NON-SURGICAL TREATMENT OPTIONS
Following a bladder diet is avoiding food and beverages that irritate the bladder and intensify urinary symptoms. A "bladder elimination diet" is a way to determine which particular foods and beverages worsen your symptoms. Click here to learn more about bladder irritants.
Bladder instillations are repeated instillations of lidocaine, heparin, and other substances into the bladder to decrease bladder pain. The mixture is instilled through a small catheter inserted into the bladder through the urethra two times per week until the desired results are acheived.
Clean Intermittent Self-Catheterization
Clean intermittent self-catheterization is for women with problematic urinary retention. A woman inserts a small tube through her urethra into her bladder for a few seconds after she urinates to drain her bladder completely. Click here for more information on clean intermittent self-catheterization.
Colpexin™ Sphere Intravaginal Device
The Colpexin™ Sphere is a removable device that is worn in the vagina to elevate vaginal prolapse and/or enhance the performance of Kegel exercises. Click here for more information on the Colpexin™ Sphere.
Kegel exercises strengthen the pelvic floor muscles. These exercies can help control stress urinary incontinence, urge urinary incontinence, overactive bladder, fecal incontinence, and can help slow the progression of vaginal prolapse. Kegel exercises must be done correctly and regularly to work. Click here for more information on Kegel exercises.
Low-Dose Vaginal Estrogen
Low-dose vaginal estrogen replaces declining estrogen in vaginal and urethral tissues easing symptoms of vaginal dryness, itching, and irritation as well as urinary urgency, frequency, and incontinence. Low-dose vaginal estrogen comes in a cream (Estrace™ or Premarin™), suppository (Vagifem™), or a ring (Estring™).
Overactive Bladder Medications
There are several brands of overactive bladder medications on the market to treat urge urinary incontinence. These medications work by relaxing the bladder muscle. Side effects are usually mild and include dry mouth, dry eyes, blurred vision, urinary retention, constipation, dizziness or drowsiness. Changing the brand or dose of medication can decrease side effects. To learn about the different brands of overactive bladder medications, click on the links below:
Pelvic Floor Therapy
Pelvic floor therapy consists of a series of visits to a physical therapist with specialized training in the treatment of pelvic floor problems. The physical therapist uses a combination of the techniques listed below depending on the type of urogynecological condition present.
Behavioral modification - education on diet, fluid intake, and other lifestyle changes to manage various bothersome symptoms.
Bladder training - learning to use the pelvic floor muscles to suppress overactive bladder symptoms (urinary urgency, frequency, noturia, and urge urinary incontinence).
Biofeedback - intravaginal device used to train the pelvic floor muscles to contract or relax correctly.
Functional electrical stimulation - a device that can be used intravaginally or externally that delivers a gentle electrical current to activate or relax the nerves and muscles in the pelvis.
Manual therapy - pressure is applied to and released from muscles in spasm to relax them and increase blood flow to the area for healing.
Joint and tissue mobilization - gentle manipulation to help calm the muscles and nerves of the pelvis.
A urethral insert is a small disposable device worn in the urethra to temporarily block leakage of urine due to stress incontinence. The device is removed for urination. Click here for more information on urethral inserts.
A vaginal pessary is a removable, diaphragm-like device worn in the vagina to support vaginal prolapse and/or decrease stress urinary incontinence. There are a variety of types and sizes of pessaries available. A pessary fitting includes two or more office visits to find a type and size of pessary that will work for you. Click here for more information on vaginal pessaries.
SURGICAL TREATMENT OPTIONS
InterStim™ Therapy is an FDA-approved treatment for urinary urgency, frequency, urge incontinence, and retention. The InterStim™ is a small device that is implanted under the skin of one of the upper buttocks. It works by gently stimulating the sacral nerves to help the bladder function more normally. Click here for more information on InterStim™ Therapy.
Anterior Colporrhaphy (Anterior Repair)
An anterior colporrhaphy repairs the wall between the vagina and the bladder. A pliable piece of material called a "graft" can be placed between the vagina and bladder to strengthen the repair. There are many types of grafts available.
A hysterectomy is the surgical removal of the uterus. This is the surgery done to repair a severe uterine prolapse. A hysterectomy can be done through a vaginal or abdominal incision.
Paravaginal Defect Repair
A paravaginal defect repair is a type of surgery to repair an anterior vaginal wall prolapse. This surgery reattaches the sides of the vagina to their normal attachments in the pelvis. This procedure can be performed vaginally or abdominally.
Perineorrhaphy (Perineal Repair)
A perineorrhaphy is the surgical repair of a weakened perineum (the area between the vaginal opening and the anus). This procedure is sometimes done at the same time as a posterior repair.
Posterior Colporrhaphy (Posterior Repair)
A posterior colporrhaphy repairs the wall between the vagina and the rectum. As with an anterior colporrhaphy, graft material can be used to strengthen this type of repair. This procedure is performed vaginally.
The Prolift™ is a minimally invasive type of surgery to repair any type of vaginal prolapse. Specifically shaped pieces of synthetic graft material are inserted through an incision in the vagina and positioned with needle-like surgical instruments. An anterior, posterior, or total Prolift™ is performed depending on the type of prolapse present. The Prolift™ can be done with or without a hysterectomy. Click here for more information on the Prolift™.
A suburethral sling is a small strip of material that is inserted through an incision in the vagina and placed beneath the urethra. It provides a firm surface against which the urethra can be compressed during physical activity to prevent stress urinary incontinence. There are a variety of types of suburethral slings.
Tension-free Vaginal Tape™ (TVT)
The TVT is a brand of suburethral sling made of synthetic material that can be placed on an outpatient basis using local anesthesia. Click here for more information on the TVT.
A transurethral or periurethral injection is a simple outpatient procedure in which a substance is injected to narrow the urethra and prevent leakage. Click here for more information on urethral injections.
Vaginal Vault Suspension
A vaginal vault suspension is the surgical repair of a vaginal vault prolapse by attaching the top of the vagina to ligaments in the pelvis with permanent sutures or graft material. This procedure can be performed vaginally or abdominally.