Urinary incontinence—the loss of bladder control—affects 15 to 25 million Americans. Its severity varies from patient to patient, ranging from occasional leakage when coughing, exercising or laughing to sudden, uncontrollable urges to urinate without warning.
Treatment options for urinary incontinence include physical therapy, medications, surgery, nerve stimulators, collagen injections, graft and mesh augmentation and pessary placement (ring device inserted into the vagina to help hold up the bladder and prevent urine leakage).
While urinary incontinence after childbirth is a common concern, it is still an issue that deserves medical attention. The most common type of urinary incontinence after childbirth is stress incontinence caused by increased intra-abdominal pressure. Treatment options depend on the degree of incontinence, future family plans and your medical history. In general, more conservative approaches include physical therapy to strengthen the pelvic floor or an incontinence pessary (device inserted vaginally to give support to the urethra). Surgery is another option.
Kegel exercises, which isolate and strengthen pelvic floor muscles, can make a big difference in bladder control. The easiest way to locate these muscles is to stop and start your flow of urine when you use the toilet. Physical therapists at the Center for Pelvic Health at Anne Arundel Medical Center can recommend various ways to perform Kegels and determine which methods are most effective for your particular condition.
Pelvic organ prolapse, or uterine prolapse, is the loss of musculoskeletal support to the pelvic organs, such as the uterus, bladder and rectum, which may cause these organs to drop or fall out of position.
Mesh augmentation to repair pelvic organ prolapse depends on many factors, including the degree of prolapse, any prior failed surgery and your medical history. If the mesh procedure is recommended by your physician, sacrocolpopexy, a minimally invasive procedure with a good long-term success rate, may be an appropriate option. If you have any degree of prolapse, be sure to visit a urogynecologist for a comprehensive pelvic examination.
The intensity and type of pelvic pain vary from woman to woman. For some, intercourse, inserting a tampon or a gynecological checkup can be painful. For others, pelvic pain may refer to pressure or discomfort around the vaginal opening that makes sitting, walking or wearing pants or underwear irritating. Pelvic pain can also be felt in the abdomen, lower back and hips. The level of pain can range from mild and fleeting to persistent and severe.
Effective treatments for pelvic pain may include physical therapy, topical creams, anti-inflammatory medications, diet modification, pain medications, and surgery.
A urogynecologist is an OB-GYN with additional training and expertise in the evaluation and treatment of conditions that affect the female pelvic organs, as well as the muscles and connective tissue that support these organs.
Urodynamics is the investigation of functional disorders of the lower urinary tract. Urodynamics testing helps identify the conditions causing you to leak urine. The test typically takes about one hour once all catheters are in place. The catheter occasionally may cause some burning or discomfort, and you will also feel the pressure of having a full bladder.
A cystoscopy is a quick, painless procedure that allows your doctor to look directly inside your urethra and bladder using a telescope-like instrument called a cystoscope. Cystoscopy is used to help diagnose problems with the urethra or bladder.