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Treatments for Pelvic Floor Conditions


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It is estimated that nearly 50 percent of women suffer from bladder and pelvic floor disorders at some point in their lifetime. And, because of the embarrassment associated with these types of disorders, many women suffer in silence.

Bladder and pelvic floor disorders, also known as urogynecologic disorders, include any pain or dysfunction in the uterus, cervix, vagina, bladder or rectum. Urogynecologic disorders affect women of all ages, but post-menopausal women and women who have given birth are at the highest risk.

The sudden urge to empty the bladder for no apparent reason, or urine leakage when coughing or sneezing, is called urinary incontinence.

There are two types of conditions that cause urinary incontinence: stress incontinence and urge incontinence.

Stress Incontinence

“Stress incontinence, the most common form of urinary incontinence, often occurs while coughing, sneezing, laughing or exercising,” says Lily Arya, MD, chief of urogynecology and pelvic reconstructive surgery at Penn Medicine. “It occurs when the urethra and surrounding muscles of the bladder lose their strength due to physical changes from pregnancy, childbirth or menopause.

Stress incontinence can be treated with physical therapy including Kegel exercises or the use of a removable pessary, similar to a diaphragm, that is inserted into the vagina or rectum to strengthen the pelvic muscles. In some cases, collagen injections may be used to help minimize urine leakage from the bladder.

In harder to treat cases, a surgical sling procedure may be used. Created from an FDA-approved mesh, the sling is inserted behind the urethra to support the weakened pelvic muscles.

Urge Incontinence

“Women with urge incontinence, or overactive bladder syndrome, experience sudden, strong urges to empty their bladders and can experience urine leakage,” says Heidi Harvie, MD, director of urogynecology at Pennsylvania Hospital. “Overactive bladder is caused by nerve damage in the bladder, which makes its treatment more complex.”

The first line of treatment, says Dr. Harvie, is fluid reduction. She also recommends women practice Kegel exercises, which can help calm the nerves of the bladder. Medications may also help overactive bladder syndrome.

“Medications can block some of the nerves in the bladder,” says Dr. Harvie. “While these medications are safe, they can have side effects such as dry mouth and constipation.”

Robotic Surgery for Pelvic Organ Prolapse

Pelvic organ prolapse, also called vaginal prolapse, occurs when the structures that stabilize the uterus are weak and the uterus falls or slides out of place into the vaginal area. Its treatment depends on the severity of the condition.

“Sacrocolpopexy, also called pelvic floor reconstruction, secures the pelvic organs in place with surgical mesh,” says Dr. Harvie. “Because we perform this surgery robotically at Penn, women leave the hospital within a day with minimal incisions, less blood loss and can recover faster.”

“Penn is setting the standard for the treatment of women with bladder and pelvic floor disorders,” says Dr. Arya. “Penn specialists are national leaders in urogynecology, and offer the latest procedures so women don’t have to suffer in silence.”

To schedule an appointment, call 800-789-7366 (PENN).

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