Frequently Asked Questions
These questions and answers are meant to address the most common topics of interest in Urogynecology. If you cannot find the answer to your question, please call our office.
What is a urogynecologist?
A urogynecologist is a physican (obstetrician/gynecologist or urologist) who completed residency training in obstetrics and gynecology or urology followed by additional fellowship training focused on female pelvic floor disorders. Currently the typical fellowship length is 3 years for obstetrician/gynecologists and 2 years for urologists.
What kind of disorders does a urogynecologist treat?
A urogynecologists is an expert in treating a wide vareity of female pelvic floor disorders which includes bladder problems, pelvic prolapse problems, female sexual dysfunction and congenital anomalies of the vagina.
What are the female bladder disorders?
Bladder problems include: incontinence, urinary urgency, frequency, voiding dysfunction (difficulty voiding), sensation of incomplete emptying of the bladder, difficulty initiating a urinary stream, urine retention, painful bladder syndromes and painful urination, recurrent bladder infections.
I have leakage of urine when I cough, laugh, sneeze or exercise. Is this just aging?
Urinary leakage on laughing coughing or sneezing is a symptom of what is called “stress urinary leakage”. This is not normal, even with aging. Stress urinary leakage can be due to weakness of the sphincter muscle that controls the urine or due to changes of the angle of the urethra “dropped urethra”. This condition can be treated with surgical and non-surgical approaches.
I have urinary urgency and frequently go to the bathroom day and night.
I have tried medications and they do nothing! What can do?
Urinary Urgency (a sudden, compelling urge to urinate) and frequency (needing to urinate more often than usual) might be a sign of an overactive bladder. Basically , the bladder wall is a muscle that is normally relaxed at all times and only contracts when you want to urinate to push urine out. If the bladder wall has abnormal contractions , it will give you the sensation of urgency and frequency and sometimes involuntary leakage of urine before you reach the bathroom.
Medications act to relax the bladder wall and prevent abnormal contractions. Unfortunatley, a considerable portion of patients discontinue the medication due to minimal improvement of symptoms or side effects of the medication. Patients who fails medications may be a candidate for nerve stimulation therapy.
What is vaginal prolapse and what causes it?
Vaginal Prolapse is a term used to describe “sagging” or “drop” of the bladder, urethera, rectum or uterus. Your physician may refer to these disorders as “cystocele, rectocele or enterocele”. The most common causes of prolapse is injury to the pelvic floor support during vaginal delivery, also aging, menpause and congenital weakness of the natural connective tissue support of the pelvic organs.
If I have "urinary leakage" or "dropped bladder or recturm" do I have to have surgery?
The answer is no. There are a variety of surgical and non-surgical options for treatment. Our physician will educate you regarding your condition and the options of treatment and help you choose the best treatment option for you.
I had a bladder surgery in the past but it did not work. What do I do?
In the past bladder lifts and incontinence procedures had bad reputation for a high recurrence rates. However, the field of urogynecology has progressed and continues to develop everyday. New procedures have evolved. Also the development of fellowship training programs in urogynecology has led the availability of trained experts in the field. The type of the procedure, the level of training of your physician and the severity of your condition are factors that may influence the success rate. Our physician will educate you as to the expected chance of cure and help you take an educated decision regarding your therapy.
What kind of work up would I have prior to proceeding with a treatment plan?
The process starts with a detailed interview with our physician about your symptoms followed by a pelvic examination. Your phycisian might request urodynamic testing, cystoscopy and or an ultrasound depending on your condition.
What is da Vinci robotic surgery?
The da Vinci robotic surgical system is a state of the art system that allows the surgeon to perform most complex and delicate procedures through very small incisions with unmatched precision. For the patient, potential benefits may include: Significantly less pain, less blood loss less scarring shorter recovery time and faster return to normal daily activities. Our physician received extensive robotic surgery training at Mayo Clinic hospital. For more information on robotic surgery visit http://www.davincisurgery.com.