"It’s important for women of all ages to understand that while pelvic floor issues are certainly common, it doesn’t mean that they’re normal."
Lauren B. Witmer, DO, Urogynecologist, Penn Medicine Lancaster General Health
What Does a Urogynecologist Do?
Urogynecology is a surgical subspecialty of both urology and gynecology, and addresses everything from the diagnosis to the treatment of pelvic floor disorders. While you’ve probably heard of the pelvic floor, you may not realize just how important it is. The muscles, ligaments, and tissue that make up the pelvic floor help support your bladder, bowel, uterus, vagina and rectum, and keep all of these organs functioning properly.
Pelvic floor disorders generally happen as a result of weakened muscles or tears in the connective tissue in the pelvic floor, and can cause irregular function. For example, have you ever heard a fellow mom talk about accidentally peeing her pants? Urogynecologists are largely focused on improving quality of life, helping women experience fewer issues with discomfort and incontinence.
“It’s important for women of all ages to understand that while pelvic floor issues are certainly common, it doesn’t mean they’re normal,” says Penn Medicine Lancaster General Health urogynecologist Lauren B. Witmer, DO. “You don’t have to live with pelvic floor conditions that make you uncomfortable or interfere with your everyday life. Our experienced providers are here to help treat you with as much care and compassion as possible.”
What Conditions Do Urogynecologists Treat?
Urogynecologists are trained to treat a large number of pelvic floor disorders, including:
- Urinary incontinence: Urine leakage during physical activity like exercising or coughing, or as a result of overactive bladder. With either condition you may notice a small or large amount of urine leakage, or a frequent, sudden urge to urinate.
- Fecal incontinence: When stool leaves the body involuntarily. You are more likely to experience this after a higher-degree tear during childbirth.
- Pelvic organ prolapse: Occurs when pelvic organs such as the bladder or uterus drop due to weakened or damaged supportive tissue in the pelvic floor or vagina.
- Complex perineal tearing or prolonged wound healing.
- Sexual discomfort
- Pelvic floor weakness, which can contribute to any combination of the above disorders.
Urogynecologists also offer preventive services, and can assess a woman’s risk for complications associated with future pregnancies, childbirth, and aging.
How Do Urogynecologists Treat Pelvic Floor Disorders?
Your urogynecologist will assess your medical history and conduct a physical and pelvic examination before beginning treatment. If needed, they may utilize the following tests to help diagnose your condition and decide on a course of treatment:
- Cystoscopy: A procedure that uses a small camera to look directly into the urethra and bladder.
- Urodynamics: A series of tests that evaluate how well your bladder fills and empties.
- Electrodiagnostic testing (EMG): Evaluates nerve function by the pelvic floor’s response to a series of small electrical pulses.
- Anorectal manometry: A test that measures how well the rectum and anal sphincters work together to eliminate stool.
After evaluation and diagnosis, your urogynecologist can provide a number of different treatments and therapies to help improve your condition, including:
- Lifestyle and behavioral therapy: This can include pelvic muscle training, retraining the bladder between trips to the bathroom, relaxation therapy, and weight-loss counseling.
- Pelvic floor physical therapy. Pessaries: A safe and effective alternative to surgery, these devices are inserted into the vagina and can help provide support for prolapse, as well as bladder and bowel control problems.
- Medication.
- Surgery: If initial therapies don’t improve your condition, your urogynecologist may recommend surgery. Surgical repairs conducted by urogynecologists can include minimally invasive procedures for urinary leakage as well as pelvic reconstructive surgery.
We know a pelvic floor disorder may feel uncomfortable to talk about, but urogynecologists at Penn Medicine Lancaster General Health are here to help treat your condition and improve your quality of life. If you think you may be suffering from a pelvic floor disorder, don’t wait to get help. Talk to your provider for a referral or contact a urogynecologist near you to schedule an evaluation.