Female Pelvic Medicine
At St. Peter's, we are committed to helping women maintain and improve their health throughout their lives. As women age, some of them experience urinary incontinence and pelvic prolapse.
While urinary incontinence does occur in men, it is most common in women due to childbirth and aging. Many times, women will adjust their lifestyles or even put their lives on hold as they try to accommodate their incontinence.
Fortunately, today's technologies have revolutionized the treatment options now available for women with weakening and aging pelvic organs.
Today's diagnostic tools (including multi-channel urodynamic testing) allow physicians to determine the best treatment options for patients.
Some treatment options include:
Incontinence is an involuntary loss of urine. It is further defined by type as either stress (leakage with straining, coughing, sneezing), urge, mixed, overflow, functional or reflex incontinence. Treatment is dependent on the type of incontinence. Current therapies include dietary changes, scheduled voiding, bladder retraining, pelvic muscle exercises, biofeedback, electrical stimulation therapy, medication, collagen implants and minimally invasive surgery. Urinary incontinence can result from a weakening of the pelvic floor muscles, which support the urethra, bladder and other pelvic organs.
Weak pelvic floor muscles may cause one or more of these organs to fall out of place, a condition called prolapse. A number of factors may lead to prolapse, including childbirth, hormonal changes from menopause, being overweight or severe coughing due to bronchitis or smoking.
In vaginal vault prolapse, for example, the uppermost part of the vagina slips downward. This condition can be treated by a procedure called a sacrocolpopexy. Through a small entry in the lower abdomen, a surgeon implants a mesh material to reconstruct the vagina. At St. Peter's, surgeons can perform a sacrocolpopexy using the da Vinci® Surgical system. It combines the precision of computer-assisted, robotic surgery with the advantages of minimally invasive procedures (faster healing, smaller risk of blood loss and other complications).
Other "suspension" and "sling" procedures may achieve bladder control for other causes of incontinence. For example, "Stress Urinary Incontinence" (SUI) can be triggered when someone is straining, coughing or sneezing. There are several types of slings, including the pubovaginal sling, the midurethral retropubic sling and transobturator slings, which support the urethra and help maintain bladder control.
Overactive Bladder/Interstitial Cystitis
Many women suffer bladder pain or feel the need to frequently urinate, affecting their ability to sleep or fully participate in everyday activities. An overactive bladder or interstitial cystitis can have many causes, and treatments range from medication to surgery.
Using Interstim neuromodulation therapy, doctors at St. Peter's can bring relief to patients in nearly the same way that a pacemaker modulates a person's heart rate. By installing tiny electrodes, Interstim neuromodulation therapy controls the nerve endings to reduce the constant urge to urinate. If this treatment is successful, the electrodes may be permanently installed for up to nine years of effective treatment.