Frequently Asked Questions

These questions and answers are meant to address the most common topics of interest in Urogynecology. If you cannot find the answer to your question, please call our office.

Q: What is a urogynecologist?
A: A urogynecologist is a physican (obstetrician/gynecologist or urologist) who completed residency training in obstetrics and gynecology or urology followed by additional fellowship training focused on female pelvic floor disorders. Currently the typical fellowship length is 3 years for obstetrician/gynecologists and 2 years for urologists. Female Pelvic Medicine and Pelvic Reconstructive Surgery (FPMRS/Urogynecology) is a recognized subspeciality by the American Board of Medical Specialities (ABMS).

Q: What kind of disorders does a urogynecologist treat?
A: A urogynecologists is an expert in treating a wide vareity of female pelvic floor disorders which includes bladder problems, pelvic prolapse problems, female sexual dysfunction and congenital anomalies of the vagina.

Q: Will my health insurance cover my bladder testing and procedures?
A: The simple answer is yes. Bladder testing, pelvic floor physical therapy and vaginal prolapse repair procedures are mostly covered by health insurance plans like any other surgical procedures and are NOT considered as cosmetic procedures. Our office will obtain prior authorization from your insurance company prior to any testing or procedures to make sure that they are covered and will let you know ahead of time if you have any financial responsibility.

Q: I have leakage of urine when I cough, laugh, sneeze or exercise. Is this just aging?
A:Urinary leakage on laughing coughing or sneezing is a symptom of what is called “stress urinary leakage”. This is not normal, even with aging. Stress urinary leakage can be due to weakness of the sphincter muscle that controls the urine or due to changes of the angle of the urethra “dropped urethra”. This condition can be treated with surgical and non-surgical approaches.

Q: I have tried medications for frequent urination but they did not work. What can I do?
A: Urinary Urgency (a sudden, compelling urge to urinate) and frequency (needing to urinate more often than usual) might be a sign of an overactive bladder. Basically , the bladder wall is a muscle that is normally relaxed at all times and only contracts when you want to urinate to push urine out. If the bladder wall has abnormal contractions , it will give you the sensation of urgency and frequency and sometimes involuntary leakage of urine beforereaching the toilet on time.

Medications act to relax the bladder wall and prevent abnormal contractions. Unfortunatley, a considerable portion of patients discontinue the medication due to minimal improvement of symptoms or side effects of the medication. Patients who fails medications may be a candidate for nerve stimulation therapy (Interstim procedure) and / or Botox Bladder injections.

Q: I am having complications from a previous vaginal mesh, what are my options?
A: Vaginal mesh implants are often used to treat vaginal prolapse and urinary incontinence. Meshs have potential complications including vaginal / pelvic pain, painful sexual intercourse, erosion into the vaginal wall, infection and recurrent prolapse or increased incontinence. Treatment options depends on the nature and severity of the complication including vaginal creams, pelvic floor physical therapy and/ or vaginal mesh excision (i.e. removal) and repeat vaginal repair using non mesh procedures.

Q: If I have “urinary leakage” or “dropped bladder or recturm” do I have to have surgery?
A: The answer is no. There are a variety of surgical and non-surgical options for treatment. Our physician will educate you regarding your condition and the options of treatment and help you choose the best treatment option for you.

Q: I had a bladder surgery in the past but it did not work. What do I do?
A: In the past bladder lifts and incontinence procedures had bad reputation for a high recurrence rates. However, the field of urogynecology has progressed and continues to develop everyday. New procedures have evolved. Also the development of fellowship training programs in urogynecology has led the availability of trained experts in the field. The type of the procedure, the level of training of your physician and the severity of your condition are factors that may influence the success rate. Our physician will educate you as to the expected chance of cure and help you take an educated decision regarding your therapy.

Q: What are the options for fecal incontinence (Accidental Bowel Leakage)?
A: Fecal Incontinence (Accidendal Bowel Leakage) is more common in women espcially those who have a history of a difficult vaginal birth with possible injury to the anal sphincter muscles. An anorectal manometry test may be done to measure the strength of the anal sphincter muscles. Options may include dietary modifications, medical therapy, pelvic floor physical therapy & biofeedback, Interstim neuromodulation and / or surgical repair of the anal sphincter. After completetion of a detailed history and physical exam and appropriate testing you will receive extensive counselling on the pros and cons of nonsurgical and surgical options and the success rate of each approach.

Q: I have been diagnosed with Interstitial Cystitis (IC). What are my options?
A: Patients with Interstitial Cystitis (IC) often have bladder pain and painful frequent urination. Symptoms may resemble those of a bladder infection however urine analysis is usually negative for bacteria. Our office offers an organized management protocol for IC including bladder diet, medical therapy and bladder instillations. We also offer more advanced treatments including cystoscopy + hydrodistension, Interstim Neuromodulation and Botox bladder injections for more complicated cases as clinically appropriate.

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