Different Specialties For Different Ailments
A urologist specializes in the urinary system the bladder, kidneys, ureter and urethra. Its a common misconception that urologists only treat healthcare issues in men. They treat women, too. They provide care for anything related to the urinary tract, such as incontinence, overactive bladder and hematuria .
A gynecologist specializes in the female reproductive system. They provide care for issues related to the reproductive organs, including menstrual cycle problems, fertility and sexually transmitted infections .
Because the urinary tract and female sex organs have a lot of overlap in the body, gynecologists and urologists often work collaboratively to address a patients needs. For example, if youre experiencing pelvic organ prolapse and incontinence, these doctors may work together to treat both conditions.
What Is Bladder Prolapse Surgery With Mesh
Bladder prolapse surgery is most commonly performed through the vaginal entrance. They can also do it abdominal but doctors prefer transvaginal as it is easier, faster, and not as invasive. What they aim to do, is to settle the bladder in its original position and mobilize it. For this, they use a surgical mesh that is made of synthetic material or animal tissue.
Depending on a womans condition and the complexity of the procedure, they do bladder lift surgery with regional, or local anesthesia, or if necessary, under general anesthesia.
A good thing to know about this surgery is that most often, they release women from the hospital the same day after the surgery.
Should Women See A Urologist
Urologists treat urinary tract problems in both men and women.
We see women for any and all symptoms in the pelvis or urinary tract, says Michael Lasser, M.D., urologist and medical director of robotic surgery at JFK Medical Center. Most of the things that urologists treat, such as kidney stones or cancer, can occur in both men and women. And then there are conditions like pelvic organ prolapse that we only see in women.
Here are five of the most common reasons a woman might go to a urologist:
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What Urogynecologists Treat: Pelvic Floor Disorders
Pelvic floor disorders are common and treatable. Urogynecologists treat a broad spectrum of pelvic floor disorders, which includes incontinence issues , pelvic organ prolapse , and pelvic floor dysfunction. Learn more about pelvic floor disorders.
At AHN, we can help women with symptoms such as:
- Pelvic organ prolapse: Vaginal bulge or pressure that may involve organs such as your bladder, rectum, bowel, or uterus.
- Urinary incontinence: Loss of bladder control, including stress or urge incontinence and overactive bladder. Urinary incontinence falls on a spectrum. Some people may dribble a little bit after they pee and some people may need to wear absorbent pads every day.
- Urinary retention: Not being able to empty your bladder all the way, which may feel like you have to pee even though you just went.
- Recurrent urinary tract infections: These are infections that keep coming back. They may affect the kidneys, bladder, ureters , and urethra .
- Fecal incontinence: Loss of rectal control .
- Bladder pain syndrome/interstitial cystitis: Urinary frequency, urgency, burning, pressure, and pain.
- Pelvic floor dysfunction: When your pelvic floor muscles are overactive or too tight, it can cause vaginal pain, painful sex, and pain with activities. Learn more about pelvic floor dysfunction.
- Chronic pelvic pain: Pain in the pelvis, bladder, or bowels.
- : A narrowing of vaginal opening and length, which may require corrective surgery.
What Does A Urogynecologist Do
Urogynecologists handle issues related to the pelvic floor and bladder. This includes overactive bladders, weak pelvic muscles, reproductive issues, and bladder or rectal incontinence . Urogynecologists perform evaluations, diagnose and treat patients.
Your treatment plan will depend on the problems youâre having and their cause. Common treatments are:
Although not all incontinence issues call for medications, some do. Likewise, other pelvic floor conditions might benefit from treatment with medication.
For bladder control issues and other incontinence issues, âbulking agentsâ can be used to help. Urogynecologists can do injection procedures with local anesthesia, outpatient, or in the office.
Pelvic Floor Muscle Training
Exercises called Kegels can help issues like prolapse. Kegel exercises involve squeezing and relaxing the muscles within the pelvic floor. More severe prolapse symptoms can be improved with these exercises — but they wonât correct them completely.
Similar to acupuncture, nerve stimulation treatments can help an overactive bladder.
The urogynecologist could suggest surgery as well. These include:
- Vaginal wall repair
To become a urogynecologist, you need many years of study and firsthand experience.
Typically, the path to becoming a urogynecologist involves:
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Frequently Asked Questions About Pelvic Floor Disorders
Every year, 300,000 American women have an injury during vaginal childbirth that leads to incontinence and other pelvic floor disorders, including prolapse. But what do you really know about these disorders? Here are some of the most common questions that our Michigan Medicine urogynecologists answer about pelvic floor disorders:
Where Can Someone Get More Information On Prolapsed Bladders
- Urologic conditions that can occur around the time a woman goes through menopause include
- bladder control problems,
- bladder prolapse , and
- urinary tract infections.
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Will You Use Transvaginal Synthetic Mesh
The FDA has issued several documents on the use of reconstructive materials for pelvic floor surgery. The conclusions to date have been that transvaginal placement of these materials are of uncertain effectiveness and are associated with safety risks. In contrast, use of synthetic mesh for sacral colpopexy or for full-length retropubic or transobturator midurethral slings was considered safe and effective.
