Urinary incontinence : affects 70% of women between 40 -70 years, many women suffer in silence thinking it is a normal aging process, with no treatment for urine leakage. It posses a tremendous physical & psychological limitation to their professional and social life styles, and embarrassment.
Child birth trauma, aging, constipation, chronic cough, and obesity are factors leading to pelvic floor muscle weakness and laxity of ligaments, causing lack of support to the bladder and urine leakage.
. Stress urinary Incontinence (SUI) : Urine leak during a cough, sneeze or laugh.
. Over Active Bladder (OAB) : Frequent urination or compelling urge to urinate.
. Nocturnal Enuresis (NE) : Unconscious bed wetting at night.
. Overflow Incontinence : Overflow of urine after bladder is filled.
. Coital Incontinence : Loss of urine during sexual relationship.
. Athlete Incontinence: Loss of urine during sport activities.
. Urinary Fistula: Abnormal passage between the bladder or ureter and vagina.
Treatments in Urogynecology:
Conservative : Bladder retraining – kegel exercises – avoiding dietary irritants – physiotherapy
Medical : anticholinergic medication – bladder wall muscle relaxants – hormone replacement therapy
Non invasive : laser & radiofrequency – platelet rich plasma (PRP) – amniotic fluid – stem cell therapy
Surgical : Burch colposuspension – urethral fascia plication – mid-urethral slings (TVT – TOT – Mini Arc)
Platelet Rich Plasma (PRP) :
PRP injection in the peri-urethral area, anterior vaginal wall and clitoris, helps may women especially mid-aged to increase intimate sensitivity and correct or improve their urinary incontinence symptoms.
An abnormal communication between the bladder and vagina (Vesico-vaginal – VVF) or ureter and vagina (Uretero-vagianl – UVF) caused by trauma to bladder wall, during delivery, pelvic surgery or accidents. Treatment is usually surgical by closing the fistula tract (VVF) or re-implanting the ureter in the bladder wall (UVF).
Rectal / Fecal Fistula & Complete Perineal Tear:
Recto-vag fistula – (RVF): An abnormal communication between rectum and vagina, due to trauma, accidents, rape, or by delivery of large size baby tearing the vagina, perineum, and anal canal on its way out. This causes fecal and flatus incontinence and poor control. Treatment is by surgical repair.