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.
Reasons For Women To See A Urologist
Urologists arent just for men. Women may need to see this type of doctor, too. Urologists are trained to treat problems that affect the urinary tract. This is a system of muscles, tubes and organs, such as the kidneys. Urologists also treat problems with the reproductive system in both men and women.
Some women may want to see a urogynecologist. This doctor is a gynecologist with special training in treating bladder control problems and other conditions involving the female reproductive system and urinary tract, such as pelvic organ prolapse.
Warnings signs of problems involving the urinary tract include:
- Pain in the back or sides
- Pain or burning during urination
These symptoms may signal the need to see a urologist or urogynecologist. Common urinary conditions among women include:
Urinary Tract Infections
Most women will develop a urinary tract infection at some point in their lives. The infection develops when bacteria enter the urinary tract. Women with a UTI may have pain or burning when they urinate. They may also feel a sudden urge to go to the bathroom, but then have trouble urinating. UTIs can be serious, but they also can be treated with antibiotics.
Bladder Control Problems
Women of all ages can have problems with bladder control. Another name for this is urinary incontinence . It is a very common problem among women. Women are twice as likely as men to have this problem.
Other conditions that can cause problems with bladder control include:
What Are The Symptoms Of Prolapse
Physical symptoms include:
- A sense that something is falling out
- Pelvic pressure
- Urine leakage, frequency, chronic urinary tract infections, difficulty urinating
- Difficult bowel movements or trapping of stool
- Painful intercourse because of a bulge or protrusion
Women with pelvic organ prolapse can experience all, some or none of these symptoms.
Women with pelvic organ prolapse often feel alone, isolated and depressed. They may feel embarrassed by this condition and, because the condition is generally not discussed, do not seek treatment.
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Medications For Overactive Bladder
Medications for overactive bladder target muscles that control bladder function. These drugs can be used alone or in combination, and include:
- Anticholinergics such as trospium , darifenacin and oxybutynin relax bladder muscles. They are the most commonly prescribed medications for overactive bladder and are well tolerated. Side effects include constipation and dry mouth.
- Tricyclic antidepressants, such as imipramine and doxepin, stop contractions in the smooth muscle of the bladder. Side effects include dizziness, fatigue, changes in vision, nausea, insomnia, and dry mouth.
Treatment Of Incomplete Bladder Emptying And Urinary Retention
We treat symptoms of slow urine stream, difficulty starting urination, a sensation of incomplete bladder emptying, and urinary retention in men and women. We also treat urinary retention in patients with an enlarged prostate, neurogenic bladder caused by multiple sclerosis, Parkinsons disease, diabetes, back pain , spinal cord trauma, pelvic and spinal surgery as well as brain surgery.
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Finding The Right Doctor For Pelvic Prolapse Surgery
If you plan to have pelvic prolapse surgery, youll want a highly qualified experienced doctor to perform the procedure. While obstetrician-gynecologists commonly perform pelvic prolapse surgeries, female pelvic medicine and reconstructive surgeons specialize in these types of surgeries. How do you find the best surgeon for you? Here are important factors to keep in mind.
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Surgical Treatment For Overactive Bladder
Surgery may recommended for severe cases. The two most-commonly used procedures are:
- increases bladder size by removing a section of the bowel and adding it to the bladder. Increased bladder size allows someone to store more urine, reducing the urge to urinate. Possible complications include infection, blood clots, bowel obstruction, urinary fistula, and an increased risk of bladder tumors .
- Sacral Nerve Stimulation is a newer surgical technique that involves placing a small electrical device in the lower back. The device sends electrical impulses to the sacral nerve, which improves control of the muscles in the bladder and pelvic floor.
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Pelvic Organ Prolapse Stages
The doctor’s diagnosis is made by considering your symptoms, performing a pelvic exam, and possibly doing additional testing. The pelvic exam typically lasts a few minutes and may be conducted while laying down or standing.
If the doctor thinks it is necessary, you may be scheduled for additional testing.
Recovery Time For Bladder Prolapse Surgery
Depending on the type of surgery, you might stay in the hospital for 1 to 3 nights.
Its important to rest for a few weeks after the surgery to allow the area to heal. You will likely have a follow-up appointment with your surgeon a few weeks after the surgery to confirm that its healing well. You may also have additional follow-ups.
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What Medications Treat A Prolapsed Bladder
- In mild cases of prolapsed bladder, estrogen may be prescribed in an attempt to reverse bladder prolapse symptoms, such as vaginal weakening and incontinence. For more severe degrees of prolapse, estrogen replacement therapy may be used along with other types of treatment.
- Estrogen can be administered orally as a pill or topically as a patch or cream. The cream has very little systemic absorption and has a potent effect locally where it is applied.
- Topical administration has less risk than the oral preparations.
Causes Of Sudden Urine Loss
Some women develop symptoms of urinary dysfunction after childbirth or while pregnant. Other women develop symptoms during menopause or from illnesses such as diabetes.
Additional causes include bladder cancers, urinary tract infections, obesity, and a C-section or pelvic floor surgery. Even if you believe you know the cause, it is important to discuss the issue with your gynecologist so you can receive proper treatment.
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Will Sex Be Better If You Have Surgery
To answer this, a recent American study questioned a group of women before and after surgery to repair a prolapse or incontinence. About half of these women were sexually active. Before surgery, 82% of the sexually active women reported being happy with their sex lives, and after surgery, 89% of the women felt happy with their sexual relationship.
