Urogynecology

Treatment and Topics of Interest

Healing is always possible

Break out from pain, anxiety, and daily discomfort

Women of all ages commonly experience problems with their bladder or vagina. In fact, urinary leakage may be one of the most commonly under-treated health issues for women.

At Selah, we want you to know this doesn’t have to be something you just live with. Many women never seek medical treatment for pelvic floor issues because they feel embarrassed or assume these issues are a natural consequence of aging or childbirth. 

Fortunately these, and other pelvic floor disorders are completely treatable. Break out from pain, anxiety, and daily discomfort with treatment at Selah!

What is the Pelvic Floor?

The pelvic floor includes the muscles, connective tissue and ligaments that support a woman’s internal organs (bladder, bowel, uterus, vagina and rectum). The pelvic floor plays an important role in the support and proper function of these organs.

What Are Pelvic Floor Disorders?

There are many conditions that cause pelvic floor dysfunction, including aging, loss of muscle tone, menopause, multiple vaginal deliveries, obesity, family history, stroke, and certain medical conditions such as diabetes. However, the vast majority of pelvic floor conditions are treatable.

Topics of Interest

Urinary incontinence

Urinary incontinence is the loss of bladder control. Leaking urine is a common problem for women, and it can happen to anyone but is more common with age. For some, symptoms are so severe that they significantly restrict their activities to avoid embarrassing accidents. Most bladder control problems happen when muscles are too weak or too active.

If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh, jump or lift a heavy object. This is stress incontinence.  If bladder muscles become too active, there may be a strong urge to go to the bathroom even when the bladder is not full. This is urge incontinence or overactive bladder.  There are other causes of incontinence, such as nerve damage from certain medical conditions or radiation damage from cancer treatment.

Treatment depends on the type of bladder problem and a woman’s personal preference. Treatments may include simple exercises, medicines, special devices prescribed a provider, or surgery. Many of these treatments are available at Selah.

Free resource guide for patients interested in learning more about Stress Urinary Incontinence.

Overactive bladder

Overactive bladder is a condition in which the bladder muscle contracts frequently, triggering the sensation of the urge to urinate. This can be caused or worsened by various bladder irritants in the diet, by aging, by nerve dysfunction, or unknown causes.

Sometimes it also results in involuntary leakage of urine. This is a condition that is more common in women than men. It is also treatable, with options ranging from dietary changes, bladder retraining therapy, physical therapy, medications, or nerve stimulator treatments.

Interstitial cystitis

Interstitial cystitis is a chronic painful bladder condition thought to be caused by a type of autoimmune inflammation. Symptoms include bladder and pelvic pain or pressure and a frequent urge to urinate. Symptoms are often mistaken for recurrent urinary tract infections (UTI) or endometriosis. Sometimes women will experience chronic pelvic pain and pain with sex that has not responded to typical treatments for reproductive tract problems.

Effective treatment often needs to be multifaceted, including nutritional changes, medications, instillations (direct bladder treatments done in the office setting), physical therapy, and biofeedback.

Often women come to us feeling hopeless about their long-standing symptoms, but we have witnessed so many of them achieving pain-free living through this type of treatment approach.

Pelvic organ prolapse

Weakness in the pelvic muscle floor can lead to prolapse. Symptoms include vaginal bulging or pressure, difficulty emptying the bladder completely or experiencing frequent urinary tract infections, and difficulty passing bowel movements (sometimes requiring pressure in the vagina from a finger in order to pass).

Prolapse treatments can vary from special pelvic exercises or physical therapy, to pessary use or surgical reconstruction.

https://www.acog.org/Patients/Patient-Education-Videos/Pelvic-Organ-Prolapse

Pessary care

A pessary is a silicone device that is helpful as a conservative treatment for vaginal prolapse. These come in various sizes and shapes, and can be fitted by a medical provider to hold up prolapsing areas of the vagina.

For some women, whether by personal preference or medical necessity, this proves to be a better treatment than surgery.

Selah providers are skilled at helping patients choose the right pessary and providing the maintenance care required for it several times a year.

Dyspareunia

Dyspareunia, or pain with sexual intercourse, is unfortunately common among women. The causes that can contribute to discomfort include sexual arousal disorders, vaginal atrophy (common after menopause), effects of prior sexual trauma, pelvic muscle dysfunction and spasm, and structural abnormalities of the female reproductive system, such as uterine fibroids, endometriosis, or ovarian cysts.

Since the causes are so varied, it is important to seek evaluation with an experienced gynecology provider. This may include hormonal lab testing, physical exam, and ultrasound imaging.

Most women can experience complete relief with the proper treatment for the specific cause. These treatments can range from topical or oral medication to physical therapy, laser therapy, or counseling. It is also not unusual for us to recommend more than one treatment modality to fully resolve the cause(s).

Conditions treated:

  • Urinary incontinence (loss of bladder control)
  • Overactive bladder (urinary urgency and frequency)
  • Interstitial cystitis (painful bladder syndrome)
  • Fecal incontinence (loss of bowel control)
  • Recurrent bladder infections
  • Difficulty emptying the bladder or rectum
  • Pelvic organ prolapse (bladder, rectum or uterus dropping into vaginal area)
  • Pessary care
  • Trauma from childbirth
  • Dyspareunia (painful sexual intercourse)

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PRACTICE PHILOSOPHY

Our approach to quality patient care.

Hospital Affiliations

Our Services

core service categories

Gynecology

Providing a full range of gynecology services from contraception counseling to surgeries.

Obstetrics

We offer a patient-focused approach that allows patients their own style of birthing.

Fertility

Offering complete evaluation and treatment of infertility issues up to, but not including IVF.

What our patients say

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