Pelvic Floor Disorders and Urogynecologists

by Natalie Piekos

Not only is Emory healthcare on the cutting edge of technology, but Emory also strives and succeeds in their efforts at providing excellent quality patient care. At Emory, we realize that advanced technology is only a portion of good healthcare. Compassionate and understanding doctors are also critical. Emory realizes that it is the combination of providing up-to-date procedures along with personalized care that sets Emory apart from other medical facilities and is especially critical in their Gynecology and Obstetrics division.

At Emory’s Women’s Center, this two pronged philosophy is especially important. A developing area in Obstretrics and Gynocology is urogynecology. While a urologist specializes in the treatment of the urinary system, and a gynecologist focuses on the female reproductive system, a urogynecologist is the first sub specialist to combine the two fields. Simply put, a urogynecologist is an Ob/Gyn or Urologist who specializes in caring for women’s urology and pelvic problems.

Urogynecologists who specialize in caring for a woman’s specific urology and pelvic problems. Although it may seem that this area is not needed, conditions treated by urogynecologists affect 1 out of every 4 women. This number actually exceeds the amount of women who suffer from hyper-tension, diabetes or depression. An easy way to grapple with the term urogynocologists is to think of this sub-specialist as an Ob/Gyn or Urologist who concentrates on caring for a woman’s urology and pelvic problems.

Urogynecologists are knowledgeable in Obstretrics and Gynecology, and have additional training in the evaluation and treatment of conditions that affect the female pelvic organs and the muscles and connective tissues that support the organs. This training allows them to help women with both surgical and non-surgical treatment of non-cancerous gynecologic problems that often result due to childbirth, menopause or aging. Conditions treated by urogynecologists affect 1 out of every 4 women. This number actually exceeds the amount of women who suffer from hyper-tension, diabetes or depression.

Pelvic floor disorders such as urinary or fecal incontinence and prolapse (bulging or falling) of the vagina, bladder and/or the uterus are among the most common procedure urogynecologists treat. Prolapse is when female organs fall down into the pelvic area; a gradual procedure that occurs over the course of many years. This problem is often accompanied by incontinence because both conditions are believed to result from damage to the pelvic floor that occurs after childbirth. However, while delivering a child is often a factor, other possible factors can lead to these conditions. For example, very heavy lifting on a daily basis (as some paramedics and factory workers might do) chronic coughing, severe constipation and obesity may all play a role in developing prolapse or incontinence.

Treatments for these conditions fall under three main categories: behavioral, pharmacological, and surgical. Behavioral changes like diet and exercise modification can greatly help patients. Certain foods and beverages contribute to urgency, increased frequency, and urge incontinence, and by reducing or eliminating these items, women can decrease their symptoms dramatically. Kegel, or Pelvic Muscle Exercises, can also help, as they strengthen a woman?s sphincter muscles thereby reducing incontinence. These methods can be enhanced by Biofeedback or Electric Stimulation which are two newer treatment options that urogynecologists often recommend.

If these fail, pharmacological treatment is attempted and medication is proscribed. Surgical treatments for these conditions may also be used. One of the more common surgical procedures is called Interstim Therapy and this is used specifically for treating incontinence. Small electrical impulses are sent to the sacral nerve to decrease the symptoms of urgency, frequency, urinary retention and most importantly, urge incontinence. In addition, there are ongoing studies involving injecting Botox into the bladder wall; more information on this procedure is still needed before it is recommended. Other more recent methods are Biofeedback or Electric Stimulation which help a woman to recognize how to control certain pelvic muscles.

Emory continues its role as a top medical institution because it is not simply research oriented but understands the stress, anxiety, and confusion its patients may face when seeking treatment and going through the steps of recovery. Women’s Health Services are especially attuned to the concerns of its patients, and responds with a staff team that is especially understanding, supportive, and compassionate. In addition to a caring medical staff, Emory Women’s Health Services still remains at the forefront of new procedures and technology with its Center for Pelvic Reconstructive Surgery & Urogynecology. Emory is cognizant of new research and problems that women are incurring, and responds appropriately.

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