Women’s Pelvic Health

By Briana Walton, MD

Anne Arundel Medical Center

. https://briwaltonmd.com/

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Women’s Pelvic Health

Happy Women’s History Month and as we celebrate HIStory do not forget about HERstory.

Many patients, and for that matter providers, have not heard of the sub-specialty of urogynecology, which is the discipline that combines the experience of urology, gynecology and colorectal surgery. The sub-specialty focuses on pelvic floor disorders, which include problems with the three “B’s”: bladder problems, bowel dysfunction, and bulges below the belt.

As we celebrate Women’s History Month, let pelvic floor disorders be in your rearview mirror and a part of your history as you seek treatment for these embarrassing and sometimes life-altering conditions. A multidisciplinary program that combines treatments from fellowship-trained and double board-certified specialists in obstetrics and gynecology, female pelvic medicine and reconstructive surgery is a one-stop stop for diagnosing and treating all pelvic health needs.

Female Urinary Incontinence/Loss of Bladder Control

Experts in the clinic strive to help women improve bladder control, eliminate leakage and enjoy a more normal lifestyle. From biofeedback to physical therapy to surgical interventions, there are many treatment options available depending on the severity of incontinence. Treatment options also include:

• Pelvic floor physical therapy

• Pessary fitting

• Peri-urethral bulking agents

• Urethral sling surgery

• Posterior tibial nerve stimulation

• Intravesical botox

• Sacral neuromodulation

• Pelvic organ prolapse (the dropping down of female pelvic organs including bladder, vagina, rectum due to loss of vaginal support)

Many women are able to reduce discomfort and pressure from a pelvic organ prolapse with nonsurgical treatment, which may include making lifestyle changes, doing exercises, and/or using a removable device called a pessary that is placed into the vagina to support areas of prolapse.

Surgical procedures used to correct different types of pelvic organ prolapse include:

• Repair of the bladder (cystocele) or urethra (urethrocele)

• Removal of the uterus (hysterectomy)

• Repair of the rectum (rectocele) or small bowel (enterocele)

• Repair of the vaginal wall (vaginal vault suspension)

• Closure of the vagina (vaginal obliteration)

• Accidental bowel leakage (fecal incontinence) and constipation

Many patients do not know medications and dietary changes can help. Pelvic floor physical therapy with biofeedback is an integral part of treatment. For people whose symptoms do not improve with these first-line therapies, there are innovative approaches including nerve stimulation, bulking injections and surgery to repair muscle disruption.

This program empowers women through education and enlightenment. Our knowledge of pelvic floor concerns/conditions/disorders help women make great decisions for themselves.