Pelvic & Bladder Health

INTERSTITIAL CYSTITIS

You already know…

Bladder related pain can significantly impact your life. This pain may result in emotional distress, depression, painful intercourse and interference in relationships and work.

You may not know…

Interstitial Cystitis/ Painful Bladder Syndrome (IC/ PBS) describes pain related to the bladder and/ or urethra. It is estimated to affect over one million American women. The exact cause of this condition is not fully understood.

Many times, women are misdiagnosed as having recurrent bladder infections or “UTls” and most have been treated repeatedly with antibiotics, even when urine tests have confirmed that no bacterial infection exists. It may take years to get an accurate diagnosis for IC/ PBS, and this condition is commonly associated with other painful conditions including painful intercourse, vulvodynia and vaginal pain, irritable bowel syndrome, fibromyalgia and other auto-immune diseases, which also may require further diagnosis and therapy.

You need to know…

IC/ PBS and its associated conditions can be treated through a variety of options. In time, most women have considerable relief with proper diagnosis and appropriate treatment.

To arrive at the proper diagnosis, your provider will get a detailed medical and surgical history and conduct a physical exam, including a gentle pelvic examination. Additionally, questionnaires and a bladder diary can be helpful in establishing the diagnosis as well as the severity.

Urinalysis and Culture
A urine specimen will be examined for abnormalities including infection and blood.

Dietary and Behavioral Changes
Many common foods and beverages (caffeine, soda, citrus, spicy foods are some examples) can have a negative impact on the bladder in patients with IC/ PBS. Modifications in diet, through attempts to identify and eliminate triggers, can be very helpful in preventing bladder pain or flares. www.ichelp.org/icdiet

Medications
Multiple medications are used to treat IC/ PBS at various levels. Medications to treat nerve pain, decrease inflammation, improve mood and help seal the bladder lining ore often employed. It is common to use more than one medication in combination and your regimen will be determined based on your specific symptoms.

Bladder Instillations
A “cocktail” of various, soothing medications, including pain relievers and anti-inflammatories, are instilled directly into the bladder to provide immediate relief of painful bladder symptoms.

Physical Therapy (PT)
In patients who have IC or other pelvic pain conditions, the pelvic floor muscles may be tight or in spasm, have a combination of tightness and weakness, or have pain-triggering spots or knots called “trigger points”. Many women use physical therapy to treat these problems and pelvic floor muscle PT can go a long way toward easing pain and improving bladder symptoms. Your provider works with pelvic floor physical therapists specially trained in the techniques that help women with IC/PBS and pelvic pain.

URINARY INCONTINENCE

You already know…

Your life has been changed by bladder control struggles. You’ve memorized the locations of restrooms in your everyday travels. Normally enjoyable activities are overshadowed by worries about leaks or the urgency to find a restroom.

You may not know…

There are many causes of urinary incontinence in women.

You need to know…

Bladder control doesn’t have to be a normal and accepted part of aging. The first step to getting the right treatment is finding a specialist who specifically addresses female bladder control. Surgical outcomes dramatically improve when performed by surgeons who regularly do the procedures. Our surgical partners at Southeast Urogyn are among the most experienced and high volume urogynecology surgeons in the country.

Stress Incontinence
When urine leakage occurs with increases in abdominal pressure it is known as stress incontinence. Weak or stretched muscles in the pelvic floor fail to provide the support needed to hold in urine. Many women with stress incontinence complain of leaks caused by straining with coughing, laughing, sneezing, and exercising.

Urge Incontinence/ Overactive Bladder
With urge incontinence, urine leaks occur when the bladder muscles contract at the wrong time, day or night. The bladder may not even be full when the contractions happen.

Overflow Incontinence
When you are unable to completely empty your bladder, it may result in overflow , with unexpected or even continuous leakage. This can cause kidney damage and increased risk of infection.

Mixed Incontinence
Women often experience a combination of symptoms associated with both urge and stress incontinence. When this occurs, our doctors treat each symptom to help improve quality of life.

OVERACTIVE BLADDER

You already know…

The urgency and frequency associated with trips to the restroom are disrupting your life. You know other women struggle with this condition, but most hesitate to talk to their doctors.

You may not know…

OAB is really a neurological condition. A special area in the brain controls bladder function. Once you have decided whether to void or to hold, a signal is sent from the brain back down the spinal cord to the bladder, telling it what to do. In certain cases with women, these nerve loops become disoriented so that the normal process of coordinating this event malfunctions and instead of your brain telling your bladder what to do, your bladder starts doing what it wants and not what you want.

You need to know…

Urgency and overactive bladder are easily treatable through non-surgical or minimally invasive procedures. Your provider will use the latest approaches to treat OAB with little impact to your daily life.

Dietary Counseling
We recommend patients adopt a bladder-friendly diet. Our team will work with you to help you find the right dietary solution to support on-going treatment plans.

Medications
Several medications are available to treat the symptoms of overactive bladder or urge incontinence. These medications help communication between the brain and the bladder to stop spasms.

Retrain Your Bladder

Your provider will set a time interval for you to follow during your awake hours, and you should do your best to only go to the restroom at that time. For example, if you are advised a 2-hour interval and on a particular day wake up at 6:00AM, then you should only urinate at 2-hour intervals from then (8:00AM, 10:00AM, etc.). If you feel the need to use the restroom at a non-advised time, perform a kegel and try and ignore the need—generally, doing so is successful after about 30 seconds. If the urge remains, use the restroom, but be sure to still urinate at your upcoming advised time. For example, if you urinate at 7:30AM and were scheduled to urinate at 8:00AM, still try and do so again at the latter time. Essentially, the point of bladder retraining is to teach your bladder when to go and when not to.

Once you are able to meet your goal time easily, begin to increase times between urination by 15 or 30 minutes and continue to do this until you can make it to 3 or 4 hours between voids.