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Pelvic Health Institute

The Pelvic Health Institute at Northwest Medical Center specializes in the diagnosis and treatment of pelvic floor dysfunction. The experts at Northwest Medical Center offer the latest surgical treatment options using minimally invasive and robotic techniques.
Various pelvic floor treatments are available including:

  • Incontinence
  • Inflammatory bowel disorders and defectory dysfunction
  • Pelvic organ prolapse
  • Neuro-urologic disorders

The pelvic floor muscles may weaken due to aging, pregnancy and vaginal childbirth, injury, surgery, chronic cough, or lack of exercise. If the pelvic floor is weak, your bladder and other pelvic organs may sag out of place.  Kegel exercises can help you strengthen your pelvic floor muscles so they can better support the pelvic organs and control urine flow.

Types of Urinary Incontinence

Urinary incontinence is the inability to control the release of urine. You may leak urine. Or you may not be able to hold urine until you can get to a bathroom. Read on to learn more about the types of incontinence.

Stress Urinary Incontinence (SUI)

If you have SUI, urine leaks out of the bladder during activity. Symptoms of SUI include leaking when coughing, sneezing, or laughing. This may occur because muscles under the bladder are weak. It also sometimes happens in men for a time after prostate surgery.

Urge Incontinence

Urge incontinence is also called an “overactive bladder.” With this type, the bladder feels full even when it’s almost empty. The main symptom is a sudden urge to urinate that can’t be controlled. The urge is felt often. This type can be caused by infection or by a nerve problem. It can also be caused by a growth in the bladder.

Overflow Incontinence

With overflow incontinence, the bladder doesn’t empty when it should. It then gets very full. Urine may leak out in small amounts. Or the urge to urinate is felt often, but urine trickles instead of flowing freely. The bladder may never feel empty. Blockage of the opening to the bladder or the urethra may cause this type. Or it may be caused by nerve or muscle problems that stop the bladder from contracting.

What Is Stress Urinary Incontinence (SUI)?

Do you sometimes leak urine when you cough or sneeze? If so, your doctor may have told you that you have stress urinary incontinence (SUI). Stress urinary incontinence may occur when the structures that help hold urine in your bladder become weak.

The Symptoms of SUI

If you have SUI, you may leak urine when you:

  • Cough, sneeze, or laugh
  • Lift something heavy
  • Exercise

Normal Urine Control

The bladder holds urine until you are ready to let it flow out. These structures help:

  • The pelvic floor muscles and connective tissue help hold the pelvic organs in place. When the muscles and connective tissue are strong, the urethra and bladder are well supported. This helps keep the urethra closed, so urine doesn’t leak.
  • The urethral sphincter is a band of muscles around the urethra. When these muscles are strong, they keep urine in the bladder. These muscles relax when you want urine to flow out.

If Urine Leaks Out

The pelvic floor muscles and connective tissue may stretch, weaken, or tear. Weak or torn structures can’t support the urethra and bladder. The urethral sphincter may also weaken. These changes can cause urine to leak. The changes may be caused by:

  • Pregnancy and vaginal childbirth
  • Constant coughing (such as with bronchitis)
  • Being overweight
  • Aging

Treating Incontinence in Women: Lifestyle Changes

The best treatment for you will depend on the type of incontinence you have. Your symptoms, age, and any underlying problems that are found also affect your treatment.
How Lifestyle Changes May Help

  • Quitting smoking. Smoking can lead to a chronic cough that strains pelvic floor muscles. Smoking may also damage the bladder and urethra.
  • Losing weight. Excess weight puts extra pressure on the pelvic floor muscles. Exercising and eating right can help you lose weight. This helps other treatments work better.
  • Making certain diet changes. Some foods may make you need to urinate more, so it may be good to avoid them. These include caffeinated drinks and alcohol. Ask your doctor whether these or other diet changes might be helpful.

Treating Incontinence in Women: Medication

Urinary incontinence is the leaking of urine from the bladder. In some cases, medication can reduce or stop the leaking. It is mainly given for urge incontinence. But it may help with stress incontinence. Your doctor will talk with you about your options. Make sure to ask what side effects to expect.

Types of Medication

Below are some types of medications that may help.

  • Anticholinergics. These may increase how much urine the bladder can hold. They may also help relax bladder muscles.
  • Alpha-adrenergics. These may help tighten the bladder neck and urethra.
  • Estrogen. This may help improve muscle tone in the urethra and bladder.
  • Antibiotics. These are used to treat urinary tract infections.

Treating Urinary Incontinence: Urethral Implants

You may have trouble holding your urine. This may be due to a weak muscle around the urethra. This muscle is called the sphincter. Urethral implants are one method to help treat a weak sphincter. A bulking agent is implanted (injected) into your urethra. This may help close the sphincter. It can help restore most or all of your control over urine flow. This procedure is often done in the hospital. You will likely go home the same day.

Your Experience

  • You will be given medication (anesthesia) to keep you from feeling pain. This may be one or more of the following:
    • Local anesthesia to numb your urethra and bladder.
    • Regional anesthesia to numb your body below the waist.
    • General anesthesia to put you into a state like deep sleep.
  • The doctor inserts a cystoscope (a thin, tubelike telescope) into your urethra. This instrument lets the doctor see the inside of your urethra.
  • A needle is inserted (either through the cystoscope or along the outside of your urethra) into the sphincter area.
  • The doctor injects a bulking agent through this needle into the wall of the urethra. This makes the wall of the urethra thicker. It then closes up. This stops urine from leaking out of the bladder. When you try to urinate, the wall moves apart to allow urine to flow.

Pelvic Prolapse

The uterus is held in position by pelvic muscles, ligaments and other tissues. If the uterus drops out of its normal position, this is called prolapse. Prolapse is defined as a body part falling or slipping out of position. Prolapse happens when the pelvic muscles and connective tissues weaken. The uterus can slip to the extent that it drops partially into the vagina and creates a noticeable lump or bulge. This is called incomplete prolapse. Complete prolapse occurs when the uterus slips to such a degree that some uterine tissue is outside the vagina.

Pelvic prolapse may also involve sagging or slipping of other pelvic organs, including the bladder, the urethra which is the tube next to the vagina that allows urine to leave your body, and rectum.

Diagnosis

Diagnosing pelvic prolapse requires a pelvic examination usually performed by a gynecologist. The doctor will ask about your medical history and perform a complete pelvic examination to check for signs of pelvic prolapse. You may be examined while lying down and standing. Imaging tests, such as ultrasound or magnetic resonance imaging (MRI), may be performed to further evaluate the pelvic prolapse.

Consult with your physician to seek which treatment option is best for you. Northwest Medical Center treats various types of Pelvic Health Disorders; many of which are minimally invasive surgical options. For more information about the Pelvic Health Institute at Northwest Medical Center and a free physician referral call 1-866-442-2362.


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