Dr Fadi | Why Are So Many Women Living with Incontinence? #173

In this episode, consultant obstetrician and gynaecologist Dr Fadi joins Laura for an honest, practical conversation about pelvic floor health, incontinence, prolapse and modern obstetrics. Dr Fadi explains how childbirth, ageing and menopause affect the pelvic floor, and why so many women end up living with stress incontinence, prolapse and faecal incontinence in silence. He walks through the full range of treatment options — physiotherapy, pessaries, urethral bulking, Botox, sacral neuromodulation, robotic surgery, and the mesh procedures paused in Ireland since 2018. The conversation also takes in interstitial cystitis, vaginal oestrogen, why long inductions hit older mothers hardest, and the trade-offs women now weigh up between a vaginal delivery and a caesarean. Dr Fadi closes with a reflection on his time with Syrian refugees, where he met 13-year-old mothers and a 26-year-old grandmother. 🔑 Key Points 1. Pelvic floor problems are common and treatable — Stress incontinence, prolapse and faecal incontinence are usually linked to childbirth, not an inevitable part of being a woman. 2. Mesh for incontinence has been paused in Ireland since 2018 — Ireland is the only country in the world where this procedure is unavailable, and patients are being sent to Spain. 3. There is no single fix for incontinence — Treatment depends on the type, from physiotherapy and urethral bulking to mesh slings, Botox and sacral neuromodulators. 4. Prolapse is not just the womb — Bladder, womb and rectum can all prolapse, each with their own grade and treatment pathway. 5. Pessaries give women back some control — Different types can hold a prolapse in place, and many women learn to manage their own at home. 6. Faecal incontinence is more common than women admit — Third and fourth degree tears can damage the anal sphincter, and primary repair at delivery gives the best outcome. 7. Vaginal oestrogen is a low-risk, high-impact tool — It can ease overactive bladder, recurrent UTIs and dryness, and slow the progression of prolapse after menopause. 8. Older mothers face different trade-offs — Long inductions, instrumental deliveries and unplanned caesareans are more common. Follow us on: 👇👇 📸 Instagram: instagram.com/fabulouspharmacist 💼 Wellness Blog: fabuwellness.com/en-gb/blogs/wellness-blog 💌 Newsletter: manage.kmail-lists.com/subscriptions/subscribe?a=SCV6tN&g=S9dSq8 🤗 Subscribe to Our Channel 👇👇    / @lauradowling   To find out more information about Fabuwellness and Laura Dowling please visit 👉https://fabuwellness.com ⌚Time Stamps:👇👇 01:46 — Introducing Dr Fadi and urogynaecology 02:49 — Why pelvic floor problems happen 05:09 — Robotic surgery and vault prolapse 06:34 — Stress incontinence and mesh as the gold standard 09:01 — Why mesh has been paused in Ireland 12:31 — Sending Irish patients to Spain for mesh 14:25 — Botox for overactive bladder and Interstim 15:43 — Faecal incontinence and tears at delivery 19:17 — Interstitial cystitis and hyaluronic acid 21:21 — Types and grades of prolapse 24:25 — How a pessary works 28:01 — Surgery for prolapse 34:18 — Vaginal oestrogen and pelvic floor 37:25 — Why more women are asking for caesareans 45:00 — Working with Syrian refugees Resources: 👇👇 Love Your Vulva — Laura Dowling's new book on intimate health, available in bookshops, pharmacies, Kilkenny Design and at lauradowlingofficial.com fabÜ Hello Healing — Non-hormonal vaginal moisturising ovules from Fabuwellness — https://fabuwellness.com Continence Foundation of Ireland — https://www.continence.ie Rotunda Hospital, Dublin — https://rotunda.ie 🤝 For supplements created by Fabuwellness please visit fabÜ SHROOMS MENO & PERI https://fabuwellness.com/products/fab... fabÜ R&R RELAX https://fabuwellness.com/products/fab... fabÜ SKIN GLOW https://fabuwellness.com/products/fab... fabÜ SHROOMS IMMUNE https://fabuwellness.com/products/fab... fabÜ FOCUS BRAIN https://fabuwellness.com/products/fab... fabÜ GUT CULTURE https://fabuwellness.com/products/fab... #️⃣Hashtags: #WomensHealth #PelvicFloor #Incontinence #Prolapse #MeshSurgery #UrogynaecologyIreland #VaginalOestrogen #ChildbirthRecovery #MenopauseHealth #DrFadi #TheLauraDowlingExperience