My condition is so embarrassing. Can you help me talk about it?

We understand that it can be embarrassing or difficult to talk about your symptoms. Know that pelvic floor disorders are common medical conditions. You are not alone.
 
Our first goal is to make you feel comfortable.

We approach your concerns with compassion. We will talk about your options, listen to your preferences, and find a solution that works for you. We want to improve your quality of life.

What is a urogynecologist?

A urogynecologist and reconstructive pelvic surgeon is a doctor who has advanced training in caring for women with pelvic floor disorders.

Our urogynecologists completed a residency in obstetrics and gynecology, followed by several additional years of fellowship training in pelvic floor disorders.

Our physicians are national board-certified and are experts in surgical and non-surgical treatment options.

What is the pelvic floor?

The pelvic floor is the muscle, connective tissue and nerves that help support and control your bladder, uterus, vagina and rectum.

Pelvic floor disorders include loss of bladder or bowel control, difficulty emptying your bladder or bowels, and dropping or bulging of your pelvic organs (prolapse).

I have mild bladder leaks when I sneeze. How do I know when it’s time to see a doctor?

Many women have small urinary leaks when they sneeze, cough, laugh or exercise. This is called stress urinary incontinence.

You should see a doctor if your leaks bother you, interrupt your everyday activities or affect your quality of life. Tell your doctor if you feel isolated or fearful of being social or active.

We can help you gain control over your bladder and return to your regular activities.

I’m using pads to handle bladder leaks. Can you change that?

Yes, we can help control your leaks, so you can stop using pads. We offer effective non-surgical and surgical treatments for urinary incontinence.

If you use pads, we recommend using ones for urinary leaks, not menstrual pads. Incontinence products come in different types and sizes and are designed to absorb urine.

I have loss of bowel control. Can you help this condition?

Yes, we are experts in treating women with bowel control problems (fecal incontinence), and we can help you.

You can usually manage this condition with changes to your daily habits. You can also exercise to strengthen your muscles. In some cases, you may have damage to the muscles around your anus that hold in stool. So, you may need surgery to repair them.

We will do a full assessment of your pelvic floor and talk with you about your care options.

I feel a bulge or pressure in my vaginal area. What is this?

As you age, the muscles that support your pelvic organs can weaken. This may be more likely if you had a baby by vaginal delivery.

Sometimes this weakness causes your pelvic organs to drop or press into your vaginal wall, which feels like a bulge or pressure. You may even feel or see a bulge outside of your vagina. This is called pelvic organ prolapse.

If your symptoms are bothersome, we can help. We have expertise in treating prolapse with and without surgery.

I have tried Kegel exercises and they do not seem to solve my problem. Should I keep doing them?

Yes. Kegel exercises may not fix your condition completely, but you will benefit from strong pelvic muscles. Your condition could get worse if these muscles are weak.

We will check your muscle strength during your visit with us. We can help you target the right muscles with help from physical therapists and biofeedback devices.

Whether you choose a non-surgical or surgical approach to your condition, Kegel exercises can help improve your results.

Can I still have sex if I have a pelvic floor disorder?

Yes, many women continue to have enjoyable sex while managing a pelvic floor condition. If your symptoms make sex painful or uncomfortable, we can help. Your care plan may include physical therapy, vaginal estrogen, or other treatments to ease pain and improve intimacy.

What is robotic minimally invasive surgery?

The da Vinci Surgical Robot allows your surgeon to perform complex abdominal surgeries without making a large incision. We are the most experienced team in Oregon and Southwest Washington using the da Vinci robot to treat pelvic floor disorders.

During robotic surgery, we place a lighted telescope, several mechanical arms, and surgical instruments in your abdomen through a few small incisions.

Your surgeon uses a console outside your body to control the robot’s arms inside your body. The "hands" on the robotic arms can be moved like a human wrist.

The surgeon can see what they’re doing in 3D on a screen. A second surgeon is there at all times to assist at the bedside.

There are other kinds of minimally invasive surgery. These techniques help you heal faster with less pain and scarring.

What are some pain conditions that can affect the bladder?

Several conditions can affect the function and sensation of your bladder and pelvic floor.

An acute urinary tract infection is the most common reason for temporary pain in the bladder.

Painful bladder syndrome is a chronic condition. This happens without a urinary tract infection. This condition can cause pain in your bladder as it fills, making you want to urinate frequently.

Pain in the muscles of your pelvic floor also can affect your bladder function. We focus on relieving your symptoms with physical therapy and pain management.

Do you use mesh in your surgical procedures? Is it safe?

Surgical mesh is a man-made material that is used in many types of surgery to treat pelvic floor disorders. Mesh is a safe and effective option for many women, especially when used by surgeons with extensive experience.

OHSU is a leader in the safe use of surgical mesh. We follow the latest safety standards and only use mesh when it’s the best choice for you and your specific condition. If you have concerns or questions, talk with us.

Will I need to keep coming back for treatment?

It depends on your condition and your care plan. Some women find relief with one-time treatment, while others benefit from ongoing therapy. Some conditions or treatments require follow-up for a short while or long-term. We’ll tailor your plan to meet your needs and adjust it as your body changes over time.