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Incontinence specialist joins Urology Department

by Michael Baker
Public Relations 
Eric Rovner, M.D., traversed the United States before settling in South Carolina. The newest associate professor in the Department of Urology honed his skills in California and Pennsylvania before bringing his expertise to Charleston in July.  
  
“I came to MUSC for a couple of reasons,” he said. “It was a good opportunity to join a growing urology department, vigorously led by a new chairman, Dr. Thomas Keane, who expressed a clear and progressive vision of the future. He is remodeling an already strong department into an outstanding, nationally and internationally recognized leader in clinical and academic urology. Moreover, the changing demographics of the Charleston area were such that the MUSC Urology Department was in need of another subspecialist in my area of interest.”
  
Rovner joined forces with Ross Rames, M.D., in the Section of Voiding Dysfunction, Female Urology and Urodynamics, assisting patients who struggle with bladder and urinary problems such as urinary incontinence (uncontrolled urinary leakage) and other pelvic floor disorders. These problems, he asserted, are extremely common but often underappreciated by the public as well as the medical community.  
  
“Urinary incontinence and related conditions rank among the most common problems seen in the general population, and yet it is barely on the medical radar screen,” he said. “Between 20 and 30 million Americans suffer from these problems, representing a larger group than many other well-publicized medical conditions like diabetes, Alzeimer’s disease and virtually all types of cancers.” 
  
He also noted that Americans will spend nearly $30 billion this year for the diagnosis and treatment of urinary incontinence.  
  
“In fact,” he added, “the adult diaper industry rakes in almost $4 billion every year selling these products. The next time you're shopping for food, you'll notice that most grocery stores carry a wider variety of incontinence products than virtually any other item.
 
“Despite this, most people don’t realize how common incontinence really is because it isn’t discussed openly like diabetes or cancer,” he continued. “It’s really a closet condition. People don’t talk about it with friends and family because they are embarrassed or ashamed about it or maybe because it represents a certain loss of self-control, independence or dignity. You just don’t hear much about it publicly, especially in the media. You don’t see public figures such as athletes or movie stars lining up to speak about their own incontinence, and yet we know it 's out there and is a highly prevalent and bothersome condition. Because of this, sufferers aren’t aware that there are excellent and effective treatment options.”
 
Underscoring this point, he added that in several published studies, the only health condition that consistently decreased patient’s quality of life more than incontinence was depression. 
  
“Like those with depression, people who suffer from incontinence live with it every second of every day,” he explained. “They’re always thinking about it, mapping the number of bathrooms between here and there, constantly worrying about public embarrassment.”
  
Fortunately, Rovner brought a great deal of clinical and research expertise on incontinence to MUSC.  While on faculty at the University of Pennsylvania, Rovner wrote more than 100 papers in scientific literature and co-authored a book, “A Woman’s Guide to Regaining Bladder Control.” Among other topics, the book offers tips on treatment options to combat incontinence. 
  
At MUSC, he puts the book’s suggestions into practice, offering a multitude of treatment options for urinary incontinence and other pelvic floor disorders. Similar to his experience in Pennsylvania, part of his job involves breaking down certain myths.
  
“People live with the condition, assuming it’s a natural part of aging, but it’s really not,” he said. “There are many changes to the urinary tract with aging, but none invariably lead to incontinence. Urinary incontinence may be due to a number of causes. Fortunately, with a proper evaluation and diagnosis followed by appropriate individualized therapy, it can usually be treated and often cured.”   
  
As director of the Section of Voiding Dysfunction, Female Urology and Urodynamics, Rovner uses advanced diagnostic testing such as videourodynamics to help direct therapy. A relatively simple test, videourodynamics offers the most precise method for determining the cause for an individual's incontinence.  
  
After identifying the problem, Rovner may suggest a number of therapies, non-surgical and surgical. One example of the former is behavioral modification.   
  
“An integral part of behavioral modification includes pelvic floor exercises also known as Kegel exercises. They are effective for many types of incontinence and are a reasonable and effective place to start therapy in many patients,” he said. MUSC’s Department of Physical Therapy often assists in teaching and reinforcing these therapies, taking into account each patient’s unique needs, desires, and expectations.
 
If behavior modification proves unsuccessful, medications offer another alternative. If all else fails, Rovner may discuss surgical therapy with the patient, highlighting a treatment option that evolved significantly during the last  five to 10 years.  
 
“In the past, surgery for some types of incontinence could take two to three hours to complete, requiring another three to seven days in the hospital to convalesce. This is simply no longer necessary for most patients with today’s techniques,” he explained. ”Now, certain surgeries require a 20-minute outpatient procedure with a 90-percent success rate. The patient often leaves the hospital the same day as the procedure without tubes or catheters.”  
  
In an effort to maximize the considerable talents already available at MUSC, Rovner contacted Steven Swift, M.D., associate professor of gynecology, and in combination with Rames will discuss opening a continence center at MUSC for the advanced diagnosis and treatment of urinary incontinence, pelvic floor dysfunction and urinary tract reconstruction. 
  
Rovner also wants to organize a combined fellowship training program between Urology and Gynecology to offer advanced training to the departmental residents who desire additional post-graduate training.  

Friday, Sept. 3, 2004
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