Urogynecology and Pelvic Reconstructive Surgery

Non-surgical Treatments

Non-surgical Treatments Dr. Hall offers comprehensive treatment options for women with pelvic disorders. Depending on the exact problem or problems and the patient’s wishes, treatment can be surgical or non-surgical.

Pelvic exercises—pelvic muscle rehabilitation
Pharmacologic treatments
Pessaries
Behavioral modification

Pelvic exercises—pelvic muscle rehabilitation. Pelvic exercises can be done anywhere at any time, sitting, standing or lying down. The exercises are designed to strengthen a woman’s ability to hold and release urine and stool, and are easily integrated into a person’s day. Many women find it hard to identify and contract these muscles and, therefore, it is necessary that a caregiver makes sure that a woman is doing the exercises properly. Referral to a specialized physical therapist is sometimes necessary to use modalities such as biofeedback and electrical stimulation to optimize improvement. Pelvic floor physical therapy also is intrinsic to improvement in women with pelvic floor dysfunction and Levator Muscle Spasm.

Pharmacologic treatments. Patients have many different pharmaceutical options for treating incontinence, including medications taken by mouth and a patch that is applied to the body. They are especially useful for

Did you know….

Only 50% of women are able to perform a “Kegels” exercise properly. Biofeedback can help teach a woman the correct technique to strengthen the pelvic floor maximally.

women with overactive bladder symptoms and may also be offered to improve stress urinary incontinence. Women with pain disorders can be treated with neuromodulators and other medications in conjunction with other modalities. Constipation management is important in women with defecation disorders and rectal prolapse.

As with all drugs, side effects and results vary by patient but the pros and cons are discussed in full before prescribing medication.

Pessaries. A pessary is a device (kind of like a diaphragm) worn in the vagina to support the vagina due to uterine or vaginal vault prolapse and cystocele (bladder) prolapse.

Pessaries are placed in the vagina in the office to support the pelvic organs and relieve symptoms of prolapse

Sometimes they can be used to treat stress urinary incontinence and rectoceles. Pessaries come in many shapes and sizes and are placed by Dr. Hall according to what will work best for the particular patient. Pessaries can be used temporarily in a patient who ultimately desires surgery, or may allow the patient to avoid surgery altogether.

Behavorial modification. For some women, behavioral modification can be very effective in minimizing symptoms. Women with urinary frequency without leakage can train their bladder to hold more by gradually increasing their voiding interval. Other women, who have a poor sensation of bladder filling until it is too late, can void more often to minimize leakage. Avoidance of bladder irritants such as caffeine, alcohol, and artificial sweeteners can also be helpful.