Urogynaecology is a sub-speciality of gynaecology that focuses on helping women with problems related to their pelvic floor and bladder.
The pelvic floor is the muscular base of the abdomen, which attaches to the pelvis bone. The pelvic floor is an important part of female anatomy as it supports the bladder, intestines and the uterus. It also plays a role to retain continence in the urinary and anal sphincters.
Urogynaecology conditions we diagnose and treat at Westminster Gynaecology include:
- Bladder disorders
- Prolapse, including:
- Cystocele – bulging of the bladder into the vagina
- Enterocele – bulging of the small intestine between the vagina and rectum
- Rectocele – bulging of the rectum into the vagina
- Uterine prolapse – dropping of the uterus into the vagina
- Urinary urgency, frequency and urgency incontinence
- Stress urinary incontinence
- Overactive bladder – medical management – drug therapy / Botulinum Toxin injections
- Voiding dysfunction
- Recurrent cystitis
- Painful bladder syndrome
- Pelvic organ prolapse (cystocele, rectocele, uterine / vault prolapse, primary and recurrent) – conservative and surgical management
- Surgical management for prolapse including Vaginal Hysterectomy, Anterior repair, Posterior repair, Uterine preservation surgery for prolapse and Laparoscopic Sacrocolpopexy
- Defecatory difficulty and anal incontinence
Are you experiencing any of these symptoms?
- Pelvic discomfort or pressure
- Painful urination
- Frequent urination – more than every 2 hours
- Urgent need to urinate immediately
- Nocturia – waking up more than once in the night to urinate
- Stress incontinence – leakage of urine during activities such as laughing, coughing or sneezing
- Urinary incontinence – leakage of urine
- Constipation or painful bowel movements
- Fecal incontinence – accidental loss of solid stool, liquid stool or gas
- Repetitive urinary tract infections
- Pressure on bladder or rectum
- Passing blood clots in your urine
- Dropping, or slipping, of your vagina or uterus
These symptoms could be the sign of a number of common, and less common, urogynaecology conditions.
The pelvic floor can be damaged by childbirth, repeated heavy lifting, surgery or chronic disease. Symptoms can leave you feeling not only in pain but also scared to leave the house for fear of needing to urinate. It can also leave you feeling low on energy as sleep can be regularly disturbed.
Consultation with an Urogynaecology specialist is the first step to highlighting the cause of your symptoms and taking the right steps to treating them.
Diagnosis and treatments may include:
Many Urogynaecology symptoms can be eased or eliminated using evidence-based treatment and by working closely with a specialist Urogynaecologist, who has experience in treating your symptoms.
Diagnosis will help to put your mind at ease and you can feel reassured that specialist help is available.
Treatments for a Urogynaecology condition may include, but are not limited to:
- Pelvic floor exercises
- Bladder training
- Changes to diet
- Pelvic Reconstruction
Also known as “Kegal” exercises, these involve tightening the muscles that support the pelvic floor. Incontinence and pelvic prolapse can be the result of these muscles weakening. A specialist exercise programme helps women to identify the right muscles they need to work on.
Bladder training involves training your body to urinate according to a timetable, rather than upon an urge.
Bladder symptoms may improve with some modest changes to diet, which are irritants to the bladder.
There are medications that treat incontinence and overactive bladders
This is a treatment to stimulate the nerve that communicates with the bladder. It can help if you have frequent urination, or urgent urination and also urinary retention.
Pessaries are used to help support a prolapsed vagina, bladder, uterus or rectum. They are silicone devices that a specialist doctor needs to fit. They can usually be worn for many years and are comfortable for women using them.
There are surgical options to correct stress incontinence and / or prolapse.
Pelvic reconstruction surgery aims to reconstruct the pelvic floor so all organs are in their original place.