Pelvic Floor Dysfunction / Urinary Incontinence

Many women are reluctant to discuss urinary incontinence or organ prolapse because they are embarrassed by it and feel it is a normal part of the aging process. Many women suffer in silence, often become limited in their regular activities and lifestyle, rather than seeking help.

Stress Urinary Incontinence (SUI)

Stress urinary incontinence occurs due to pelvic floor relaxation and anatomic changes of the urethra, often associated with childbirth, which causes leakage of urine with increased intraabdominal pressure like laughing, sneezing, coughing or exercise.

Urge Incontinence (UI)

This term is used when involuntary contractions of the bladder muscles causes the patient to have an urgent feeling of having to urinate and often leads to leakage of urine before the patient makes it to the toilet.

OAB

Overactive Bladder syndrome is a condition of the bladder where involuntary contractions of the bladder muscles causes the patient to have an urgent feeling of having to urinate immediately, and this occurs frequently throughout the day, even if the bladder is not full. Unlike UI, patients with OAB do not have urinary incontinence.

Diagnosing the different types of urinary incontinence is relatively straightforward by taking an accurate and careful history. More complicated cases can be assessed by urodynamic testing.

Different treatments are available, depending on the type of incontinence. These include lifestyle and dietary changes, behavioral modification, biofeedback, medication, laser therapy for milder cases, and finally, surgical correction.

Intersitial Cystitis

This is a non infectious bladder condition that causes a patient to feel pelvic and bladder pain and pressure in addition to symptoms similar to OAB which include the sudden need to urinate. Accurate diagnosis is crucial and bladder infection must always be ruled out. There are several treatments for this condition that include pelvic floor rehabilitation, dietary guidelines, medication and bladder instillation therapy.

Pelvic Organ Prolapse (POP)

This term is a general term used to describe relaxation and stretching of the pelvic floor support structures that can occur with age, genetic predisposition, childbirth, as well as obesity and other medical conditions. Organ prolapse can involve the uterus, the vaginal walls as well as the bladder and causes these structures to descend or slip out of place, often protruding through the vagina. This condition can be associated with significant pelvic discomfort and pressure, urinary incontinence, and difficulties with intercourse and bowel movements. Treatments include pelvic floor rehabilitation and surgical correction.