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Urogynecology and Pelvic Medicine

Urogynecology and Pelvic Medicine2019-09-12T11:13:39-04:00

If you have pain, pressure or leaking “down there,” there’s no need to suffer in silence. CentraState Pelvic Medicine specialists can help you with both surgical and nonsurgical options.

Symptoms like these could be the sign of a pelvic floor disorder—a group of conditions that happen when the muscles, ligaments, and tissues holding the pelvic organs in place become weak and cannot hold up the pelvic organs properly. The pelvic organs are the vagina, uterus, bladder, urethra, and rectum.

Pelvic floor disorders are surprisingly common. They affect about a quarter of all women, more than 40 percent of women ages 60 to 79, and half of women ages 80 and older. CentraState offers surgical and nonsurgical options that strengthen pelvic muscles, restore pelvic anatomy, and enhance your quality of life.

CentraState offers a free lecture on new treatments for pelvic floor disorders by Martin Michalewski, MD. To register for a class, visit our Classes & Events page.

866-236-8727
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866-236-8727
REQUEST INFORMATION

If you have pain, pressure, discomfort, or leaking “down there,” it’s not always easy to talk about. But there’s no need to suffer in silence.

Symptoms like these could be the sign of a pelvic floor disorder—a group of conditions that happen when the muscles, ligaments, and tissues holding the pelvic organs in place become weak and cannot hold up the pelvic organs properly. The pelvic organs are the vagina, uterus, bladder, urethra, and rectum.

Pelvic floor disorders are surprisingly common. They affect about a quarter of all women, more than 40 percent of women ages 60 to 79, and half of women ages 80 and older. CentraState offers surgical and nonsurgical options that strengthen pelvic muscles, restore pelvic anatomy, and enhance your quality of life.

WHO IS AT RISK?

Every pelvic organ has a certain position, shape, and function. Sometimes the muscles, ligaments, and tissues holding them in place weaken due to factors like:

  • Aging
  • Being overweight or obese
  • Childbirth, especially a vaginal delivery
  • Having a past hysterectomy

These factors can increase the likelihood of a pelvic floor disorder like prolapse, which is when an organ moves or drops from its normal position, or incontinence, which is urine or stool leakage. Both men and women can develop a pelvic floor disorder.

risk

WHAT ARE THE SYMPTOMS?

You may have a pelvic floor disorder if you experience any of these symptoms:

  • Pain, pressure, or discomfort in the pelvic area
  • A feeling of heaviness or aching in the vagina
  • Seeing or feeling something coming out of the vagina
  • Trouble urinating or pain while urinating
  • The feeling of having to urinate urgently or frequently
  • Leaking urine when you cough, laugh, or exercise
  • Having many urinary tract infections
  • Leaking stool
  • Constipation
  • Having trouble making it to the bathroom on time

COMMON CONDITIONS

At CentraState, we can diagnose and treat a wide range of pelvic floor disorders and their symptoms, including:

  • Urinary incontinence (urine leakage)
  • Constipation or fecal incontinence (stool leakage)
  • Pelvic organ prolapse—when the muscles or ligaments supporting a pelvic organ weaken, causing the organ to change position or drop from its normal position. Types of prolapse include:
    • Uterine prolapse – the uterus drops into the vagina
    • Rectocele – the rectum bulges into the vagina
    • Cystocele – the bladder drops into the vagina
    • Enterocele – the small intestine bulges into the vagina
    • Vaginal vault prolapse – the top of the vagina loses its support and drops down
  • Pelvic pain—internal or external pain that may include rectal, genital, abdominal, hip, tailbone, or low back pain. Pain can be caused by many factors, such as:
    • Endometriosis
    • Fibroids
    • Interstitial cystitis (painful bladder syndrome)
    • Ovarian cysts
    • Urinary tract infections
  • Painful intercourse
  • Pelvic bleeding
  • Post-childbirth issues like muscle weakness
Common Condition

TREATMENTS

The pelvic floor is a group of muscles that stretch from the pubic bone to the tail bone, acting as a sling or hammock to hold up the pelvic organs. These muscles benefit from exercise just like any others. If they become weak, the pelvic organs drop, which can cause urinary incontinence and other issues. If they become too tight, they can cause pain.

CentraState’s OceanFirst Rehabilitation Center offers a Pelvic Floor Program designed specifically to treat pelvic floor conditions by targeting and strengthening these muscles. Our specially trained therapists evaluate and treat pelvic floor disorders with gentle physical therapy interventions, which typically improve symptoms after a few visits.

