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The physicians at the Good Samaritan Women’s Center for Specialized Care and at Cincinnati Urogynecology Associates regularly treat these urogynecological conditions:
Urine leakage is a sign that you have a medical problem that needs to be treated. Treatments depend on the type of incontinence you are experiencing. To properly diagnose, your doctor will ask about your symptoms and medical history including your pattern of urinating. You may be asked to complete a bladder diary for a few days. Depending on your type of incontinence, tests may be recommended. These may Dr. Kleeman with patientinclude a simple bladder filling study, complex urodynamics or cystoscopy.
If certain everyday activities cause your urine to leak, you likely have stress incontinence. It can occur when you stress the bladder with a sudden increase in pressure such as:
Your doctor will help determine the reason for your stress incontinence. Treatment depends on the severity of your symptoms. Options include exercises, lifestyle changes, medications and surgery.
If you have sudden urges to urinate that can be difficult to suppress, you probably have an overactive bladder. This occurs when your bladder muscles contract without warning, causing you to urinate more frequently than normal. This may or may not be associated with urge incontinence (frequent, sudden urges to urinate followed by leakage).
Symptoms include:
If an overactive bladder disrupts your daily routine, talk to your doctor. Treatments are available that can help considerably. They may include bladder training, exercises and/or medication.
Functional incontinence is most common among elderly patients with arthritis, Alzheimer’s or Parkinson’s disease. It occurs due to limitations in moving, thinking or communicating.
If you experience problems with pelvic organ support, you are not alone. This can be described as a sensation of bulging, or pressure in the vagina, or the feeling of “falling down” in the vagina. The problem often begins after childbirth and may get progressively worse during the aging process. You may hear health care professionals refer to pelvic support problems as prolapse or herniation.
Symptoms of pelvic support problems depend on the organ involved. Symptoms can range from
mild to severe. They can include:
Feeling of pressure, pelvic heaviness, bulging sensation or something falling out of your vagina
Your symptoms of pelvic support problems may be worse at certain times, (for example, at the end of a long day, especially after standing for long periods, or just prior to menstruation.) Conditions may occur separately or in conjunction with other types of prolapse.
Specific pelvic support problems are designated by the organ bulging into the vagina:
Your health care provider will do a complete history and physical exam. A pelvic exam will be performed while you are lying down and again while standing. If you have problems with leaking urine or voiding completely, bladder function tests may be necessary.
Treatment of pelvic support problems may include:
Problems with sexual desire, arousal, orgasm, and pain that bothers you is considered sexual dysfunction. The causes are varied and may include:
If you experience pain during or soon after sexual intercourse (called dyspareunia) you are not alone. There are many possible reasons for the pain. Your doctor can help you pinpoint the cause. Possibilities include:
Depending on the cause, your doctor may recommend treatments that you can administer at home. Other treatment options include medications and/or therapy. Be sure to notify your doctor if the pain is accompanied by bleeding, vaginal discharge, genital lesions or irregular periods.
Resolving sexual function issues begins by discussing them with your doctor. She can help you find the reason for your symptoms. Recommended treatment will depend on your specific problem.
Painful bladder is a syndrome of recurring discomfort in the bladder, urethra or the surrounding pelvic region. Symptoms include:
Your pain may increase as your bladder fills, and decrease as it empties. It may go away for weeks, then return for no apparent reason.
It is important to rule out other causes for your bladder discomfort, or urgency and frequency. Your physician visit will include a detailed history and physical exam. Other testing may include a urine sample, performing a simple bladder-filling study, or looking in the bladder with a camera (cystoscopy.) Following these procedures, your treatment may include bladder retraining, lifestyle changes, physical therapy or medications.
Pain in a broad area below your abdomen is called pelvic pain. You may have it during your period, during intercourse or bowel movement or whenever you are seated. The pain can be intermittent or steady, severe or a dull ache. It can feel like a pressure deep within your pelvic area.
If the pain is severe enough to disrupt your day, you should see your doctor. Finding the cause of pelvic pain may be difficult. Once the reason for the pain is found, treatment will focus on eliminating the cause. In some situations where an obvious cause is not identified, treatment will focus on managing the pain.
Sometimes your bladder may not empty completely. This can lead to symptoms of fullness or discomfort, as well as leakage of urine due to an overly full bladder. Causes can include:
In order to determine the cause, a complete history and physical exam is necessary. Urodynamic and other imaging testing with fluoroscopy may assist in understanding how your bladder is emptying, and likely will improve your diagnosis. Treatments may include physical therapy, surgical interventions or medications.