Women’s Health Topics

Millions of women suffer from several bladder and bowel related issues in silence and shame. The most common problem females face is

  1. Overactive bladder or OAB as it is known commonly known results in frequency to prevent embarrassing leakage and urgency when they just have to go. The bladder rules them so much that they scout for bathrooms when they reach a new place, know where all the bathrooms are located, they get dehydrated because of the fear of drinking fluids in case they are unable to make it to the bathroom.
  2. Urge Incontinence: Patients have this sudden need to just make a run to the bathroom. They can just wait for a few minutes or not at all. The bladder just spasms causing a severe urgency to void.
  3. Stress Incontinence: Leakage a few drops or more occurs during laughing, sneezing, coughing, running, jumping, dancing or any physical activity. The pelvic floor muscles are generally weakened and the patients may have certain degree of pelvic organ prolapse.
  4. Mixed Incontinence is a combination of both urge and stress combined.
  5. Overflow Incontinence: It is the sudden release of urine, the most likely cause being weak detrusor muscle, pelvic floor muscles or blockage of the bladder. Pt presents with the symptoms of sudden leakage of urine, while awake or sleeping, a need to urinate even though they have just urinated, stopping and starting of urination.
  6. POP or Pelvic Organ Prolapse: These are further subdivided into
    1. Cystocele: When the bladder descends into the vagina due to weakness or tearing of the tough fibrous wall between the vagina and the bladder. Usually it is noticed by women after menopause due to the decrease of the estrogen. Estrogen maintains the strength and elasticity of the pubocervical fascia. Symptoms include leakage with coughing, sneezing, laughing, lifting.
      There are 3 grades of cystocele.
      Grade 1: Here the bladder just drops slightly.
      Grade 2: Bladder can sometimes be seen at the vaginal opening.
      Grade 3: descends out of the vagina.
    2. Urethrocele: When the tissues which hold the urethra in place weaken, the urethra falls into the vagina. It frequently occurs in conjunction with a cystocele. The term for that is cystourethrocele.
    3. Rectocoele: When there is a tear in the the fascia between the rectum and the vagina, the rectum falls into the vagina. Causes include childbirth and hysterectomy in women and prostatectomy in males. Symptoms include incomplete defecation(passing of stools) because the fecal material stays in the pouch formed by the rectum in the vaginal. In males the prolapse may be from the anus.
    4. Enterocele In this case the small intestine protrudes into the vagina.
      Treatment options: Include physical therapy to strengthen pelvic floor muscles, including Kegel exercises, core muscle exercises, Biofeedback, electrical stimulation, Neuromuscular reeducation, pessaries and surgical options per the recommendations of the gynecologists and urogynecologists. Please refer to the treatment page for detailed information.
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