Make sure to ask your surgeon plans to use transvaginal mesh and in what way. This way you can weigh the benefits against the risks.
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What Conditions Does A Urogynecologist Treat
Urogynecologists treat a variety of pelvic conditions and disorders. Sometimes, these problems happen due to trauma from childbirth, frequent heavy lifting, or other strenuous activity. Types of conditions urogynecologists treat include:
- Incontinence of the bladder and rectum
- Pain during sex
You can get referred to a urogynecologist by your primary care doctor or gynecologist. Be sure to bring up any of these symptoms up at your next visit with either of them.
What Treatment Options Are Available For Prolapse
Treatment options depend on the severity and discomfort of the prolapse. Three main choices exist for the treatment of prolapse:
- Do nothing if your prolapse is not bothersome
Vaginal Surgeries: In general, vaginal-approach surgeries have a faster recovery time and cause less pain than abdominal surgeries.
Abdominal Surgeries: Abdominal-approach surgeries are performed through a larger abdominal incision, have a longer recovery time and generally cause more discomfort than vaginal surgeries. Sometimes, however, due to the patientâs anatomy or other existing conditions, the only approach can be an abdominal one.
Robotic-assisted Laparoscopic Surgery: Robotically assisted laparoscopic surgery, with the daVinci Robot, is performed through several very small, one-centimeter incisions with the use of a video camera. The advantage of this approach is faster healing time and shorter hospital stays than with a more traditional abdominal approach.
Top Things To Look For
Find a doctor who:
Is board certified and who specializes in pelvic prolapse surgery
Has experience treating patients with your specific condition
Practices at a hospital known to have high-quality outcomes in pelvic prolapse surgery or gynecologic surgery in general
Accepts your insurance
You are comfortable talking with and who fully answers your questions
Here are five steps to finding the best doctor to perform your pelvic prolapse surgery.
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How To Fix A Prolapsed Bladder Without Surgery
Kegel exercises, special exercises that strengthen the pelvic floor muscles, can help control urine leakage. Estrogen replacement therapy can also help improve muscle strength. In some cases, inserting a pessary may be enough to support the bladder.
According to the American Urological Association Foundation, the stress on the area during childbirth is a significant cause of women getting a bladder prolapse.
They estimate that one out of three women who gave birth vaginally have a stage 2 pelvic organ prolapse. Stage 2 is when the bladder pushes the vaginal wall within 1 cm of the vaginal opening. Surprisingly, many of these women are not aware of it because they have no bothersome symptoms.
What Is A Urogynecologist
A urogynecologist is a surgeon who has specialized in the care of women with pelvic floor disorders.
A pelvic floor disorder occurs when women have weakened pelvic muscles or tears in the connective tissue due to excessive strain on the pelvis due to childbirth, repeated strenuous activity, menopause, chronic disease, or pelvic surgery. Other factors that can weaken the pelvic floor include repetitive heavy lifting, tobacco use, and genetics.
The following are some problems that arise from damage to the pelvic floor:
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Your Chances Of Experiencing Pelvic Organ Prolapse Increase Greatly As You Age Pelvic Organ Prolapse Is Especially Common In Women Who Have Given Birth
Pelvic organ prolapse occurs when organs of the lower abdomen descend, putting pressure on the vaginal walls and causing vaginal bulging. Prolapse is typically due to pelvic floor muscle weakness or damage following surgery or childbirth.
Your bladder is one of the organs supported by the pelvic floor, and shifting or tilting can cause incontinence, pain and tissue damage. If your pelvic organ prolapse is affecting your bladder, you may require bladder surgery to repair or move it.
Reasons To See A Gynecologist
Common symptoms that indicate you should see a gynecologist include:
Increased vaginal discharge and/or color changes in discharge
Itching, swelling, or soreness in the vaginal area
Lumps or sores in the vaginal area
Pain or discomfort during sex
Unusual vaginal odor
Neurological diseases of the bladder
Recurrent urinary tract infections
Talking about issues related to the reproductive and urinary systems can be uncomfortable for women, but its the first step toward getting the right treatment. Stress urinary incontinence, UTIs, pelvic pain, and prolapse are common conditions many women experience, and doctors who specialize in these issues are here to help.
If youre not sure if you should see a urologist or gynecologist, talk to your primary-care doctor. They can refer you to the right specialist to ensure you get an accurate diagnosis and the appropriate treatment.
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Why Is Vaginal Prolapse Surgery Performed
Your doctor may recommend vaginal prolapse surgery to repair or correct weaken or damaged muscles, ligaments and tissues that hold your pelvic organs in place. Problems with this support system, called the pelvic floor, can result in prolapse of the bladder , rectum , bowel , uterus, and vaginal vault . This is common in women who have had children.
Doctors generally recommend vaginal prolapse surgery when your symptoms are severe enough to interfere with your daily life.
