Uro-gynaecology

A one-stop evaluation and treatment of women with urinary incontinence as well as pelvic floor dysfunction, including urogenital prolapse and post-hysterectomy vaginal vault prolapse. Depending on the nature of the urinary incontinence or pelvic floor dysfunction, therapeutic options including non-surgical management. Surgical management may be considered in some women with severe symptoms or when conservative treatment is ineffective.

Condition & treatments

Urinary Incontinence: Urinary incontinence in simple terms means a person urinates when they do not want to. Control over the urinary sphincter muscles is either lost or weakened. Urinary incontinence is a much more common problem than most people realize

Causes of Urinary Incontinence

There are many causes of urinary incontinence.

Temporary causes include

  • Urinary tract infection
  • Constipation
  • Certain medications
  • Increased dietary intake of caffeine, alcohol, artificial sweeteners and carbonated beverages

Other causes for which the treatment differs based on what causes the condition.

  • Pelvic floor muscle weakness
  • Weakness of the bladder and/or the sphincter muscles
  • Overactive or underactive bladder muscles
  • Decreases in certain hormones, especially oestrogen

Treatment of Urinary Incontinence

The treatment of urinary incontinence depends on the type of incontinence and the severity of it. The various modalities available for treatment are lifestyle changes, bladder retraining, physiotherapy or medications and surgery.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when a pelvic organ-such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. Your pelvic floor muscles also hold up your pelvic organs from below. If the fascia and ligaments are torn or stretched for any reason, for example, obstetric trauma, or weakened pelvic floor muscles, then your pelvic organs (your bladder, uterus, or rectum) might not be held in their right place and they may bulge down into the vagina (birth canal). This is called prolapse.

Causes of POP

The main cause is damage to or weakening of the nerves, ligaments and muscles which support the pelvic organs as a result any of the following:

 

  • Pregnancy and childbirth (considered to be major factors leading to weakening of the vagina and its supports)
  • Aging and menopause
  • Overweight
  • Previous pelvic surgery
  • Conditions like obesity, chronic cough, chronic constipation.

Types of Prolapses

  1. Prolapse of the Anterior compartment
  2. Prolapse of the Posterior compartment
  3. Prolapse of the apical compartment

Symptoms of Proplapse

Common symptoms reported by women are:

  • A sensation of something coming down
  • Feeling of a bulge in the vagina
  • Pressure in the vagina
  • Back pain
  • Interference with bladder/bowel functions – need to push the prolapse to help urination or bowel movement

Bladder Pain / Interstitial Cystitis

Interstitial cystitis also called painful bladder syndrome is a chronic condition associated with inflammatory changes causing bladder pressure, bladder pain and sometimes pelvic pain. The pain ranges from mild discomfort to severe.

Symptoms of Interstitial Cystitis

  • Urgency
  • Frequency of Urination-sometimes 60 times in a single day
  • Dysuria (burning and stinging during urination)
  • Bladder pain – may intensify when bladder is filling or emptying
  • Pelvic Pain
  • Blood in urine
  • Pain with intercourse.