Urogynecology (Pelvic Medicine)
Live life to the fullest again.
Regain control through treatment for urinary incontinence or pelvic organ prolapse.
About one-quarter of all women experience a pelvic floor disorder, whether it’s stress urinary incontinence or a bladder issue. Yet many women are too embarrassed to seek help. If laughing, coughing and sneezing is causing “accidents,” it’s time to find a urogynecologist who will listen to your concerns and work with you to restore your comfort and freedom.
St. Luke’s provides expert urogynecology care, along with physical therapy programs designed specifically to improve pelvic floor strength and function. Our pelvic medicine specialists offer leading-edge treatments and minimally invasive surgical procedures as well as counseling, medication and in-office procedures. In addition, St. Luke’s physical therapists work in tandem with our pelvic medicine physicians and are specifically trained in pelvic floor disorders (leakage, pelvic pain, etc.). Click here for more information about St. Luke’s Pelvic Health Physical Therapy.
Urogynecology Conditions We Treat
- Pelvic organ prolapse
- Urinary and bowel incontinence
- Overactive bladder (urinary urgency, frequency, and waking up to urinate)
- Urinary retention / sensation of incomplete urination
- Childbirth-related pelvic floor injury
- Constipation
- Urethral diverticula
- Vaginal fistulas
- Recurrent urinary tract infections
Who is at risk?
About 40 percent of women who give birth vaginally will develop one or more of the conditions collectively known as pelvic floor disorders. Several key factors raise their risk including:
- Older age of the mother
- Larger weight of the baby
- The number of vaginal births
- Longer second stage of labor (the time spent “pushing”)
- Forceps or vacuum-assisted delivery
- Episiotomy (a surgical cut made in the perineum during childbirth)
Testing for pelvic health
- Complex bladder testing (urodynamics) to measure bladder and urethral functions
- Anal manometry to measure rectal function
- Anal ultrasound images the anal sphincter muscle involved in bowel and gas control
Therapy for pelvic health
- Pelvic floor exercises to strengthen the pelvic floor muscles and decrease bladder and bowel urgency
- Biofeedback and electrical stimulation therapy to help patients to find and effectively work their pelvic floor muscles
- Fluid and dietary management
- Bladder retraining or scheduled voids
- Medication therapy
- Bladder instillation treatments
Click here for more information about St. Luke’s Pelvic Health Physical Therapy.
We offer various minimally invasive surgical treatment options catered to your goals and preferences. Most surgeries do not require overnight stay in the hospital.
For prolapse, these include both laparoscopic/robotic and vaginal surgical approaches, mesh-augmented and native-tissue surgeries, as well as surgeries that include:
- Hysterectomy or preserve the uterus
- Laparoscopic/robotic sacrocolpopexy
- Laparoscopic sacrohysteropexy
- Laparoscopic uterosacral suspension
- Vaginal sacrospinous ligament suspension and vaginal uterosacral ligament suspension
- Vaginal anterior and posterior vaginal wall repairs (colporrhaphy)
For "stress" urinary incontinence that occurs with physical effort (e.g. laughing, coughing, sneezing) we offer urethral slings of various types and supportive urethral injections (Bulkamid; with the benefit of minimal recovery period).
For urinary urgency/frequency and "urge" urinary incontinence we offer bladder Botox injections, office based tibial nerve stimulation therapy, and sacral neuromodulation devices (Axonics and InterStim).
Sacral neuromodulation devices (Axonics and InterStim) also are treatments for urinary retention and accidental bowel leakage. This technology helps improve control of these functions.
Many times, women believe pelvic floor disorder symptoms are a normal consequence of childbirth or a normal part of aging. Women are often too embarrassed to mention these problems to their doctor. The truth is that pelvic floor disorder symptoms, although common, are never a “normal” part of childbirth or aging. Let us help improve your quality of life.
Your health matters: find the right urogynecologist.
Managing pelvic health can feel personal and sometimes overwhelming, but finding expert, compassionate care shouldn’t be. Whether you’re experiencing bladder issues, pelvic floor discomfort or navigating changes related to aging or childbirth, our urogynecology specialists are here to help.