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Urogynaecology & Pelvic Health

Urogynaecology is a subspecialty within obstetrics and gynaecology that focuses on pelvic floor disorders and pelvic reconstructive surgery. Urogynaecologists are fellowship trained surgeons, who has completed extra training in both gynaecology and urology - to evaluate, diagnose, treat and manage pelvic floor conditions.

The pelvic floor is a series of muscles and connective tissue that support the organs in your pelvis: the bladder, uterus, vagina, small bowel and rectum. When that support system is weakened, these organs can’t function properly, resulting in conditions like prolapse and incontinence.

Bladder Problems

Vaginal Bulges

Pelvic Floor Disorders

Many women may not have symptoms of pelvic floor problems at first.

If, however, you start to develop some of these symptoms, you should not be embarrassed to tell your health care provider about them.

You do not have to suffer through these symptoms. They are treatable symptoms that specialists call pelvic floor disorders. A urogynaecologist treats these symptoms and conditions and can help you increase your quality of life.

1 in 3 Women
Experiences Pelvic Floor Disorders

Feeling an urgent or frequent need to pee

Leaking pee when you cough, laugh, or exercise

Having a hard time peeing or emptying your bladder completely

A bulge or something visibly coming out of the vagina

Constipation or pain during bowel movements

Pain and pressure in the pelvis, vagina or rectum area

What Causes Pelvic Floor Disorders?

Vaginal birth

C-section

Obesity

Aging

Multiple Pregnancy

Chronic Constipation

Chronic Coughing

Radiation Therapy

Strenuous Activity

Heavy

Lifting

Prior Pelvic Surgery

Genetics

Conditions We Treat

Urinary Tract Infection

Antibiotic Therapy: The primary treatment for UTIs is antibiotics. Patient will be prescribed a course of antibiotics tailored to the specific bacteria identified in the urine culture.
Addressing Recurrent Infections: For patients with frequent UTIs, you may be prescribed a longer course of antibiotics or a low-dose antibiotic regimen to prevent future infections.
Managing Underlying Conditions: Conditions such as pelvic organ prolapse or bladder dysfunction can contribute to recurrent UTIs. These issues are addressed through targeted therapies or surgical interventions if needed.

Bladder Pain

Treatment of Underlying Conditions: Addressing issues like interstitial cystitis (painful bladder syndrome), pelvic floor disorders, or anatomical abnormalities that may contribute to bladder pain.
Pain Management: Prescribing medications to relieve pain and inflammation, and offering physical therapy or bladder instillations to reduce discomfort.
Lifestyle and Behavioral Modifications: Recommending changes such as dietary adjustments, hydration, and bladder training to manage symptoms and improve quality of life.

Frequent Urination

Medications: Prescribing drugs to manage symptoms of overactive bladder or other underlying conditions.
Behavioral Therapy: Recommending bladder training techniques or scheduled voiding to help manage and reduce urgency.
Lifestyle Adjustments: Advising on fluid intake, dietary changes, and strategies to avoid irritants.
Addressing Underlying Conditions: Treating any anatomical or functional issues found, which might include physical therapy or surgical options if necessary.

Urinary Incontinence
(Urine Leakage)

Behavioral Therapy: Techniques like bladder training and pelvic floor exercises (e.g., Kegel exercises) to strengthen the muscles and improve control.
Medications: Prescribing drugs to manage symptoms, such as anticholinergics for overactive bladder or hormone therapy for estrogen deficiency.
Physical Therapy: Offering specialized therapy to improve pelvic floor strength and function.
Minimally Invasive Procedures: Utilizing options like botulinum toxin injections or bladder instillation therapy for targeted treatment.
Surgical Options: If conservative treatments are ineffective, procedures such as midurethral sling surgery or bladder neck suspension may be considered to provide more permanent solutions.
Lifestyle Modifications: Advising on changes in fluid intake, diet, and weight management to help alleviate symptoms.

Chronic Constipation & Bowel Problems

Behavioral Therapy: Implementing dietary changes, increasing fiber intake, and establishing regular bowel habits.
Pelvic Floor Therapy: Using exercises and biofeedback to strengthen and improve the function of the pelvic floor muscles, which can help with bowel movements.
Medications: Prescribing laxatives or stool softeners as needed, and addressing any underlying issues such as pelvic floor dysfunction.
Biofeedback Therapy: Teaching patients how to better coordinate the muscles involved in defecation.
Addressing Structural Issues: Evaluating and treating any anatomical abnormalities or pelvic floor disorders that may contribute to constipation or bowel problems.
Surgical Options: In cases where conservative treatments are ineffective, surgical interventions may be considered to correct structural problems or severe pelvic floor dysfunction.

Pelvic Pain

Medications: Prescribing pain relievers, anti-inflammatory drugs, or medications specific to conditions like interstitial cystitis or endometriosis.
Pelvic Floor Therapy: Utilizing physical therapy to address muscle dysfunction, improve strength, and alleviate pain.
Behavioral and Lifestyle Modifications: Advising on dietary changes, stress management techniques, and exercises to manage pain and improve overall function.
Minimally Invasive Procedures: Procedures like bladder instillations, nerve blocks, or other targeted treatments to reduce pain.
Management of Underlying Conditions: Addressing specific causes of pelvic pain such as pelvic inflammatory disease, fibroids, or prolapse through appropriate medical or surgical interventions.

Pelvic Organ Prolapse

Conservative Management:
• Pelvic Floor Exercises: Prescribing Kegel exercises to strengthen pelvic muscles and support the prolapsed organs.
• Pessary: Fitting a pessary device to provide support and alleviate symptoms, which can be a non-surgical option for managing prolapse.
Medications: Managing associated symptoms like urinary incontinence or discomfort, though medications alone don’t treat the prolapse itself.
Surgical Options: For more severe cases or when conservative measures are ineffective, recommending surgical interventions to repair the prolapse, such as:
• Anterior or Posterior Repair: Surgery to repair the front or back wall of the vagina.
• Hysterectomy: Removal of the uterus in cases of uterine prolapse.
• Sling Procedures: To support the pelvic organs and prevent recurrence.
Lifestyle Modifications: Advising on weight management, avoiding heavy lifting, and other lifestyle changes to reduce pressure on the pelvic organs.

Painful Intercourse (dyspareunia)

Medications: Prescribing treatments for underlying conditions, such as hormonal therapy for vaginal dryness or antifungal/antibiotic medications for infections.
Pelvic Floor Therapy: Utilizing physical therapy to address pelvic muscle dysfunction, which can help relieve pain and improve muscle coordination.
Behavioral Therapy: Recommending techniques to manage and reduce pain, such as relaxation exercises and improving sexual communication.
Lubricants and Moisturizers: Advising the use of vaginal lubricants or moisturizers to alleviate discomfort caused by dryness.
Counseling: Offering support for psychological factors that may contribute to pain, including sexual or relationship counseling if needed.
Management of Underlying Conditions: Treating specific causes like vulvodynia, endometriosis, or pelvic inflammatory disease through appropriate medical or surgical interventions.

Blood In Urine
(Hematuria)

Addressing Underlying Conditions: Treating identified causes such as urinary tract infections (UTIs), kidney stones, or bladder tumors with appropriate medications, procedures, or surgery.
Medications: Prescribing antibiotics for infections, or other medications based on the underlying cause.
Procedures: Performing minimally invasive procedures if needed to remove stones or tumors, or to address other issues identified during diagnostic testing.
Lifestyle and Behavioral Adjustments: Advising on fluid intake, dietary changes, and avoiding irritants that may contribute to urinary issues.