Bladder, bowel and pelvic health issues are extremely common. It’s estimated that one out of every three women will experience some form of pain or dysfunction in the area of the uterus, cervix, vagina, bladder or rectum.
Urogynecology is a subspecialty of obstetrics and gynecology dedicated to diagnosing and treating pelvic floor disorders, such as pelvic organ prolapse, pelvic pain, urinary incontinence, fecal incontinence, overactive bladder and sexual dysfunction.
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Common Pelvic Disorders
- Stress urinary incontinence: Stress incontinence is the loss of urine during physical activity such as coughing, sneezing, laughing or lifting something heavy. These activities cause an increase in a woman’s abdominal pressure, which forces the urine out of the bladder. Some patients will leak only a few drops while others may leak more than a cup. Stress incontinence occurs almost exclusively in women. The most common reason is thought to be due to loss of urethral support from childbirth or aging. Excessive weight can also be a contributing factor.
- Overactive bladder and urgency urinary incontinence: Urge incontinence is a leakage of urine that is experienced when someone cannot delay the bladder's message to empty. They experience "the urge" and often cannot make it to the bathroom on time. This is the most common type of incontinence and is treated with medication. Patients may experience:
- Feeling of a weak bladder or a small bladder
- Difficulty maintaining their urine on the way to the bathroom
- Getting up frequently during the night to urinate
- Frequent , small painful urination
- The need to go to the bathroom frequently, sometimes every one to two hours
- Painful Bladder Syndrome: Also called interstitial cystitis, the chronic condition causes bladder pressure, bladder pain and sometimes pelvic pain. People with severe interstitial cystitis experience a persistent, urgent need to urinate.
- Chronic Bladder Infections
- Constipation: Bowel movements that hard to pass or infrequent – less than three movements per week.
- Fecal incontinence: Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.
Pelvic Organ Prolapse
Pelvic organ prolapse: Prolapse simply means displacement from the normal position. When this word is used to describe the female organs, it usually means bulging, sagging or falling into the vagina. It can occur quickly, but usually happens over the course of many years.
- Diastasis Recti: Abdominal muscle separation that can cause back pain, constipation, urine leaks and a bulge in the middle of the abdomen.
- Painful intercourse: Dyspareunia is the medical term for painful intercourse. It is defined as persistent or recurrent genital pain that occurs just before, during or after intercourse. Treatments focus on the underlying cause, and can help eliminate or reduce this common problem.
- Pudendal Neuralgia: Long-term pelvic pain that is caused by damage to the pudendal nerve – one of the main nerves in the pelvis. The pain may feel like a prickling, shooting, crushing or burning sensation.
- Tailbone pain: Coccydynia is the name of a very painful condition that causes persistent pain at the bottom of your spine or coccyx. It can occur as a result of a fall, childbirth, repetitive strain, surgery or in rare cases by a tumor or infection.
- Vaginismus: An ailment marked by severe tightening or spasms of the vaginal muscles during penetration.
- Vulvodynia: A frustrating condition that creates burning, soreness, stinging, throbbing or itching sensations in the vulva without an identifiable cause.
- Genitourinary fistula: A vaginal fistula is an abnormal opening that connects the vagina to another organ, such as the bladder, colon or rectum. Vaginal fistulas can develop as a result of an injury, a surgery, an infection or radiation treatment. Whatever the cause of a fistula, it may need to be closed by a surgeon to restore normal function.
- Mesh complications: Surgical mesh is a medical device that is used to provide extra support when repairing weakened or damaged tissue. Most surgical mesh devices are made from synthetic materials or animal tissue. Research has shown that surgical mesh for transvaginal repair of POP can cause complications such as mesh erosion, pain, infection, bleeding, pain during sex, organ perforation and urinary problems. Many of these complications require additional treatment, including surgery.
- Rectovaginal fistula: A rectovaginal fistula is an abnormal connection between the lower portion of the large intestine — the rectum — and the vagina. Bowel contents can leak through the fistula, allowing gas or stool to pass through the vagina. A rectovaginal fistula may result from:
- Injury during childbirth
- Crohn's disease or other inflammatory bowel disease
- Radiation treatment or cancer in the pelvic area
- Complication following surgery in the pelvic area