Continence & pelvic health
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Center for Continence and Pelvic Floor Disorders
A comfortable place to address sensitive issues
Urinary Incontinence
Women no longer have to think that urinary incontinence is a natural part
of life. It is a common medical condition and can be treated. We provide
safe and discreet services where you can seek viable solutions to your
incontinence concerns.
 Treatment
of urinary incontinence is based on understanding the underlying cause of
the problem, starting with an accurate diagnosis. Sometimes multiple factors
are involved so it is important for women to have care that is integrated
and coordinated.
The Center for Continence and Pelvic Floor Disorders is comprised of
specialists who work together to provide highly effective diagnosis and
treatment. Through a multidisciplinary team of urogynecologists,
gastroenterologists, occupational therapists and nurses, we can help women
identify the source of their condition and create a personalized plan to
address their concerns.
To shcedule an appointment at the Center for Continence & Pelvic Floor
Disorders, please call 414-329-5650.
There are numerous types of incontinence. Four of the more common ones
include:
- Stress incontinence. Urinary leakage due to
coughing, sneezing, laughing, bending or lifting.
- Urge incontinence. A sudden need to use the
restroom and not always making it in time. Women with urge incontinence
often also deal with urinary frequency. Frequency can occur during the
day as well as at night.
- Overflow incontinence. Frequent or constant
dribbling of urine and incomplete emptying of the bladder.
- Mixed incontinence. This can occur when a woman
experiences more than one type of incontinence, most commonly stress and
urge incontinence. The cause of both forms of incontinence may or may
not be related.
Women often adjust their activities and lifestyle due to their continence
problems.
If you suffer from urinary incontinence there is no need to suffer in
silence. With appropriate medical/surgical care you can significantly
improve your quality of life.
 Urodynamic
Testing:
Urodynamics is a series of test to evaluate the
function of your bladder and urethra. The goal of the test is to reproduce
bladder filling/storage and voiding/emptying symptoms to identify underlying
causes. The procedure takes about 45 minutes.
Two small catheters about the size of a
spaghetti noodle are used. One is placed in the bladder and the other in the
vagina. The test measures the activity of the nerves and muscles that are
used to hold and release urine. There are no special preparations necessary
before urodynamic testing and it is done in the outpatient clinic. Patients
can drive home on their own following the procedure. The information gleaned
from the testing is valuable to your physician in guiding proper treatment
options for you to consider.
Uterovaginal Prolapse
When an organ slips down in the body, it is
referred to as a prolapse. A pelvic organ prolapse occurs if part of the
vagina has become weakened or displaced. Symptoms of pelvic prolapse can
include pressure or discomfort in the vaginal or pelvic area, often made
worse with physical activities such as prolonged standing, jogging or
bicycling. Some women experience diminished comfort and control in the
bladder and/or bowels which can be an indicator of a worsening prolapse
condition.
Prolapse is a common condition. It often occurs
when women have carried pregnancies to term (regardless of whether they
deliver vaginally or by cesarean section). It most commonly occurs when
women reach the menopausal age and to those who are physically active.
Prolapse can also occur in women who do not meet the above profile.
Prolapse can be treated with expectant
management, kegel exercises, pessaries, or surgery. Each approach has its
advantages and disadvantages. Ultimately a treatment can be found that will
provide an adequate success rate for the majority of women.
 Fecal
Incontinence
This is the uncontrolled loss of gas or liquid
stool from the rectum or vagina. The two main types of fecal incontinence
are anal sphincter injury and rectovaginal fistulas. Both conditions are
usually the result of vaginal delivery and are usually unavoidable. There
are no nonsurgical options for treatment. Surgical treatments, however, have
good success rates and can often take place in an outpatient setting.
Reconstructive, Reoperative and Reparative
Surgery
There are a multitude of gynecologic conditions
stemming from congenital abnormalities, problems from previous gynecologic
surgery and other gynecologic conditions such as endometriosis, crohns
disease and others. All of these fall into the realm of pelvic surgery. The
scope of this category includes but is certainly not limited to vaginal
reconstruction, fistulas involving the bladder, ureters and bowels, damage
secondary to endometriosis, and a host of other conditions. The Center for
Continence and Pelvic Floor Disorders specializes in the operative
correction of these conditions and has extensive experience in treating
them.
Center for Continence and Pelvic Floor Disorders
Care Coordination
Seeking help for a continence or pelvic floor problem can cause fear and
anxiety for many women. These are often problems that are difficult to talk
about and which raise many questions and concerns.
At the Aurora Women’s Pavilion, our continence and pelvic floor
coordination team will listen to your concerns, answer your questions,
provide you with educational resources and do all we can to support you with
your treatment choices. We will be your advocate and educator as you strive
for better health.
We will help you understand the diagnostic testing, treatments and
surgical options that are offered to you at the Center for Continence and
Pelvic Floor Disorders with an individualized plan of care. Our goal is to
provide holistic, comprehensive care to improve your quality of life.
PELVIC PROLAPSE
When an organ slips down in the body, it is referred to as a prolapse. A
pelvic organ prolapse occurs if part of the vagina has become weakened or
displaced.
Symptoms of pelvic prolapse can include pressure or discomfort in the
vaginal or pelvic area, often made worse with physical activities such as
prolonged standing, jogging or bicycling. Some women experience diminished
comfort and control in the bladder and/or bowels which can be an indicator
of a worsening prolapse condition.
Pelvic prolapse repairs can be performed in several ways: 1.) through
vaginal incisions. 2.) through an abdominal incision, or 3.) through a
laparoscopic approach.
TYPES OF PROLAPSE
CYSTOCELE: THE BULGING BLADDER
A cystocele is a condition in which weakened
pelvic muscles cause the base of the bladder to drop from its usual position
down into the vagina.
A cystocele is often referred to as a “dropped”
bladder, and it is one of the most common prolapses within the vagina among
women following pregnancy and childbirth.
A cystole develops when the flat upper
vaginal wall loses its support and sinks downward. This allows the bladder,
which is located just above the upper vaginal wall, to drop along with it.
When a cystocele becomes advanced, the bulge may become visible outside the
vaginal opening. The visible tissue is the weakened vaginal wall; the
bladder is right behind the skin but cannot be seen. The symptoms caused by
cystoceles can include vaginal bulging or pressure, slowing of the urinary
stream, overactive bladder symptoms, and an inability to fully empty the
bladder.
RECTOCELE: THE BULGING RECTUM
A rectocele is the mirror image of a cystocele.
Cystoceles result from a weak upper vaginal wall, allowing the bladder to
bulge downward, while rectoceles result from a weak lower vaginal wall,
allowing the rectum to bulge upward. This creates an extra pouch in the
normally straight rectal tube.
ENTEROCELE: THE FEMALE HERNIA
An enterocele occurs when the intestines bulge
downward into the upper vagina. The symptoms are often vague, including a
bearing down pressure in the pelvis and vagina, and perhaps a lower
backache. They often exist alongside vaginal vault prolapse in women who
have had a hysterectomy.
VAGINAL VAULT PROLAPSE
The top of the vagina (called the vault or
apex) is attached to supportive ligaments on either side of the pelvis.
These attachments prevent the top of the vagina from bulging outward beneath
the constant pressure of the abdominal contents. If these attachments weaken
and the vaginal apex drops, a bulge may form near the vaginal opening. This
is called vaginal vault prolapse, a condition that only happens to women who
have had a hysterectomy, and one that can cause severe pressure and bulging
symptoms.
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