Answers to Your Pelvic Health Questions

This quick, painless procedure allows your doctor to look inside your urethra and bladder with a cytoscope, a telescope-like instrument, to diagnose any problems you may have. 

These exercises strengthen your pelvic floor muscles to help you with bladder control. You can practice by stopping and starting your urine flow while you sit on the toilet. Physical therapists at the Center for Pelvic Health at AAMC can recommend specific Kegel exercises that will work best for you.

If you have a dropped bladder, schedule an appointment with a urogynecologist for a comprehensive pelvic exam. Your urogynocologist can then consider factors like the degree of prolapse and your surgical and medical history. If your doctor recommends mesh augmentation, a minimally invasive procedure called sacrocolpopexy, which has a good long-term success rate, may also be an option.

Some women feel pain during intercourse, when they insert a tampon or have a gynecologic exam. Others feel pressure or discomfort around the vaginal opening that makes sitting, walking, wearing pants or underwear irritating. You can also feel pain in your abdomen, lower back and hips. Pain levels can range from mild and fleeting to constant and severe. 

Urodynamics testing helps identify what is causing your urine leaks. The test takes about an hour and involves the use of catheters. The catheters may cause some burning or discomfort, and make you feel like you have a full bladder.

• Biofeedback
• Electrical stimulation
• Graft and mesh augmentation: Repairs, replaces and/or strengthens with synthetic or natural materials to add support for your pelvic organs
• Pessary: Vaginal ring to help support the bladder and prevent urine leaks. May be an alternative to surgery
• Physical therapy

Loss of bladder control can range from occasional leaks when coughing, exercising or laughing to sudden, uncontrollable urges to urinate. Common causes are pregnancy, the after-effects of surgery, injury or obesity.

Symptoms include:

• Bed-wetting or leaking while sleeping.
• Needing to urinate during sleep.
• Painful urination.
• Strong urge to urinate, whether or not your bladder is full, often including pelvic pressure.
• Urinating more often than usual.

Treatment options include physical therapy, medication, surgery, nerve stimulators, collagen injections, graft and mesh augmentation and pessary placement (a vaginal ring that helps support the bladder and prevent leaks).

A urogynecologist is a doctor trained in urology, gynecology and obstetrics who can evaluate and treat conditions that affect organs like the uterus and bladder.

Pelvic organs like the uterus, bladder and rectum can drop or fall out of position when they don’t have enough support from your surrounding muscles and bones.

Symptoms include:

• A heavy feeling or a lump in the vagina.
• Lower back pain that goes away when you lie down.
• Pain or lack of sensation during sex
• Pelvic pain or pressure.

Urinary leaks after you give birth are often caused by increased pressure inside the stomach. Treatment options depend on the degree of incontinence, future family plans and your medical history. Your options may include exercising to strengthen your pelvic floor or using a pessary (a vaginal ring to help support the urethra). Surgery may also be an option. 

• Adhesions (scar tissue) inside the uterus
• Childbirth
• Genetics
• Hormonal changes, like a decrease in estrogen
• Injury to or irritation of the nerves that supply sensation to the vaginal area
• Muscle spasms
• Postural and musculoskeletal imbalances
• Vaginal or urinary tract infection

Effective treatments include physical therapy, topical creams, anti-inflammatory medications, changes in diet, pain medications and surgery.