Services for Bladder and Pelvic Floor Problems
There is no reason to suffer in silence from
a pelvic or bladder condition. Nearly 85 to 90
percent of urogynecologic conditions can be diagnosed
and successfully treated through minor lifestyle
changes, medications, or surgery.
The Division of Urogynecology at Penn offers
comprehensive, efficient, state-of-the-art services
for a variety of bladder and pelvic floor disorders.
Our specialists
are amongst the best in the nation and are dedicated
to the evaluation and treatment of urogynecologic
conditions in women. We conduct national and
international clinical trials, providing our
physicians access to the most progressive therapies
available.
Our services and treatments include but are not
limited to:
Diagnosis and Evaluation
Our goal is to provide diagnostic and therapeutic
options tailored to your urogynecologic needs.
Our approach is to efficiently complete your
evaluation in a comfortable and friendly environment.
We keep you informed of your condition, enabling
you to make educated decisions and take control
of your situation.
Your evaluation may include:
- History and physical examination – The
first office visit consists of an interview
and consultation followed by a physical exam
and pelvic exam. Following the exam, the
doctor may recommend specialized testing.
- Urine examination – A urine
analysis and culture are performed to detect
infection, inflammation, blood or other underlying
kidney problems.
- Cystoscopy – This in-office
test enables the physician to look directly
inside the bladder through a small camera inserted
through the urethra. It is a common test used
to detect inflammation, stones or tumors.
- Multi-channel urodynamics – Urodynamic
testing evaluates the bladder's function. These
in-office tests are particularly useful for
women with urinary incontinence or urinary
frequency.
- Electrodiagnostic testing (EMG) of the
pelvic floor – This testing evaluates
nerve function of the pelvic floor. EMG determines
the pelvic floor's muscle response to a series
of small electrical impulses.
Depending on your condition, additional tests
such as anal manometry, defecography, anal ultrasound
and pelvic magnetic resonance imagery (MRI) may
be performed. We strive to evaluate your problem,
offer a diagnosis, and recommend the best treatment
options for you.
Behavioral Therapy
Behavioral therapy is safe, easy to learn, and
does not have side effects. Examples of behavioral
therapy are:
- Pelvic Muscle Training – Regularly
practicing pelvic muscle (Kegel)
exercises to help muscle control and manage
leakage
- Bladder Training – Lengthening the
time between trips to the bathroom to train
the bladder to help women with urge incontinence
- Relaxation Exercises – Breathing slowly
and deeply when the urge strikes
- Fluid and dietary modification – For
example, decreasing daily
caffeine intake to help reduce or eliminate
urine leakage
Devices and medications
Pessaries and other devices can be used to treat
some conditions as a safe alternative to surgery.
Medications are available to treat a variety
of urogynecologic problems.
Surgery
Surgeons specialize in a variety of surgical treatment options that range from minimally invasive surgery (including robotic gynecologic surgery), vaginal surgery and abdominal surgery.
- Minimally invasive surgery
for stress incontinence – This surgery includes
transvaginal slings ('tapes'), fascial slings
and collagen injections.
- Minimally invasive surgery
for urge incontinence: Sacral Nerve Stimulation – This technique
electrically stimulates the sacral nerves that
influence the behavior of the bladder, urinary
sphincter and pelvic floor. It is an outpatient
procedure, performed in two stages and is highly
effective, safe and well tolerated.
- Laparoscopic surgery – A surgery performed
via small incisions using specially designed
surgical instruments and viewed through a laparoscope,
or surgical telescope. This surgery can be
used to treat a prolapsed uterus.
- Pelvic reconstructive
surgery – If
your condition permits, urinary incontinence
or pelvic organ prolapse can be repaired
through the vagina with no visible abdominal
incisions. For advanced conditions, abdominal
surgery may be recommended.
Our surgeons use advanced techniques and materials
such as biologic grafts and synthetic meshes
to minimize the chance of recurrence after surgery.
Surgeons also can perform vaginoplasty operations
for women who do not have a vagina.
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