Constipation is most often defined as having a bowel movement less than three times per week. It usually is associated with hard stools or difficulty passing stools. You may have pain while passing stools.

A prolapse or bulging of the bladder into the vagina.

Prolapse or bulging of the small intestine into the space between the rectum and vagina.

Interstitial cystitis is a long-term (chronic) inflammation of the bladder wall.

Urge incontinence is the strong, sudden need to urinate due to bladder spasms or contractions.

Abnormal connections from a tract between the rectum and vagina, causing passage of gas or fecal material in an uncontrolled manner from the vagina.

Urinary (or bladder) incontinence is when you are not able to keep urine from leaking from your urethra, the tube that carries urine out of your body from your bladder.

Uterine prolapse is falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal.

A condition that occurs in women who have previously undergone hysterectomy in which the ligaments which normally hold the upper vagina in place have torn or weakened and allow the upper vagina to fold down into itself, or to protrude through the vaginal opening.

Abnormal connections between the bladder and the vagina, resulting in uncontrolled loss of urine from the vagina.

If vulvodynia localized to the vulvar region, it tends to be associated with a highly localized “burning” or “cutting” type of pain.

Botox relaxes the bladder muscle. This allows more urine to be held in the bladder before you have to go to the bathroom. Botox injections are usually performed at the clinic. You do not need general anesthesia or a hospital stay. You can usually drive yourself and can return to work immediately after the procedure. Most people do not find these injections painful. Your provider uses a small camera and needle to inject Botox into the bladder wall. Ask your provider if Botox is right for you.

Cystoscopy is a procedure that lets your doctor look inside of your urethra and bladder using a special camera, called a cystoscope. Cystoscopy is a short procedure that can be done in the office with little pain. You will often be able to watch the images on the screen while it is being done. It takes about 10 to 20 minutes to set up and five minutes to complete the procedure.

Your Urogynecologist might suggest cystoscopy if you have bladder control problems such as urinary incontinence or overactive bladder, blood in the urine, unusual cells seen under the microscope in your urine sample, frequent urinary tract or bladder infections, pain in the bladder, urethra, or pelvic area.

MonaLisa Touch utilizes fractional CO2 laser for the treatment of certain gynecologic conditions such as vaginal atrophy (thinning of the vagina that occurs in the absence of estrogen and causes symptoms of vaginal burning, irritation, and dryness) and lichen sclerosis. The laser treatment helps restore gynecologic health by generating new collagen, elastin and vascularization. Generally three treatments are provided, six weeks apart.

Pelvic Floor Therapy is a technique that allows us to assess your pelvic floor muscle function. The muscles may be weak or tight. The goal is to have the best muscle function possible. Most women find that pelvic floor muscle exercises (Kegels) help improve symptoms. For the best effect, work with a trained provider to learn the techniques. It may take three to six months of regular pelvic floor muscle exercise to see results.

The basic evaluation (also referred to as peripheral nerve evaluation or PNE) is typically used to evaluate patients with bladder control problems. It is initiated through a simple, in-office procedure, during which the lead is placed in the upper buttock.

This lead connects to an external neurostimulator (ENS) that the patient wears on a belt. For approximately 3-7 days (depending on physician guidance) the patient completes a voiding diary that is eventually compared to a baseline (established by using a voiding diary prior to the evaluation). Based on the results your provider will determine if surgery to implant a permanent device would be the next option.

There are many nerves involved in bladder function. Nerve stimulators help control these nerves, reducing the need to urinate often. Tibial nerve stimulation is similar to acupuncture. A small needle is inserted near a nerve in the ankle and connected to an external device that delivers small pulses to the nerve. Each treatment lasts approximately 30 minutes, and you would typically receive 12 treatments one week apart. After the first 12 weeks, your provider will evaluate your response to treatment and determine if additional treatments are necessary.

In this procedure, a substance is injected near the urethra to ’’bulk up" the walls. This works well when a sphincter muscle that circles the urethra weakens. There are different types of bulking agents. This outpatient procedure is usually done in the office. It is low risk and allows you to continue to be active immediately, but wears off after several months. The injections will need to be repeated.

Urodynamics is a series of tests that evaluate how well your bladder, urinary sphincter and urethra work. These tests focus on how well the bladder fills and empties. Urodynamics tests examine what the bladder and urethra are doing if urine leakage occurs. For example, the tests can show if involuntary bladder contractions (spasms) are causing urinary incontinence. The results of this study assist your Urogynecologist in determining which treatment options will be most effective for you.

A pessary is a silicone device inserted into the vagina. It is similar to a diaphragm. Pessaries push the urethra closed to help control urine leakage. They still allow you to urinate normally when you need to. Some women wear a pessary only when they exercise. Others leave it in all the time.