Urogynecologic Disorders: Effective Treatments
Now Available
It can happen after childbirth or menopause
and can strike while exercising or laughing -
embarrassing problems such as urine leakage or
uterine prolapse that you're reluctant to discuss
with anyone including your doctor. But according
to Lily
Arya, MD, a urogynecologist at Penn Health
for Women, you're not alone and effective treatments
are available.
What are Urogynecologic Disorders?
At almost every stage of life, women might experience pain or dysfunction in
the urogynecologic area, which includes the uterus, cervix, vagina, bladder
and rectum. In addition to incontinence and pelvic organ prolapse, common
disorders include painful bladder syndromes such as interstitial cystitis
and recurrent urinary infections.
The Impact of Pregnancy and Childbirth
Pregnancy and childbirth can stretch or damage tissues that support the pelvic
organs. As a result, many women suffer from urogynecologic problems both
while carrying and after delivering their babies. It's not uncommon to have
trouble holding your urine, especially during exercise or physical exertion.
Another common condition is uterine prolapse, often described as a dropped
uterus, fallen bladder or bulging rectum. Prolapse results when the ligaments
holding the uterus in place stretch or break. The uterus moves out of place
and can protrude through the vagina.
Menopause
Although urogynecological problems can affect women at any age, they're more
common in post-menopausal women. If you've had children, pregnancy and delivery
may have strained and damaged supportive tissues in the pelvic area. During
menopause, further loss of bladder support can occur naturally. Weakened
supportive tissues, damage to the nerves that control the function of the
bladder and the urethra and certain medications can contribute to urinary
incontinence and uterine prolapse.
How are Urogynecological Problems Diagnosed?
To determine the best treatment, your physician will want to know everything
that could be causing the problem. This includes discussing your lifestyle
and medical history thoroughly, in addition to diagnostic tests such as cytoscopy,
urodynamic evaluation and lab work.
Cytoscopy, a procedure that can be done in the
doctor's office, allows your physician to view
the inside of the bladder through a small telescope.
Urodynamic testing measures the pressure and
volume of the inside of the bladder as it's filled
with fluid. Lab tests are used to detect infection.
You might also be asked to keep a detailed diary
of when you urinate, when you leak and your fluid
intake. Then, depending on the cause of your
condition, treatment choices range from conservative
to aggressive and include medications, surgery
and behavioral or lifestyle changes.
What are the Latest Treatments?
Depending on the nature and severity of your problem, most doctors will suggest
starting with a conservative approach such as exercise, physical therapy,
biofeedback, lifestyle changes and medication. In some cases, special exercises
focusing on muscles in the pelvic region are all that may be necessary to
relieve incontinence. This might be coupled with medication or dietary adjustments.
When the problem is pelvic organ prolapse, your doctor might suggest surgery
to re-attach and strengthen the support of the affected organs.
Cut the Caffeine and Other Lifestyle Modifications
Dr. Arya has studied simple lifestyle changes that can impact urogynecological
health such as caffeine intake. According to Dr. Arya, just cutting your
daily caffeine intake to two cups a day could help reduce or eliminate urine
leakage. "We suspect caffeine irritates parts of the urinary system,
thereby weakening its normal functioning," said Dr. Arya. No matter
what your symptoms or condition, advanced diagnostic techniques and treatment
make relief readily available. There's no need to suffer in silence. If you
are concerned about your urogynecologic health, talk with your obstetrician-gynecologist
or call 1-800-789-PENN (7366) to make an appointment with Dr. Arya.
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