previous tetanus inoculation. The booster shot is the same as regular tetanus toxoid and often protects against diphtheria as well.

Dear Dr. Gott: I am a 52-year-old male in generally good health. I have regular daily bowel movements. I have observed during the past year that my stools are flat, not round. Is this evidence of a collapsed colon?

Dear Reader: Changes in bowel movements, as well as an alteration in the shape of the stool, are red flags for doctors. Although your “flattening” may be inconsequential, it should not be ignored. I don’t want to frighten you, but the doctors must be sure that this is not caused by a rectal tumor; therefore, I advise you to bring this matter to your physician’s attention. Unless I am way off base, I predict that he or she will refer you to a gastroenterologist or a surgeon for a colonoscopy. Don’t delay. You need a diagnosis now.