Urogynecology: Pelvic Floor Issues

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It’s embarrassing when you cough or sneeze and you leak a little. And it’s not always easy to talk about. But the reality is that pelvic floor issues are much more common than you think – especially in women. There’s good news, though. Most pelvic floor issues can be treated.

What’s a urogynecologist?

A urogynecologist is an OB-GYN doctor who’s also board-certified in female pelvic medicine and reconstructive surgery. Urogynecologists care for women who have pelvic floor issues, such as incontinence (urinary or fecal) and pelvic organ prolapse (a bulging of the uterus or vagina).

What is incontinence?

Incontinence is a loss of bladder control. It can happen to both men and women, but it’s twice as common for women. It’s estimated that 1 in 3 women will experience urinary incontinence.

Incontinence is more common in women because of pregnancy and menopause. During pregnancy, the weight of a baby can weaken the bladder and pelvic floor muscles. And labor and delivery can weaken them more. These muscles usually heal, but that’s not always the case. During and after menopause, estrogen levels decrease and urethral tissue can also weaken.

There are two kinds of urinary incontinence:

  • Stress incontinence. This is the most common kind. Leakage happens when you cough, sneeze, exercise, laugh, lift or do other movements that put pressure on your bladder.
  • Urge incontinence. This is sometimes called an “overactive bladder.” It can happen when you don’t expect it, like when you’re sleeping, after drinking water or when you hear running water.

Many women have both kinds of incontinence. This is called mixed incontinence.

Are there other pelvic floor issues?

Yes, other pelvic floor issues our urogynecologists treat include:

  • Pelvic organ prolapse. This happens when weakened pelvic floor muscles no longer support the bladder, uterus or rectum. These organs then sink into the vagina, creating a bulging or sagging sensation. Some women may even see tissue coming out of their vagina. Prolapse can cause discomfort or incontinence. It can also make it hard to empty your bladder or bowels. And it often interferes with sexual enjoyment or even sitting comfortably.
  • Fecal incontinence. Fecal incontinence is the accidental leakage of stool. It’s more common in women and older adults.

How do you treat incontinence or pelvic floor disorders?

If you have incontinence or a pelvic floor issue, you don’t have to stop enjoying normal daily activities. Treatment options are available to help you get back to living your life. Your doctor will partner with you to find a treatment that’s best for you. Treatment options may include:

  • Medication
  • Physical therapy
  • Relaxation techniques
  • Surgery

Where can I get treatment?

You can get urogynecology care at two locations in the Twin Cities: