Female Urology
Treatment
Female Urology Treatment
Most common conditions are urinary incontinence, urinary fistulas and pelvic organ prolapse.
Treatment of urinary incontinence
Treatment for urinary incontinence depends upon the cause. The same treatment does not work in all cases. Diagnostic tests and imaging is done to determine why the bladder and associated muscles are not controlling the flow of urine. Causes may be problems in the muscles or in the nerves that control them. Certain types of prior surgery that interfere with the urethra (the tube that allows urine to pass out of the body) may also result in incontinence. Treatments for urinary incontinence include:
- Strengthening pelvic muscles: Exercises can strengthen the muscles around the urethra that hold urine back. You can also develop a schedule for going to the bathroom, gradually extending this as you regain urinary control.
- Medicines: Bladder spasms may result in a frequent urge to go to the bathroom. Certain medicines can relax your bladder and give you more control over when you urinate.
- Surgery: With surgery, bladder can be repositioned, providing support and restoring control over the sphincter muscles, which hold back urine. Different materials are used to provide support like either your own tissues or synthetic or animal-based materials. Minimally invasive tools can be used to resolve incontinence like cystoscope or transurethral probe. Cystoscopes are small, flexible tubes containing cameras and sometimes other tools. They allow us to view and treat the urethra and bladder without an incision. Using the cystoscope, we can inject medicine to relax the bladder (Botox®). Transurethral probes may be used for imaging procedures, such as ultrasounds, or to deliver radiofrequency energy that stimulates the bladder.
Treatment of urinary fistulas
Fistulas are abnormal communication between the bladder/ureter and the vagina. Small fistulas can heal spontaneously by simple stenting and urinary bladder drainage while the bigger ones usually need surgery either by open surgery (through the abdomen or vagina) or by laparoscopic methods. The treatment depends upon the site, size, cause and duration of the fistulas.
Treatment of pelvic organ prolapse
Treatments vary depending on the degree of the prolapse and its cause. Possible treatments include:
- Behavioral changes - Losing weight may reduce stress on pelvic muscles. You can also avoid physically demanding activities. These changes may provide enough relief so that patients do not need any further treatment.
- Nonsurgical treatment - A device called pessary is inserted into the vagina to support the uterus, bladder or rectum. The type and size of the pessary is fitted to meet patient’s individual needs and body structure.
- Surgery - Using your own pelvic tissue, we build support for the uterus and return it to its natural position. We may also use animal-based or synthetic mesh for this procedure. One advantage of synthetic mesh is that it does not weaken over time, so the repair is very durable.