Urogynecology and Pelvic Support

Do you feel pressure or pain in your vagina or rectum?  Do you have difficulty with bowel movements or trouble emptying your bladder completely?  You may have pelvic support problems.  Fort Sanders OB/GYN can provide treatments specific to your pelvic support needs.  Kegel exercises, pelvic floor physical therapy, vaginal pessaries, and outpatient surgeries are the common corrective measures discussed for pelvic support problems.

Uterine Prolapse

Uterine Prolapse is the dropping of the uterus into the vaginal canal.  Quite commonly this problem can occur after childbirth and can cause pressure, pain, or bulging from the vagina.  Although surgery is typically needed to correct this problem the newer options can be performed on an outpatient basis with a quick return to most activities.

Bladder or Vaginal Prolapse

Similar to uterine prolapse, the bladder and the vagina itself can drop after childbirth or injury.  The symptoms are similar.  New treatment options are very effective and durable.

Cystocele and Anterior Repair

A Cystocele occurs when the thin wall of tissue that separates the bladder from the vagina weakens, allowing the bladder to bulge (prolapse) into the front wall of the vagina. It is often associated with Stress Urinary Incontinence but can cause other problems as well. An Anterior Repair is an out-patient procedure that returns the bladder and urethra to its normal position and strengthens the wall between the bladder and the vagina.

Rectocele and Posterior Repair 

A rectocele occurs when the thin wall of tissue that separates the rectum from the vagina weakens, allowing the rectum to bulge (prolapse) into the back wall of the vagina. Constipation, pressure, and splinting (the need to apply pressure in the vagina to allow for bowel movements) are common symptoms. A Posterior Repair is an out-patient procedure that returns the rectum back into its normal position and strengthens the wall between the rectum and the vagina.

Common factors that contribute to the loss of normal pelvic support are: pregnancy and childbirth, menopause, chronic coughing, obesity, chronic constipation, years of strenuous activity or heavy lifting, and/or other gynecological, bladder, or rectal surgeries.

Bladder Problems

Urinary Incontinence

Do you leak urine when you laugh or when you exercise? Do you leak before you can make it to the restroom or feel like you live in the bathroom? You may have Urinary Incontinence.

Evaluation

The first step in getting your urinary incontinence treated is to mention your symptoms to your doctor. Further evaluation will depend on your symptoms and your exam. Fort Sanders OB/GYN was the first practice in Knoxville to offer detailed, electronic bladder testing called Urodynamics. Urodynamics is a simple in-office test that provides your doctor with information about your bladder’s capacity, your voiding patterns, leaking episodes, and your bladder’s neurologic function.

Treatment

Fort Sanders OB/GYN has always been a leader in offering the best options for correction of urinary leakage. Our physicians offer medical therapies, minimally invasive bladder slings, and interstim. Dr. Erin Saunders is fellowship trained in urogynecology.

Interstim Therapy

Many women cannot tolerate medications for Overactive Bladder or Urge Incontinence due to side effects. Interstim is an implantable stimulation divide much like a pacemaker for the heart. There is a simple test-phase for the first week to make sure the therapy will work and then there is a second phase where the permanent device is placed under the skin.

Minimally Invasive Bladder Slings

A surgical procedure that uses a narrow strip of mesh tape to correct stress urinary incontinence. This procedure is completed through the vagina and two small groin incisions; it creates stabilization and support for the bladder and the urethra (the tube carrying urine from the bladder to the outside of the body)

Stress Incontinence

Stress Incontinence is the involuntary leakage of urine during episodes of increased intra-abdominal pressures, including exertion such as coughing, sneezing, laughing, exercising, or intercourse.

Urge Incontinence

Urge Incontinence or Overactive Bladder is the involuntary loss of urine that occurs when a person has a strong, sudden need to urinate. Leakage is usually caused by abnormal bladder contractions.

Urgency and Frequency

Urgency is the severe and sudden need to empty the bladder. This can be related to a severe form of Overactive Bladder or due to Interstitial Cystitis.