There’s a moment in many women’s lives when laughter, lifting, or even a sneeze comes with a consequence they didn’t expect. It’s not always spoken aloud—not at book club, not at dinner, and rarely at the doctor’s office unless they’re specifically asked. But when women do bring it up, Dr. Alex Culbreth listens.
His office in Valdosta is quiet, efficient. Not sterile in the emotional sense. The walls are soft-hued, and the intake process is direct without being impersonal. That’s where conversations about urinary incontinence begin—not with embarrassment, but with a matter-of-factness that Culbreth insists on modeling. “It’s a symptom, not a sentence,” he once told a patient.
He treats incontinence like a puzzle—one with pieces shaped by age, childbirth, lifestyle, and sometimes diseases like Parkinson’s. And each case begins not with a scalpel or script pad, but with a question: What has your bladder been trying to tell you?
Sometimes the answer is simple: your pelvic floor muscles are weak. Then come the Kegels, the biofeedback sessions, the tiny vaginal weights that seem awkward at first but gradually become part of a recovery routine. Other times, it’s a more subtle fix—training the bladder to wait, teaching the body to break habits that are only reinforcing urgency and loss.
What surprised me most was how much of his care is about patience, not procedures.
Culbreth does perform surgery—he’s known for his robotic-assisted techniques, especially when conservative routes fall short. But he doesn’t push for the operating room. That choice, he believes, should be the final card played, not the first. And when it is time for surgical intervention, like sling procedures or colposuspension, he walks patients through the potential and the pitfalls. No euphemisms, no false promises. Just clarity.
In some cases, the solution is less technical and more behavioral. Diet adjustments, weight loss, avoiding caffeine and alcohol—not revolutionary ideas, but ones that gain power when a trusted physician says them without judgment. “We can’t out-surgeon poor habits,” he’s said more than once.
The emotional weight of urinary incontinence isn’t lost on him either. This is, after all, a condition that quietly dictates lives—where women plan errands around bathrooms and avoid social events out of fear. Culbreth’s approach recognizes this, treating shame not as a side effect but as part of the illness itself.
He’s also one of the few physicians in Georgia pushing for greater patient education about the role of combined therapies. Medications like duloxetine or mirabegron aren’t miracle drugs, but paired with lifestyle changes, they offer real relief. And when none of it works, he helps patients plan for containment—not as a failure, but as a strategy with dignity.
He has served as chief of staff at South Georgia Medical Center and remains active on its Robotic Surgery Steering Committee, but in conversation, he rarely talks about titles. His tone shifts more when recounting the look on a patient’s face after their first dry week in years.
For someone who treats a condition often overlooked or downplayed, Culbreth brings a level of seriousness that doesn’t feel heavy. It feels right.
The truth is, urinary incontinence isn’t rare, and it isn’t trivial. But it has long been treated like a private shame instead of a public health issue. Doctors like Culbreth—quietly, consistently—are shifting that conversation. Not with sweeping pronouncements or flashy campaigns, but by making space in the exam room for honest talk, one patient at a time.