However, a study brought out a number of interesting findings. For one, the frequency of intercourse did not change following surgery. And two, while only 8% of the women had pain with intercourse before surgery, 19% noted pain with intercourse after surgery. About one quarter of the women who had a repair of a bulging rectum developed pain with intercourse. About one third of the women who had repair of a rectocele and a bladder suspension had painful intercourse. Unfortunately, the researchers did not ask these women why they were more satisfied with their sex lives even though more of them had painful intercourse.
Another study performed in Sweden may shed some light. This study found that one third of women noted an increased interest in sex after incontinence surgery, and one half of their male partners were more interested in sex. It could be that knowing the repair for the prolapse or incontinence had been addressed was enough to make the couples feel better about sex.
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
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What Else Can Help Prevent Leaking During Sex
Another way to prevent leaking during sex is to keep your bladder reasonably empty during intercourse. Try to avoid drinking fluids for an hour or so before you expect to have intercourse. This will keep the bladder from filling up too quickly once you get into bed. If you empty your bladder just before you begin lovemaking, leaking is much less likely.
Common Pelvic Organ Prolapse Tests
A test that uses x-rays to take detailed pictures of the pelvic organs to help rule out other possible medical conditions
A test that uses a camera to look inside the bladder and urethra to check functions and any abnormalities
A radiological test that looks at reproductive organs, bladder, and pelvic floor muscles
A test to check bladder function, such as urine speed and volume, the ability to fully empty the bladder, and the amount of urine the bladder can hold
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Are There Any Risks With Prolapse Repair
Mesh-reinforced prolapse repair is not appropriate for every patient. There are many considerations to discuss with your doctor, such as your medical and surgical history when deciding whether a procedure with surgical mesh is right for you. Find a list of what to discuss with your pelvic surgeon on the Safety Information page.
Supervising Doctor Of This Article
Koichi Nagao, MD PhD
Professor, Department of Urology, Toho University Faculty of MedicineDirector of Urinary tract reconstruction center, Toho University Omori Medical CenterDirector of Reproduction Center, Toho University Omori Medical Center
Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.
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The Causes Behind Pelvic Organ Prolapse
Your pelvic floor experiences stress from a variety of sources, including:
- Feelings of increased pelvic pressure when you cough or lift a heavy object
- Urinary tract infections become more frequent
The symptoms of bladder prolapse may be worse when you stand for extended periods, or they may ease when you lie down. Sensations accompanying these symptoms may be uncomfortable, but they usually arent painful.
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.
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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.
Cystocele Treatment At Rush
Doctors at Rush treat cystocele with a highly personalized approach. This means your treatment is customized to you based on your age, overall health, the severity of your cystocele and whether you plan to become pregnant in the future.
You and your doctor at Rush can discuss the right treatment for your prolapsed bladder, which may include the following:
Nonsurgical treatments, such as physical therapy, estrogen therapy and wearing a pessary
Surgical treatments, such as minimally invasive procedures that tighten your pelvic muscles and repair your cystocele so you can focus on other aspects of your life
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Strengthening Your Pelvic Floor Muscles
Millions who suffer with urinary incontinence feel like their bladder controls their lives. Control depends on muscles working together. This simple step can control your bladder!
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health
When the bladder fills, the bladder muscles should be relaxed and the muscles around the urethra , called the pelvic floor muscles, should be tight. Exercises that strengthen these muscles can help prevent leakage and calm the urge to go. These are commonly called Ã¢KegelÃ¢ exercises, named after the doctor who developed them. They can help keep your pelvic floor muscles toned and may reduce your problems with leakage or frequent urges to urinate.
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What Is Pelvic Floor Dysfunction
Pelvic floor dysfunction is a common condition where youre unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement. If youre a woman, you may also feel pain during sex, and if youre a man you may have problems having or keeping an erection . Your pelvic floor is a group of muscles found in the floor of your pelvis .
If you think of the pelvis as being the home to organs like the bladder, uterus and rectum, the pelvic floor muscles are the homes foundation. These muscles act as the support structure keeping everything in place within your body. Your pelvic floor muscles add support to several of your organs by wrapping around your pelvic bone. Some of these muscles add more stability by forming a sling around the rectum.
The pelvic organs include:
Normally, youre able to go to the bathroom with no problem because your body tightens and relaxes its pelvic floor muscles. This is just like any other muscular action, like tightening your biceps when you lift a heavy box or clenching your fist.
But if you have pelvic floor dysfunction, your body keeps tightening these muscles instead of relaxing them like it should. This tension means you may have:
- Trouble evacuating a bowel movement.
- An incomplete bowel movement.
- Urine or stool that leaks.
Pelvic floor muscles
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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.
Why Choose New York Urology Specialists For Incontinence And Urinary Problems
- All treatment is performed by a board-certified urologist experienced in treating men and women with symptoms of frequent urination, urge to pee, urinary incontinence, UTI, and other urinary problems using medical therapy, minimally invasive therapies, lasers, and surgery.
- We are one of the few practices in the region to offer a full range of options for treating urinary problems, erection problems in men, and sexual problems in women.
- We offer treatment options for frequent urination, overactive bladder, bladder pain, pelvic pain, and prostatitis in our office. Office procedures avoid the risks, costs, and recovery from general anesthesia.
- We offer diagnostic testing in our office, which avoids hospital costs.
- Extensive experience: Thousands of men and women have been treated successfully with Botox injections for frequent urination, tibial nerve neuromodulation, Interstim sacral neuromodulation, bladder stone removal, kidney stone lithotripsy, urethral sling, and artificial urinary sphincter.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
- We are conveniently located within a 30-60 minute commute to men and women seeking treatment for bladder control problems, enlarged prostate, bladder cancer, urinary, and cancer treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.
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