Ascension Saint Agnes Urogynecology

A woman’s pelvic floor is made up of muscles, ligaments and tissue in her lower pelvis. These muscles and ligaments play an important role in keeping organs, such as the bladder and uterus, supported. These organs need to stay in place to function properly.

Pelvic floor disorders (PFD) result from weakened pelvic muscles or tissue tears. As the pelvic floor is weakened, the bowel, bladder, uterus, vagina, and rectum are not properly supported and therefore unable to function properly.

There are many factors that contribute to the development of PFDs. Childbirth, menopause, and aging all may weaken the pelvic floor. Women who are overweight or obese may have increased stress on their pelvic muscles. Medical issues such as nerve conditions, constipation, pelvic injuries, and more can lead to the development of PFDs.

One out of four women over 20 suffer with PFDs. You are not alone in suffering from urinary incontinence, bowel leakage, or sexual discomfort. These disorders are not simply a result of childbirth or aging. Our compassionate team is ready to help you alleviate these issues.

What is a urogynecologist?

A urogynecologist has specialized training in treating pelvic floor disorders, such as urinary incontinence, pelvic organ prolapse, and overactive bladder. Urogyns treat disorders through many means, such as therapy or surgery.

Meet our urogynecologists:

• Dr. Conrad Duncan
• Sondra Barker, CRNP

Comprehensive care

There are a variety of pelvic floor disorders (PFD) that may affect women. From diagnosis to treatment, our team will work with you to alleviate your condition. Although these conditions may be embarrassing to talk about, talking with your nurse or doctor will help diagnose these conditions sooner.

Accidental bowel leakage

Women who suffer from accidental bowel leakage have lost control of their bowels. They may suffer from fecal incontinence (leaking of stool) or anal incontinence (leaking of stool and gas). Fecal/anal incontinence may be caused by damaged nerves or muscles in the rectum and anus. Common causes of fecal and anal incontinence include tears during vaginal delivery, age, and bowel problems.

Constipation

Constipation is defined as having less than three bowel movements per week and straining during a bowel movement. There are many causes to constipation, and about one in three women are affected by constipation.

Fistulas

A fistula is a connection or tunnel between organs or an organ and skin. There are two types of pelvic fistulas: genitourinary and rectovaginal. Genitourinary fistulas exist between the vagina or uterus and part of the urinary tract. A rectovaginal fistula is a tunnel formed between the vagina and rectum.

Interstitial cystitis/ Bladder pain syndrome

IC/BPS is a condition that causes symptoms such as burning, pressure, urgency, and frequency without evidence of a urinary infection. The cause of IC/BPS is unknown, and symptoms vary from woman to woman. Symptom intensity may flare up for hours or days.

Overactive bladder

Women who have overactive bladder (OAB) may feel sudden urges to urinate and may accidentally leak on their way to the bathroom. The muscles that line the bladder squeeze too often and forcefully in women with OAB. Although having OAB may feel embarrassing, many women are affected by this condition.

Pelvic organ prolapse

Pelvic organ prolapse (POP) is a condition in which pelvic organs fall downward into the vagina. POP is caused by a weakening of the pelvic floor muscles and connective tissues. POP is a common condition among women, as vaginal delivery can weaken or damage the pelvic floor. Common symptoms of POP include vaginal dryness, trouble urinating, not being able to wear a tampon, and pressure from the bulge near the opening of the vagina. Not all women have symptoms with POP.

Stress urinary incontinence

Stress urinary incontinence (SUI) is a condition in which a woman’s bladder leaks when placed under physical stress. Examples of activities that may cause leakage include sneezing, exercising, laughing or coughing. This condition affects one in three women over 45 years old. Pregnancy and childbirth, obesity, aging, and constipation are common risk factors for SUI.

Perineal tears

A perineal tear occurs during vaginal delivery when there is damage in the area between the vaginal opening and anus (the perineum). Perineal tears are common during delivery, especially in first-time moms. There are four categorizations of tears. Perineal tear repairs are usually performed following delivery. In some cases, a follow up with a urogynecologist may be needed to complete the repair.

Urinary tract infections

Urinary tract infections (UTIs) are a common condition in women. About 40 percent of women will experience a UTI at least once in their lifetime. Burning with urination is a common symptom of a UTI, as well as cloudy or bloody urine and pain. Women who experience three or more UTIs a year may be diagnosed with recurring UTIs.

Pelvic floor disorders (PFD) can be treated through a variety of both noninvasive and surgical options.

Lifestyle changes

Having an active lifestyle and healthy diet can help manage several PFDs. Eating enough fiber and drinking an appropriate amount of fluid can help with constipation and urinary incontinence. Your doctor may also instruct you to do pelvic floor muscle exercises called Kegels. These exercises strengthen pelvic floor muscles and may help relieve PFD symptoms. Bladder retraining is another option for women with urinary incontinence.

Physical therapy

Your doctor may refer you to a physical therapist for a more robust treatment plan to strengthen pelvic floor muscles. Some techniques that a physical therapist may use include Kegel exercises and nerve stimulation. Biofeedback and percutaneous tibial nerve stimulation (PTNS) are treatments that use electrical stimulation to help strengthen the pelvic floor muscles.

Pessaries

Pessaries are devices inserted into the vagina that provide bladder support or urethral compression. Pessaries may be a solution for women who have pelvic organ prolapse or bladder or bowel control issues.

Surgery

Some women may be candidates for surgery for their PFDs.