Pelvic Medicine & Reconstructive Surgery

Urogynecology, also known as Female Pelvic Medicine and Reconstructive Surgery, is a subspecialty of gynecology and urology. Urogynecologists specialize in the care of women with pelvic floor disorders including vaginal wall prolapse, urine leakage, and stool leakage.

The pelvic organs include the vagina, cervix, uterus, bladder, urethra, small intestines, and rectum. These organs are held in place by muscles of the pelvic floor and layers of connective tissue called fascia. These supporting muscles and fascia may become torn, stretched, or weakened. In this condition, the tissue and muscles can no longer support the pelvic organs. As a result, the organs can drop downward.

Prolapse

The main risk factor for pelvic organ prolapse is having had children. Other causes of pelvic support problems include the following:

  • Multiple children
  • Advancing age
  • Factors that increase pressure in the abdomen, such as obesity, constipation, and chronic coughing
  • Genetic factors

Locations & Contact Information

48 Centennial Way, Suite D
Greenville, SC 29605

Please call 864-455-1600 to schedule an appointment at any of these locations.

Incontinence (Urinary leakage)

One of the most common pelvic floor disorders is urinary incontinence (UI). Urine leakage affects both men and women, although it is nearly twice as common in women. There are several types of urinary incontinence:

  • Stress urinary incontinence – Loss of urine when a woman coughs, laughs, or sneezes. Leaks also can happen when a woman walks, runs, or exercises.
  • Urge incontinence – Leakage of urine that is preceded by an urge to void but the inability to make it to the restroom in time. Some women find themselves “dribbling” on the way to the restroom.
  • Mixed incontinence – A combination of both stress and urge incontinence symptoms.
  • Overflow incontinence – loss of small amounts of urine when the bladder does not empty all the way during voiding.

Though common, UI should not be accepted as a normal result of aging. The choice to seek treatment is usually based on how bothersome the leakage is and how it affects your quality of life. There are lifestyle changes that can be used to help manage urine leakage. If any of these apply to you, you may want to consider making one or more of these changes.

  • Lose weight. In overweight and obese women, losing weight has been shown to decrease urine leakage
  • Avoid constipation. Repeated straining may damage the pelvic floor. Constipation can also worsen bladder leakage
  • Perform pelvic floor muscle exercises (commonly known as Kegel exercises)
  • Drink less fluids and limit intake of caffeine
  • Seek treatment for chronic coughing
  • Stop smoking

Symptoms of pelvic floor dysfunction

  • Incontinence (Involuntary urinary or bowel leakage)
  • Prolapse (Descent of pelvic organs, causing a bulge and/or pressure in the vagina)
  • Emptying Disorders (Difficulty urinating or moving bowels)
  • Pelvic or Bladder Pain (Discomfort, burning or other uncomfortable pelvic symptoms, including bladder or urethral pain)
  • Overactive Bladder (urine frequency and urgency, or frequent night-time voiding)

When to See a Urogynecologist

You should see a urogynecologist when you have bothersome symptoms of prolapse, urinary or bowel leakage, sexual dysfunction, or when your primary care physician or obstetrician/gynecologist recommends consultation with a specialist. Other issues that may prompt you to consult a urogynecologist include the need for special expertise in vaginal surgery. Although your primary care physician or obstetrician/gynecologist may have knowledge about these problems, a urogynecologist can offer additional expertise. We do not require a physician referral to schedule an appointment with one of our providers. If you have insurance, you may want to check with your insurance provider to see if they require a referral to ensure optimal coverage.

Treatment options

Your urogynecologist can recommend a variety of therapies to cure or relieve pelvic floor problems. He or she may advise nonsurgical or surgical therapy, depending on your wishes, the severity of your condition, and your general health.  We offer the full range of treatments for pelvic floor disorders and are experienced in vaginal and abdominal approaches to treatment

Pelvic Floor Physical Therapy

We often recommend our patients have follow-up consultations and evaluations with a pelvic floor physical therapist. We partner with a team of physical therapists who specialize in working with women experiencing urinary, bowel and/or sexual problems. Pelvic floor physical therapists have advanced training in working with the musculoskeletal aspects of these diagnoses and are skilled in evaluating and treating the pelvic floor muscles as well as other musculoskeletal structures around the pelvis.

Your pelvic floor therapy may include Kegel exercises to help strengthen the pelvic muscles. Kegel exercises, along with bladder training and modifying fluid intake, are often very successful in treating stress incontinence and urge incontinence.

It may take 4-8 weeks to notice an improvement in urinary incontinence symptoms.

In addition, pelvic floor physical therapists provide behavioral education to help women understand how to develop healthy habits for bladder, bowel, and sexual function. Often times, we find that making small changes in daily routine, nutrition and fluid intake can create significant improvements in function.

What to expect during your first visit to our office

You may or may not be asked for a urine sample so try not to void prior to seeing your provider. We will take a history and do a physical examination which will include a pelvic (internal) examination. After making a diagnosis related to your individual situation, your urogynecologist will propose a treatment plan.

For more information on pelvic floor disorders you can refer to:
https://www.augs.org/patient-fact-sheets/