Pelvic floor therapy begins with a comprehensive evaluation, and then a physical therapist guides you with specific exercises to help restore the musculoskeletal balance of your pelvis, hip, and trunk regions – so you can regain a healthy and independent lifestyle. Treatment may include:

  • Pelvic floor exercises to strengthen pelvic muscles and improve control
  • Yoga-based movements to increase strength and body awareness
  • Biofeedback/surface EMG to help you know that you’re contracting the right muscles
  • Education on lifestyle changes that decrease bladder irritability
  • Maintaining a bladder diary to aid in retraining your bladder
  • Relaxation and deep breathing techniques

Proactive Support After Childbirth
During pregnancy and childbirth, women’s bodies can shift and change. The three months after childbirth—called the fourth trimester—is an important time for women to regain their muscle strength, as pushing during childbirth often results in weakened pelvic floor muscles. CentraState’s Pelvic Floor Program can help strengthen strained and weakened muscles before problems like urinary incontinence begin.

Contact Us
Talk to your doctor about a referral for pelvic floor physical therapy at CentraState. For more information or to make an appointment, call 732-294-2700.

A pessary is a nonsurgical treatment option for certain women with organ prolapse. A urogynecologist can fit you for this device, which is inserted into the vagina to lift up the pelvic organs. A pessary is a good option for women who are awaiting surgery, do not want surgery, or are unable to have surgery.

Pessaries can be worn all the time or just during the day. They should be checked and cleaned periodically, which can be done at the urogynecologist’s office.

Sometimes medicines can help relieve symptoms for those with certain pelvic floor disorders. For example, medicines that soften stools can be used for certain bowel conditions, and medicines that control muscle spasms or unwanted bladder contractions can help with some types of urinary incontinence.

Changes in diet and lifestyle can also help in some cases. For example, eating more fiber may help with bowel problems. Losing weight can also reduce symptoms for those with certain pelvic floor disorders.

Over the past decade, significant advances have been made in the surgical treatment of pelvic floor disorders. Many of these procedures can now be done on an outpatient basis, enabling you to return home from the hospital on the same day.

The type of surgery needed depends on each specific disorder. For example, in organ prolapse, the first step is for a urogynecologist to distinguish which organ or organs are causing the problem. Then, a solution can be offered that meets your unique expectations and lifestyle.

At CentraState, pelvic floor disorders can be treated in a variety of ways, including:

  • Vaginal surgery: Surgery through an incision in the vagina.
  • Minimally invasive laparoscopic surgery: Surgery is performed through tiny incisions, meaning less scarring and a quicker recovery.
  • Minimally invasive robotic laparoscopic surgery: In robotic surgery, our surgeons use the da Vinci® robotic surgery system to work through the arms of a robot with unmatched visualization and dexterity, along with the benefits of less pain, less scarring, and a quicker recovery for patients. CentraState recently acquired the da Vinci Xi® robotic system – the latest technology in minimally invasive surgical treatment options.

FAQs

The pelvic floor is a group of muscles in the pelvic area that support the organs in the pelvis.

A pelvic floor disorder happens when the muscles, ligaments, and tissues holding the pelvic organs in place become weak and cannot hold up the pelvic organs properly. This can cause issues like prolapse, which is when an organ moves or drops from its normal position, or incontinence, which is urine or stool leakage.

Urogynecologists are gynecologists who specialize in the care of women with pelvic floor disorders. To find a urogynecologist at CentraState, visit Physician Finder.

Female pelvic medicine and reconstructive surgery is a subspecialty in the field of obstetrics and gynecology focused on the latest treatments for pelvic floor disorders. CentraState has a department of Female Pelvic Medicine and Reconstructive Surgery with board-certified urogynecologists.

Specialized physical therapy programs like the Pelvic Floor Program at CentraState can be very effective in treating pelvic floor disorders. After a comprehensive evaluation, a specially trained physical therapist can teach you how to target and strengthen pelvic floor muscles to improve symptoms, often within a few visits. This approach includes pelvic floor exercises to strengthen muscles and improve control, along with biofeedback to help you know that you’re contracting the right muscles.

Robotic surgery is a minimally invasive surgical approach that offers an extraordinary level of visualization and control for surgeons. For patients, benefits include smaller incisions, less scarring, less pain, and a quicker recovery. CentraState urogynecologists have the expertise and technology to treat pelvic floor disorders using the da Vinci® robotic surgery system, including the da Vinci Xi® – the latest robotic technology available.

While it may seem uncomfortable to discuss, there’s no need to suffer in silence with a pelvic floor disorder. If you are experiencing pain, pressure, leaking, or other symptoms that are impacting your quality of life, don’t hesitate to contact a urogynecologist.

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