There’s Hope! Treatments for Common Bladder and Pelvic Floor Issues

Bladder leakage? Pelvic organ slippage? Take heart — you’re not alone, and treatment is available to improve your life. Start by talking with your doctor. Treatments vary widely, and will depend on your condition, its severity, the underlying cause and your general health.

Non-surgical Treatment

Many women successfully manage their symptoms without surgery. You’ll find a variety of approaches to urinary incontinence or pelvic prolapse. Chances are that one, or a combination of options, will be right for you.

With pelvic prolapse, one or more of the pelvic organs, like the bladder or uterus, bulges into or even out of the vagina. You'll find many treatment options for pelvic floor prolapse. Female Pelvic Medicine and Reconstructive Surgeon William Rush, MD, OB/GYN, Lifestages Samaritan Centers for Women, talks about treatment options for pelvic organ prolapse.

Click play to watch the video or read the transcript.

What are the treatment options for pelvic organ prolapse?

When I see a woman in the office for pelvic organ prolapse I always give them three options. The first option is to continue to monitor symptoms. If it's not interfering too much with her life or her symptoms aren't too bad that's usually what they choose to do. The second option is a pessary. A pessary is a plastic or rubber device usually made of silicon. We place it inside the office and it helps to support the vaginal tissues. It can really help relieve a lot of the symptoms from prolapse of the pressure and feeling like things are dropping down. The third option is surgery. For surgery, there's a few different ways that we can do it. But no matter how we do it the patients usually spend just one night in the hospital and are able to leave the next day. We will be able to perform it in a minimally invasive way, either laparoscopically, through a very small incisions in the belly about the size of my fingertip or, through the vagina. And so either way it's not too invasive usually and not of a large incision incision on their belly with any kind of huge recovery, although it is surgery, and that's the downside of surgery. Pessary the advantage is it's not surgery, but sometimes it has some limitations to getting the right fit.

 

Urinary incontinence is the loss of bladder control. Some women may experience leaking urine, while others experience strong, sudden urges to urinate. Female Pelvic Medicine and Reconstructive Surgeon Jerome Yaklic, MD, OB/GYN, Wright State Physicians Obstetrics and Gynecology, discusses treatment options for women experiencing urinary incontinence.

Click play to watch the video or read the transcript.

What are the treatment options for urinary incontinence?

The treatment for urinary incontinence really depends upon the causes. If it is a support defect problem that’s usually relates to stress incontinence, it tends to be mechanical type fixes. So, these patients often will respond to things like Kegel exercises, physical therapy to strengthen those muscles and help to resist the flow, involuntary flow of urine. They may respond to something conservative like a pessary, a little device that we place inside the vagina to help to support the bladder neck and prevent the dropping of the bladder that often leads to urinary incontinence or various surgical and office procedures that can help to improve those symptoms.

 

Many women have a minor degree of incontinence or prolapse, and can effectively manage their symptoms using one or more of these approaches:

  • Medication: Low-dose topical estrogen treats urinary incontinence by rejuvenating tissue in the vaginal and urethral area. Your physician may also prescribe anti-inflammatory drugs, antidepressants or antihistamines to relieve pain and other symptoms.
  • Nutrition counseling: What you eat and drink can influence your symptoms. Avoid irritants like coffee, tea, citrus and carbonated beverages.
  • Bladder retraining: Urinating at regularly scheduled times may help you manage or overcome incontinence.
  • Physical therapy: A physical therapist can instruct you in techniques like Kegel exercises to help strengthen pelvic floor muscles. They’re easy to do discreetly wherever you are.
  • Pessary: A pessary is a silicone support device that your doctor will insert into your vagina to support pelvic organs. If a pessary is right for you, it can be an ideal alternative to surgery.

Surgical Treatment

While many women can be treated successfully with non-surgical alternatives, sometimes surgery is the best option, especially if you have extreme discomfort, or your condition is interfering with your daily life. Based on your age, previous surgical history, severity of your prolapse and your overall health, your surgeon may recommend one of several procedures. There is no one-size-fits-all solution, and no single best approach for all patients.

  • Reconstructive surgery: Restores your pelvic organs to their natural position while retaining sexual function. Options include a vaginal or abdominal approach, as well as laparoscopic and robotic.
  • Vaginal closure: Can be the best choice if you have a severe prolapse, and are no longer sexually active. The vagina walls are stitched together to prevent a prolapse. Success rates are high – 90 to 95% – and recovery time is quick.
Many women successfully manage their symptoms without surgery.

Talk with Your Doctor

The key to improving your quality of life is seeking help from your doctor. If you can get past the embarrassment of talking about your urinary incontinence or pelvic organ slippage, you can regain your freedom and start enjoying life more fully again.