Conditions We Treat | Patient Care

Pelvic Organ Prolapse

When pelvic organs, such as the bladder or uterus, drop into the vaginal canal, it can cause a noticeable bulge from the vaginal opening, pelvic pain or pressure or difficulty emptying the bladder and/or rectum. Nonsurgical treatment options for pelvic organ prolapse include Kegel exercises, pelvic floor therapy or vaginal pessary. Surgical treatment options include native tissue repair or robotic/laparoscopic prolapse repairs. Pelvic Organ Prolapse

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Interstitial Cystitis

Also known as painful bladder syndrome, interstitial cystitis is a condition that causes chronic bladder or urethral pain. Common symptoms include bladder or urethral pain that becomes worse with filling the bladder, urinary urgency or frequency and nocturia (nighttime urination). Nonsurgical treatment options for interstitial cystitis include a bladder diet, pelvic floor therapy, bladder instillations or joint and tissue mobilization. Surgical treatment options include cystoscopy with fulguration, hydrodistension or Botox injections and sacral nerve modulation. Interstitial Cystitis

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Overactive Bladder

When the bladder improperly stores urine, it can be subdivided into “wet” and “dry.” A wet overactive bladder is also known as urinary incontinence and occurs when urine urgency leads to urine leakage, whereas a dry overactive bladder does not lead to urinary leakage. The most common symptoms include urinary urgency, daytime urinary frequency and nighttime urination (nocturia). There are nonsurgical treatment options for an overactive bladder, including Kegel exercises, pelvic floor therapy, behavioral modification, bladder training, biofeedback, functional electrical stimulation, medications or percutaneous tibial nerve stimulation. Surgical treatment options includesacral nerve modulation, chemo denervation of the bladder or implantable tibial nerve stimulators. Overactive Bladder

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Vaginal Fistula

An abnormal opening between the vagina and another organ in the urinary system can cause constant leakage of urine or feces through the vagina. There are nonsurgical treatment options for a vaginal fistula, including urethral stents or drainage through a catheter, as well as surgical treatment options, including minimally invasive to open surgery to repair and close the fistula. Vaginal Fistula

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Urinary Incontinence

Involuntary leakage of urine can occur with stress, urges or both. Causes include weak pelvic floor muscles, overactive or neurogenic bladder, chronic cough, medications or pregnancy. There are nonsurgical treatment options for urinary incontinence, including Kegel exercises, pelvic floor therapy, behavioral modifications, bladder training, biofeedback, functional electrical stimulation, manual therapy, joint and tissue mobilization, low-dose vaginal estrogen, vaginal pessary or medications. There are also surgical treatment options, including midurethral sling or urethral injections (for stress incontinence) and percutaneous tibial nerve stimulation, sacral nerve modulation or Botox injections (for urgency incontinence). Urinary Incontinence

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Genitourinary Syndrome of Menopause

Also known as vaginal atrophy, urogenital atrophy or atrophic vaginitis, this condition causes vaginal dryness, irritation and recurrent urinary tract infections, among other issues due to declining estrogen levels, typically during menopause. The most effective treatment is usually low-dose vaginal estrogen replacement, but other treatments include topical estrogen or systemic estrogen therapy. Genitourinary Syndrome of Menopause

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Voiding Dysfunction

Also known as bladder dysfunction, voiding dysfunction occurs when there is a lack of coordination between the bladder, urethra and pelvic floor muscles, which causes difficulty urinating. This condition is often effectively treated with pelvic floor physical therapy and bladder training.

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Mesh Complication and Placement

Mesh can be placed to treat pelvic organ prolapse or stress urinary incontinence. While mesh placement is typically effective, complications may lead to an increase in bleeding, discharge, pain when urinating or recurrent urinary tract infections. Depending on the degree of mesh complications, some can be treated with vaginal estrogen topically or an office procedure, while others may require surgical treatment.

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Dysuria

Pain or burning during urination is typically a result of urinary tract infections, but other causes can include sexually transmitted diseases, urinary stones, genitourinary syndrome of menopause (vaginal atrophy) or other inflammatory causes (such as contact dermatitis or lichen sclerosis). Treatment for dysuria depends on the individual cause; for example, if caused by a urinary tract infection, antibiotics are typically prescribed.

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Urethral Caruncle

A urethral caruncle is a benign, noncancerous growth on the urethral opening in post-menopausal women. Typically, urethral caruncles do not cause symptoms, but some may experience associated bleeding or burning when urinating. The most common cause for this growth is lower levels of estrogen, typically caused by menopause. If the urethral caruncle does not cause symptoms, treatment may not be needed. If symptoms are persistent or bothersome, nonsurgical treatment includes the use of estrogen cream, and surgical treatment involves removing the growth. If the urethral caruncle is very large and does not respond to estrogen cream, it can be removed.

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Urethral Stricture

Scarring in the urethra can narrow the tube that passes urine. The main symptoms include weakened urine stream, dysuria, difficulty emptying the bladder or urinating, urinary urgency or an increase in urinary tract infections. Nonsurgical treatment for urethral stricture includes active surveillance or dilation, and surgical treatment includes urethrotomy or urethroplasty.

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