Symptoms of vaginal prolapse include:
Difficulty having bowel movements
Pelvic or back pressure or pain
Urinary problems including stress incontinence or difficulty passing urine
Vaginal prolapse is associated with the following conditions:
Prolonged labor or having a large baby
Repeated childbirth or having a multiple birth, such as twins or triplets
Your doctor may only consider vaginal prolapse surgery for you if other treatment options that involve less risk of complications have been ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on vaginal prolapse surgery.
Who Might Experience A Pelvic Floor Disorder
Many things can affect your pelvic floor, but common causes of damage include childbirth, repeated heavy lifting, straining for bowel movements, some chronic diseases, and surgery.
One in three women after menopause is affected by these conditions. With the aging of the baby boomer generation, many of these conditions are anticipated to increase by 50 percent by the year 2050.
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When Should I Contact A Doctor
- If you have any concern at all about any condition with your body
- If you have lower back pain or increased pelvic pressure that interferes with your daily activities
- If you have irregular vaginal spotting or bleeding
- If you experience frequent urinary incontinence, urinary tract infections, difficulty urinating, frequent urination or any of the symptoms listed here that interfere with your daily routine
- If sexual intercourse is painful or difficult
Is There A Possibility Of Recurrence After Surgery
The results of a study carried out by then Radcliff John Hospital in Oxford show that 10.8 % of women undergoing pelvic organ prolapse surgery have a second or third operation within the next 11 years. The study followed a group of 2099 women that had surgery for POP between 1995 and 2005. Worth mentioning is that of the women that needed repeat surgery, 61,5% needed surgery in a different area than the site of the original operation.
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When Should You Have Surgery For Prolapse
Consider surgery if the prolapse is causing pain, if you are having problems with your bladder and bowels, or if the prolapse is making it hard for you to do activities you enjoy. An organ can prolapse again after surgery. Surgery in one part of your pelvis can make a prolapse in another part worse.
Gynecology & Prolapsed Bladder
Obstetrics and gynecology doctors may perform a prolapse surgery buy raising the bladder back up and suturing it in place. The gynecologist may use a mesh sling to support the prolapsed bladder. Prolapse surgery may be a vaginal surgery, or a da Vinci surgery Doctor Weiss performs multiple prolapse surgeries both vaginally and robotically. His other prolapse surgeries are for a rectocele or rectal prolapse and enterocele or small bowel prolapse. You can request Dr. Weiss for your robotic prolapsed bladder surgery or vaginal prolapsed bladder surgery online or by calling 518-4100 or 538-1300. At the Specialty in Obstetrics and Gynecology offices you can also be diagnosed for urinary incontinence, stress incontinence, urge incontinence, urinary retention, and floppy bladder with a urodynamic study to pinpoint the type of incontinence so that you receive the appropriate medical solution.
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Urogynecology Services At Allegheny Health Network: Why Choose Us
Youâll receive empathetic, specialized care and treatment for your pelvic floor disorder. You can expect:
- Highly focused care: The AHN Center for Womenâs Pelvic Health is home to physicians with specialized training in female pelvic medicine and reconstructive surgery. We are experienced at identifying pelvic floor conditions and using advanced treatment options.
- Sophisticated surgery alternatives: We offer noninvasive, specialized alternatives to surgery, including pelvic floor physical therapy, prosthetic devices, medications, and lifestyle modifications.
- Minimally invasive surgeries: We want you to feel better with minimal disruption to your life. Our minimally invasive surgical options offer reduced recovery time.
- Convenience: You can choose from several facilities close to home and throughout western Pennsylvania, so you can start treatment quickly and more easily.
Prolapsed Bladder Care At Home
For mild-to-moderate cases of prolapsed bladder, the doctor may recommend activity modification such as avoiding heavy lifting or straining. The doctor may also recommend Kegel exercises. These are exercises used to tighten the muscles of the pelvic floor. Kegel exercises might be used to treat mild-to-moderate prolapses or to supplement other treatments for prolapses that are more serious.
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What Do I Need To Bring To My First Visit
Fill out the questionnaire sent to your home prior to your visit or fill out the questionnaire at your first appointment. This is a long questionnaire, but it asks important questions about your reproductive and general health and family history. This information will help us help you.
Please bring relevant and important medical records, radiology reports or laboratory reports. We ask that you do not send or fax records to our clinic. Please hand-carry all medical records to your first visit.
Gynecologist Vs Urologist Vs Urogynecologist
Gynecologists are doctors who specialize in the female reproductive system. Most women see a gynecologist for routine exams, which may include Pap smears, STD screening, testing for vaginal infections, and overall health. Gynecologists can also help with family planning and birth control options. If your gynecologist is an obstetrician, they will continue your care through the stages of pregnancy and childbirth.
A urologist is a doctor who specializes in conditions that affect the urinary tract in women and men. They may treat urinary tract infections , incontinence, cancer, and male infertility problems, among other conditions.
A urogynecologist is a physician who specializes in pelvic floor disorders in women.
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