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Finding Relief with a Pelvic Floor Disorder

You’ve probably heard of urology as well as gynecology, but maybe not urogynecology – you’re not alone as it’s a relatively new medical sub-specialty. However, the problems these specialized physicians treat are not new.  

Pelvic floor disorders – which include urinary incontinence, overactive bladder and pelvic organ prolapse, among other conditions – can alter a person’s quality of life.  

This is where urogynecologists come in. These physicians specialize in female pelvic medicine and reconstructive surgery and are trained to treat these specific disorders to help patients find relief. 

“People think urogynecology is a mixture of urology and gynecology, but it is really its own unique sub-specialty,” said Dr. Elisha Jackson, a urogynecologist who joined UTMB Health this summer. “I take care of patients with pelvic floor disorders; that covers urinary incontinence, overactive bladder, fecal incontinence, prolapse, painful bladder syndrome and recurring UTIs.” 

Offering a Wide Range of Treatment Options 

Treatments for pelvic floor disorders are wide-ranging, and urogynecologists like Jackson are well-equipped to perform the full spectrum of treatments for the various pelvic floor disorders. 

Urinary incontinence can be associated with certain movements such as exercise or cough, or with urgency such as an accidental leakage on the way to the restroom. Urogynecologists can determine the type of urinary incontinence and offer the best treatment plan to alleviate someone’s symptoms.  

Overactive bladder, which causes the sudden need to urinate, can be treated with conservative options, such as physical therapy and medication, as well as more advanced treatments, including Botox injections in the bladder, tibial nerve stimulation and sacral neuromodulation (InterStim). InterStim is a device that is implanted to stimulate the sacral nerve, which helps restore control of muscles used for bladder function. 

Pelvic organ prolapse is another condition with conservative and surgical options. A pessary, which is a soft, removable device, can be inserted without surgery to support the pelvic organs. The surgical options include sacrocolpopexy, which involves use of a synthetic material called “mesh,” and native tissue repairs, which involve use of the patient’s own tissue or ligaments. 

Pelvic floor dysfunction causes the muscles of the pelvic floor to be tight. People who experience this issue may have trouble emptying their bladder or experience painful vaginal intercourse – an important part of their treatment is physical therapy of the pelvic floor muscles. For symptoms that cannot be controlled through physical therapy, a urogynecologist can inject Botox into the pelvic floor muscles and complete pelvic floor therapy in the operating room. 

Interstitial cystitis, a chronic bladder condition resulting in recurring pelvic pain, may be treated with a bladder instillation, in which a small “cocktail” of medications is added to the bladder.  

Jackson said she sees patients who are at all different points in their journeys with pelvic floor disorders – some are seeking care for the first time and others have already tried conservative therapies and need more advanced care.  

“Urogynecology is a very specialized sub-specialty,” Jackson said. “For women with pelvic floor disorders, we offer individualized care so that they can get back to enjoying life.” 

UTMB Health’s Department of Urogynecology and Pelvic Health offers medical and surgical treatments to successfully improve and restore pelvic health and continence – and the freedom and quality of life that come with them. To learn more, visit www.utmbhealth.com/services/urogynecology-and-pelvic-reconstructive-surgery.