Frequently Asked Questions

• What is a urogynecologist? What do they specialize in?
  A urogynecologist is a surgeon who specializes in the care of women with pelvic floor disorders. The pelvic floor is the set of muscles, tissues and ligaments in the pelvis that support a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum.
• What can I do to prevent incontinence and pelvic floor disorders?

  While incontinence and pelvic floor disorders are common and may be dependent on your genetics or other factors that are not avoidable, there are a few things you can do to reduce your likelihood of developing a pelvic floor disorder:

  • Do pelvic floor muscle exercises to strengthen your pelvic floor
  • Eat fiber to ease stress on the bowels
  • Avoid caffeine and other beverages to increase your bladder control
  • Maintain a healthy weight, don’t smoke and avoid excessive lifting
• What are some bladder training or pelvic muscle exercises I should do? Anything besides Kegels?

  Strengthening the pelvic floor muscles can help reduce or stop urine leakage. It is important to do pelvic floor muscle exercises correctly. To be sure that you’re working the right muscles:

  • Imagine that you’re passing gas and try squeezing the muscles that would prevent the gas from coming out.
  • Try contracting your pelvis muscles. Using a hand mirror, you should be able to see the perineum (the space between the vagina and rectum) lift up.
  • Kegel exercises: To check if you are doing kegels correctly, lay or sit down and place one finger inside your vagina. Squeeze your pelvic muscles as if you were trying to stop urine from coming out. You should feel your finger lifted and squeeze if you are successfully contracting your pelvic muscles.
• Is it possible that my pelvic floor problems will go away over time?

  It’s unlikely that a pelvic floor disorder will go away on its own. In some cases, your urogynecologist may suggest observing the situation over time, provided that the symptoms aren’t severe.

  If left untreated, some incontinence and pelvic floor disorders can get worse so it is important to talk with your doctor and explore treatment options early.

• How long does it take to recover from pelvic floor surgery?

  Pelvic floor surgeries are often reconstructive surgeries, so you should take time to heal without placing additional stress on your body as you recover.

  Many women return to their daily lives soon after surgery, keeping away from activities that stress their pelvic floor like squatting, bending or lifting. This period of limited activity may last up to three months, depending on the surgery.

• Can a urogynecologist serve as my OBGYN and conduct my annual well-woman exam?
  Yes, urogynecologists are trained in gynecology and obstetrics and are able to conduct your annual well-woman examination.
• How common is urinary incontinence in women? Is it a normal part of aging?

  Stress urinary incontinence is loss of urine that occurs at the same time as physical activities that add pressure to the abdomen, such as sneezing, coughing, laughing or exercising. Approximately 1 out of every 3 women over the age of 45 and 1 out of every 2 over 65 have stress urinary incontinence.

  While stress urinary incontinence is common, it does not need to be a normal part of aging and treatment can help.

• Does pregnancy and childbirth cause urinary incontinence and leakage?

  As the baby and uterus grow during pregnancy, there is extra pressure and stress placed on the bladder – making it easier for any exertion, like laughing or sneezing, to push urine out of the bladder. Most women who have incontinence during pregnancy return to full continence after delivery as the birth canal heals.

  During labor, the pressures generated by pushing and the delivery can damage the pelvic tissues and nerves that lie on each side of the birth canal. Over time and with age, the normal supporting tissues of the bladder, uterus and rectum weaken, adding to the effect of childbirth injuries. That said, the vast majority of women who give birth do not have any residual effects of incontinence within a few months after birth.

• What is a sling surgery and how do I know if it's a good option for me?

  Sling procedures are performed through a vaginal incision and use a strip of your own tissue (called the fascia) to cradle the neck of the bladder. Synthetic mesh materials and donor tissues are also options.

  To decide if a sling procedure is right for you, talk with your doctor about all of your options and decide which treatment is best for your specific goals and situation.

• What tests are done to diagnose incontinence?
  A physical exam by a urogynecologist is the first step in determining the cause of your symptoms. If needed, your doctor may recommend urodynamic testing – a specialized test that looks at the ability of your bladder to hold urine at different capacities by using a catheter (tube placed into the bladder).