At Metro OBGYN, we receive a lot of questions about urogynecology and pelvic health, so we decided it’s a good time to compile the most commonly asked questions into a brief guide. Below, you’ll find 15 frequently asked questions—and remember—if you’re suffering from pelvic pain, you’re not alone.
1. What is a urogynecologist?
A urogynecologist is a board-certified specialist trained in urology, gynecology, and obstetrics. In short, urogynecologists diagnose and treat any issues or problems within female pelvic health and reconstructive surgery. Specialists must spend four years studying general obstetrics and gynecology training, and they must also have an additional three years of subspecialty training in women's pelvic health.
2. What and where is the pelvic floor?
The muscles, ligaments, connective tissues, and organs located within your pelvis make up the pelvic floor. These muscles also help support and maintain bladder and colon control. When someone loses control (whether through weakened muscles, surgery, childbirth, heavy lifting, straining, or chronic diseases), it can cause a wide range of problems that may affect everyday life. Disorders of the pelvic floor may include pelvic pain, pelvic organ prolapse, urinary incontinence, or bowel incontinence.
3. What is urinary and fecal incontinence?
Urinary incontinence is when there is a loss of bladder control which can lead to urinary leakage, frequent urination, and difficulty emptying the bladder. There are seven types of urinary incontinence, with the three most common being stress urinary incontinence, overactive bladder, and mixed incontinence. Symptoms may include a high frequency of urination, a quick urgency sensation, leakage, or inability to hold urine for a long time.
Bowel (fecal) incontinence is when there is a loss of bowel control which can lead to accidental bowel leakage. There are two types of bowel incontinence, accidental and constipation. Symptoms may include leakage, straining, abnormal bowel movements, and less than three bowel movements a week.
4. I’ve heard the term POP, what is it?
POP is short for pelvic organ prolapse, and it occurs when the pelvic organs drop due to weakened muscles and loss of support from the vagina. When organs drop from where they are located, it can cause a range of issues like discomfort, bleeding, urinary leakage, difficult bowel movements, and in some cases create a painful bulge near the vagina. There are different severity levels for POP which include conservative and non-conservative treatment options. It’s best to discuss all pelvic floor disorder treatment options with your provider.
5. When should I see a urogynecologist?
There are many reasons why you should visit a urogynecologist, and a few of these may include:
- You’re having symptoms of endometriosis
- There is a concern about a possible condition
- Your symptoms are getting worse
- You feel a lump or bulge outside your vagina
- Unusual spotting or bleeding
- Your daily activities are affected by discomfort and pelvic pain
- Your daily activities are affected by frequent urinary tract infections, and other urinary problems like difficulty urinating or frequent urination
- You’re experiencing pain during intercourse
- You’re experiencing miscarriages and infertility
6. What medical conditions do urogynecologists treat?
Urogynecologists treat a variety of pelvic floor disorders which include all types of urinary and bowel incontinence. Some of the other conditions treated by an urogynecologist may include:
- Pelvic Organ Prolapse
- Uterine Prolapse
- Pelvic Pain
- Abnormal Bleeding
- Ovarian Cysts
7. What kind of treatments should I expect?
Treatments for pelvic floor disorders vary depending upon the severity of the condition. Simple changes can be made to your lifestyle such as changing your diet or quitting tobacco use. Other options include pelvic support devices like a vaginal pessary, to minimally-invasive surgery, and even more complex operations if the incontinence or pelvic floor disorder is severe enough. Discuss treatment with your provider to find the right plan for you and your lifestyle.
8. What causes incontinence and pelvic floor disorders?
Incontinence and pelvic floor disorders are caused by damage to the pelvic floor muscles, nerves, and supporting/connecting tissues. Other factors may include:
- Chronic Diseases
- And More
9. Will my pelvic floor issues go away over time?
Unfortunately, this is not the case, as problems with the pelvic floor don’t just go away. They will eventually get worse over time if precautions and steps aren’t taken to help aid the pelvic muscles. There are many different treatment options from lifestyle changes to alternative medicine to surgery that can ease any issues associated with the pelvic floor. Talk with your provider about the best treatment options for your pelvic floor disorder.
10. I’ve heard that surgery often doesn’t work, is this true?
In the past, many surgeries surrounding pelvic floor disorders often had higher recurrence rates, but today that number has decreased significantly. There are new procedures that improve the success rate. Talk with your provider about all surgical options which can help prepare you to make the best decision for your treatment.
11. Are there any at-home remedies for incontinence?
There are some at-home treatments you can do to relieve your symptoms, such as observing symptoms, monitoring experience, and increasing exercise into your lifestyle. Whether or not at-home remedies work depends on the severity of the incontinence or pelvic floor disorder. If the condition is severe enough, at-home remedies or lifestyle changes may not work. Other options for easing discomfort and pain include strengthening your pelvic floor and eating a high-fiber diet. It’s also recommended to avoid tobacco products, caffeine, and other sugary beverages.
12. Kegels don’t seem to be working, what else should I try?
Kegels are a great way to help strengthen your pelvic floor muscles, but only if you’re doing them right. We suggest scheduling an appointment with a pelvic floor specialist to see if you’re properly completing Kegels. Pelvic floor specialists and urogynecologists will also be able to give you other at-home exercise options to try. If you want to know more about how to improve your pelvic health, here are a few tips to get you started.
13. I’m embarrassed to talk about my pelvic issues, should I be?
While it may be embarrassing to discuss pelvic pain or incontinence, you should know that you’re not alone. Any pelvic issue, no matter the age, is not normal. It’s important to remember that your provider works with many people who deal with the same issues and problems that you may be having. Discuss your feelings with your provider to find a way to overcome any anxiety or stress you may be feeling when it comes to pelvic problems. Your provider is there to help you every step of the way, and they may be able to point you in the direction of support groups so you can meet others with the same condition.
14. What should I expect at my first visit?
Upon your first visit, you’ll discuss your health history and any symptoms with a provider who will then complete a specialized evaluation. This examination is similar to what you may experience during an annual gynecological exam, but it’s solely focused around the pelvic floor region. A provider may also test your muscle strength, and check your bowel and bladder for pain points. Further testing may include an ultrasound, MRI, or CT scan to determine what type of pelvic floor disorder you may have.
15. Do I need to bring anything to my first visit?
When planning your first urogynecologist visit, it’s recommended that you bring a complete medical history, any relevant medical records, radiology reports, laboratory reports, and any additional information like a bladder diary. A bladder diary is a list of times and dates you experienced any symptoms, what they were, and if you did anything to help ease those symptoms. This information will be reviewed to help better diagnose your condition.
Suffering from Pelvic Pain? Stop by Metro OBGYN
We offer four Twin Cities locations that assist pelvic pain and pelvic-related issues. Schedule your appointment today to see one of our leading metro area providers who can help you get back to feeling your best!