Urogynecology

Department of Gynecology

Patient Instructions

Urogynecology

Urogynecology treats problems affecting the your bladder function in order to precisely female pelvic floor – the urologic, gynecologic, and determine what is causing your bladder problem. rectal organs which, along with the pelvic floor This will allow him/her to recommend treatments muscles, occupy the space between the pubic bone specifically designed for your care. In order to and the tail bone. evaluate your bladder function, you may be asked to complete a bladder diary, undergo a full pelvic Why do I need to see a Urogynecologist? exam, undergo bladder function testing As the name implies, urogynecologists have their (urodynamics), or undergo cystoscopy to examine expertise in gynecology, urology, and bowel the inside of your bladder. dysfunction in women. Due to the close proximity of the pelvic organs, there is a frequent What is Vaginal/Uterine Prolapse? coexistence of problems in adjacent organs. As Due to weakness of connective tissues, the uterus, such, women with a “dropped” vagina may also vagina, bladder, or rectum can drop into the have urinary incontinence or experience trouble vaginal canal and even through the vaginal with bowel movements. It opening. This is termed prolapse. This is analogous is estimated that more than 45% of women will at to a hernia which can occur along the lower some point have problems with bladder control, abdomen due to weakness of the tissue in the 10% have problems with prolapse (dropping) of lower abdominal wall. Prolapse can result in the pelvic organs, and 10% of women may require urinary incontinence if the bladder has prolapsed surgery for correction of these problems. or problems with bowel movements if the rectum has prolapsed. Genital prolapse can range in What is Urinary Incontinence? severity from mild with few to no symptoms to Commonly known as lack of bladder control, severe where a bulge can actually be seen. Due to urinary incontinence is a common problem in adult the delicate nature of the vaginal skin, any women. There are various types of urinary prolapse that extends to or beyond the vaginal incontinence. Your urogynecologist will evaluate opening must be treated. Effective treatment

Department of Gynecology This information is for educational purposes only 2950 Cleveland Clinic Blvd. and should not be relied upon as medical advice. It has not been designed to replace a physician’s Weston, FL 33331 independent judgment about the appropriateness 954.659.5124 or risks of a procedure for a given patient. clevelandclinicflorida.org

Department of Gynecology

Patient Instructions

Urogynecology

options include the use of vaginal devices What treatments are available? (pessaries) or surgical reconstruction. Based on your complete evaluation, your urogynecologist will recommend treatment Types of Urinary Incontinence specifically designed for your case. There will likely Urinary Incontinence can have many different be a few options to choose from. The options may causes. Therefore, proper diagnosis is critical. The include non-surgical treatments such as pelvic floor following are the most common: exercises, oral, patch, or intra-vaginal medications, Stress - Loss of urine with physical activities such devices to help elevate vaginal prolapse, or as running, coughing, lifting, etc. due to weakness surgical therapy to correct an anatomic defect. of bladder support by the pelvic floor muscles. Urge - Loss of urine associated with bladder NOTES: overactivity and an urgent desire to void. ______Mixed - A combination of stress and urge ______incontinence. ______Intrinsic sphincter deficiency: Lack of urethral ______sphincter function, leading to near constant urine ______loss due to an open bladder neck. ______Overflow - Loss of urine due to bladder ______overdistention and a floppy bladder. ______Other causes - Include incomplete bladder ______emptying (urinary retention), urethral spasms, and abnormal urinary channels (fistula). Incontinence can also be a side effect of some medications.