Women’s Center for Bladder and Pelvic Health: Urogynecology at UPMC

The Women's Center for Bladder and Pelvic Health specializes in caring for women with pelvic floor disorders such as Urinary Incontinence and Pelvic Organ Prolapse. Women of all ages and races can suffer from bladder and pelvic floor disorders. The pelvic floor is a combination of muscles, ligaments and connective tissues that support the pelvic organs - the bladder, vagina, uterus and rectum. The pelvic floor can be weakened by a combination of factors such as childbirth, heavy lifting, the effects of menopause and aging, and other chronic medical and neurologic conditions. Although problems do become more common with advancing age, even young women can be affected.

Pelvic Floor Disorders We Treat

In a private, confidential setting, evaluation and treatment is available for all of the following conditions:

Urinary incontinence (leaking of urine)
Overactive bladder symptoms
Nocturia (awakening several times each night to void)
Fecal incontinence (passing of gas or stool involuntarily)
Pelvic organ prolapse (weakening of pelvis muscles)
Voiding disorders such as urinary retention
Recurrent Urinary Tract Infections
Genitourinary syndrome of Menopause (menopause related vaginal symptoms)
Painful Bladder Syndrome and Pelvic Pain
Voiding disorders such as urinary retention
Pain with Intercourse
Constipation
Genitourinary or rectal fistula

Our Services

We offer a comprehensive blend of services to bring relief for the conditions listed above.

Sometimes simple changes and interventions can have a significant impact on daily quality of life. A urogynecologist may advise conservative (non-surgical) or surgical therapy depending on your wishes, the severity of your condition and your general health. Conservative options include medications, pelvic exercises, behavioral and/or dietary modifications and vaginal devices (also called pessaries). Pelvic Floor Therapy with Biofeedback is another treatment that your urogynecologist may recommend. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse. These include minimally invasive same day surgeries such as mid-urethral slings or da Vinci Robotic Surgery.

Urodynamic Testing

Your urogynecologist will evaluate the results of your urodynamic tests to determine if your bladder is functioning normally and recommend appropriate treatment, if needed.

Treatment Options

Our goal is to restore function and improve quality of life for every woman. To do this we use the most current research and clinical standards to create individualized treatment plans that may include behavioral, medical, non-surgical, and surgical options. In addition our experts offer Robotic Assisted Surgery utilizing a dual-console da Vinci ® Surgical System for procedures.

Behavioral changes. Cutting back on fluids can be helpful in preventing sudden bladder urges or excess leakage.
Kegels. These exercises can help strengthen pelvic muscles that have been weakened by pregnancy, childbirth, surgery, aging and being overweight. View the Kegels and bladder training flyer from the American Urogynecologic Society.
Weight Loss can improve urinary incontinence.
Medication. For more severe incontinence, medication can reduce the symptoms or muscle spasms associated with the condition.

If these treatments do not help to control your urinary incontinence, your doctor may recommend specialized treatment. These options include:

Sling Surgery. If you are suffering from moderate to severe stress urinary incontinence, your doctor may recommend sling surgery. Sling surgery uses a piece of body tissue or a synthetic material to create a hammock-like cradle to support the urethra. The procedure provides support for your bladder neck and helps prevent involuntary urine leakage when coughing, sneezing, laughing or exercising.
Sacral Nerve Modulation. If medication does not help to control your urge incontinence or is not the best option for you, your doctor may recommend the Sacral Nerve Modulation. SNM is a small, surgically implanted device that is programmed to provide mild electrical stimulation to your sacral nerves at the base of your tailbone. The sacral nerves are responsible for sending messages to your brain related to bladder and urinary function. The electrical stimulation helps to improve communication between the brain and the sacral nerves so your bladder and pelvic floor muscles can function properly

What Is Urogynecology?

Urogynecology is a subspecialty of gynecology. It is synonymous with Female Pelvic Medicine and Reconstructive Surgery. A Urogynecologist is a physician with specialty training in the evaluation and management of disorders of the female pelvic floor.

What is incontinence?

Incontinence is the involuntary loss of urine, stool or bowel gas. There are a few different types of urinary incontinence. Approximate 50 percent of adult women have experienced urinary incontinence at some point in their life and 15 percent of women have experienced incontinence of stool at some point. Many women and health care providers think that this a normal process of aging and never seek any treatment and just learn to live with the conditions. Some women want help but are too embarrassed to ask. Incontinence is not a hopeless condition.

Common Incontinence Problems

Stress urinary incontinence. Stress urinary incontinence is an involuntary loss of a small amount of urine that occurs when laughing, coughing, sneezing or exercising. It is typically caused by a sagging bladder or urethra.

Urgency incontinence. Urge incontinence, sometimes called overactive bladder, is the strong, sudden need to urinate caused by abnormal bladder spasms or contractions.

Mixed incontinence. Mixed incontinence occurs when patients experience both stress and urge incontinence.

Fecal incontinence. The inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control.

It's reported that about half of all adult women say they have noticed urine leakage even in the most normal of daily activities, such as:

If you are suffering from urinary incontinence, the urogynecologists at UPMC Urogynecology provide expert, customized care for women using the latest diagnostic and treatment methods.

What is pelvic prolapse?

Pelvic prolapse occurs when the connective tissue and muscles in the pelvic floor weaken or tears. This causes the organs supported by the pelvic floor to fall into the vagina and sometimes protrude out of the vagina. Organs that can prolapse are the bladder and urethra, the uterus and cervix and the rectum. Symptoms of pelvic prolapse include a feeling of pelvic pressure, especially as exertional activity is performed or as the day progresses. Feeling as if something is falling out of the vagina or noticing a bulge or ball of tissue at the opening of the vagina. Some women may have difficulty emptying their bladder or bowel when prolapse is present.

What causes pelvic prolapse?

Like urinary incontinence, pelvic prolapse can be caused by many conditions. This can include aging and genetics, pregnancy and childbirth, obesity, chronic cough, constipation, heavy lifting and exertional lifting or exercise and smoking.

How is pelvic prolapse treated?

Pelvic prolapse can be treated with physical therapy in the early stages as well as the use of a pessary or surgery. A pessary is a device that is placed in the vagina that holds up the prolapsing organ. It is sized and fitted in the doctor's office. Patients can manage this by themselves but some women are too frail and this requires the health care provider to manage. Much like a tampon, once the pessary is placed in the vagina, a woman will not feel it. It causes little risk to most patients and is a great option for patients that do not want to have surgery or women that are not good surgical candidates. Surgical correction of prolapse is vast and is dependent on the type and degree (stage of prolapse), the patient's health and underlying medical problems and the surgeon's skill set and experience. Most prolapse surgery can be performed as an outpatient but some require the patient to send a night or two in the hospital. Surgeries can be performed vaginally, laparoscopically, robotically and through a large incision referred to as laparotomy.

Pelvic floor disorders significantly compromise the quality of women's lives, which may result in depression, social isolation, and avoidance of physical and sexual activity due to discomfort and embarrassment. Our experts are dedicated to improving the quality of our patients' lives.

Need more information?

Many of our providers offer video visits. Call the office or schedule via your patient portal.

Providers

Locations

SH Ob-gyn: Williamsport, Pa.

UPMC Williamsport
740 High St.
Suite 1004
Williamsport, PA 17701

Phone: 570-321-3300

Women's Center for Bladder and Pelvic Health-UPMC: Annville, Pa.

UPMC Outpatient Center
1251 E. Main St.
Annville, PA 17003