McLaren Health Care
Urogynecology - Urinary Incontinence and Pelvic Floor Therapy

Urogynecology
Urinary Incontinence Disorders

At McLaren, we understand that the emotional challenges brought on by urogynecology and urology problems are as life-altering as the physical ones. That’s why our visionary, board-certified physicians treat confidence, behavior and daily life alongside the symptoms of prolapse, incontinence and overactive bladder.

These insights lead to unique treatment plans, including medication, therapy, minimally-invasive surgery, or a custom combination. Areas of specialty include:

  • Bladder cancer
  • Incontinence
  • Kidney stones
  • Minimally-invasive robot-assisted surgery
  • Overactive bladder
  • Painful bladder syndrome (interstitial cystitis)
  • Pelvic organ prolapse (dropped bladder, bowel, rectum, uterus)
  • Recurrent urinary tract infections
  • Robotic surgery
  • Vaginal pain during intercourse

Causes of Urinary Incontinence Disorders:

Pelvic floor disorders can be caused by a combination of different factors. For example, pregnancy with a vaginal delivery may weaken or stretch some of the pelvic muscles or damage nerves. The more vaginal deliveries you have, the more at risk you may become for a pelvic floor disorder, according to the American Urological Association (AUA). Age is another factor that determines the likelihood of developing one of these disorders; the older you are, the greater the chances. Other causes of pelvic floor disorders may include the following:

  • heavy lifting
  • chronic coughing
  • constipation
  • obesity
  • menopause
  • pelvic surgery
  • radiation treatments
  • genetics

Symptoms of Urinary Incontinence Disorders

Sometimes a woman can have more than one type of pelvic floor disorder. Many of the symptoms are easy to see and feel. Discomfort in the vaginal area, problems with urination, and painful intercourse are all indications that you could be suffering from a pelvic floor disorder. According to NIH, other symptoms include:

  • a feeling of heaviness or fullness in the vaginal area
  • aching or bulging in the pelvic area
  • difficulty emptying the bladder or accidental loss of urine
  • frequent urination
  • painful urination
  • frequent urinary tract infections
  • pain in the lower abdomen, groin or lower back
  • tissue protruding from the vagina
  • constipation
  • difficulty controlling the bowels
  • vaginal bleeding and/or discharge

According to the American Urological Association, if severe symptoms are ignored, kidney damage or infection could occur. In some mild cases, there may be no symptoms whatsoever. If you are experiencing one or more of these symptoms, see your healthcare provider.

Types of Pelvic Floor Disorders

The different types of pelvic floor disorders are named for the organ that is affected. Many disorders involve a bulging of tissue, similar to a hernia, but some can cause an individual to lose control of bodily functions. According to the Pelvic Floor Disorder Network (PFDN), they include:

  • Rectocele - the rectum pushes through the middle of the vaginal muscles and protrudes into the back wall of the vagina
  • Enterocele - the small intestine bulges into the vagina
  • Cystocele - the bladder drops down and protrudes into the vagina. This is also referred to as a prolapsed bladder.
  • Cystourethrocele - similar to a cystocele but develops when the upper part of the urethra drops down with the bladder
  • Prolapse of the uterus - the uterus drops down into the vagina. In such cases, the cervix can be lower than normal and can be felt easily with the finger tip or even come out through the vagina
  • Prolapse of the vagina - the upper part of the vagina drops into the lower part so that the vagina turns inside out
  • Urinary incontinence - urine leakage
  • Fecal incontinence - bowel leakage

Diagnosis of Pelvic Floor Disorders

Your healthcare provider will be able to diagnose a pelvic floor disorder. This is usually done by taking a history of symptoms as well as performing a pelvic examination. Finding out how well the bladder and rectum are functioning may involve some simple tests. If necessary, your doctor may order one or more of the following procedures:

  • Cystoscopy - viewing the inside of the bladder
  • Urethroscopy - viewing the inside of the urethra
  • Voiding Cystourethrogram - an X-ray taken during urination
  • Fluoroscopy - another form of X-ray that allows physicians to obtain real-time, moving images of internal structures
  • Urodynamics - bladder testing

Factors determining the treatment of Pelvic Floor Disorders

Factors determining the treatment of Pelvic Floor Disorders:

There are many different treatment choices for people with pelvic floor disorders, but those choices depend upon a number of factors including:

  • how weak the pelvic ligaments have become
  • your health
  • your age
  • whether you want to become pregnant

Non-surgical Treatments

Non-surgical treatments range from medications to exercises, and include the following:

  • Kegel exercises - these exercises can help you strengthen the pelvic muscles. They can be performed by repeatedly tightening your pelvic muscles like you're trying to hold the flow of urine.
  • Medication (for some cases of urinary incontinence)
  • Weight control
  • Changes in diet
  • Estrogen - estrogen is sometimes prescribed to limit more weakening of the muscles and tissues that support the uterus
  • Pessary - a pessary is a rubber doughnut-shaped device that is inserted around the cervix to help keep the pelvic organs in place
  • Avoidance of heavy lifting and straining
  • Pelvic Floor Therapy - Pelvic Floor Therapy is a treatment intended to help patients with various types of pelvic floor disorders learn to strengthen and relax their pelvic muscles in order to improve bladder function and decrease pelvic pain.

    McLaren rehab services throughout Michigan offer Pelvic Floor Biofeedback using electronic and mechanical instruments as well as manual therapy to accurately measure the action of the pelvic floor muscles. This process provides 'feedback' information to the patient so that the patient can learn to better use the pelvic muscles.

    Patients can learn to use the pelvic floor muscles to decrease the sudden urge to urinate, decrease incontinence, and lessen certain types of pelvic pain. An important part of pelvic floor biofeedback therapy is consistent exercise of the pelvic muscles at home, and biofeedback therapy can help teach proper pelvic muscle exercise techniques.

Surgical Treatments

  • tightening the weak muscles without removing the uterus
  • hysterectomy - only recommended if symptoms are severe or if the uterus has dropped down through the vagina
  • repositioning of the bladder

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