Bladder Control What Do We Do?

What Do We Do?

Services and Symptoms

Bladder Care and Complete Urologic Workups
We offer complete and comprehensive urologic workups in an office setting. The specialists at Women’s Excellence in Bladder Control want to ensure that your full evaluation is done conveniently and discreetly in our center, which is dedicated to bladder control issues. We offer cystoscopy, urodynamic bladder testing, potassium sensitivity testing and ultrasonography in the office.

Entercoele Repair
An enterocoele is suspected when there is a loss of posterior vaginal wall support or upper vaginal bulging. At Women’s Excellence in Bladder Control, we evaluate everyone with prolapse in a comprehensive manner in order to ensure we have detected this major problem. A thorough bidigital examination of the rectovaginal septum is performed on every patient in order to detect and prevent this from causing pressure. One a thorough diagnosis has been made, the specialists at Women’s Excellence in Bladder Control begin to exclude all other causes of pelvic pressure and will ensure there are no bladder issues, other pelvic floor abnormalities, or pelvic masses.

Evaluation and Treatment of Vulvodynia (Vulva Pain)
We understand the major life altering disorder of vulvodynia. Vulvodynia is defined as excessive pain in the vulvar region and can cause significant physical, sexual, and psychological distress. Vulvar pain can be related to a specific disorder such as infection, inflammation, neoplasm, or neurologic disorders. Vulvodynia refers to vulvar discomfort without an associated secondary cause. The exact cause of vulvodynia in unknown and varies in different patients. The actual diagnosis is often made on the basis of exclusion. We realize that this problem can be very troublesome to any woman and we take the complaint seriously.

Treatment For Women Who Leak Urine When Sneezing Or Coughing
Stress Urinary Incontinence (SUI) is the leakage of urine during activities that increase abdominal pressure such as coughing, sneezing, laughing, or other physical activities. SUI results from the relaxation of vaginal and pelvic support tissues often due to vaginal trauma from childbirth and/or the aging process. Other causes include previous surgery for incontinence and radiation.

 

How do I know if I have SUI?

Women’s Excellence will go through a comprehensive history and physical exam that can reveal the signs and symptoms of SUI. Urodynamics (link this to the page) testing will evaluate the function of the bladder and urethra. As well as other tests may be ordered to rule out other urinary disorders as well. After evaluating an individual patient, how much their urinary incontinence affects their life, and what it may be caused by, Women’s Excellence can then create a personalized treatment plan.

Treatment To Stop Constant Dribbling Of Urine
Stress Urinary Incontinence can be treated a few different ways, and Women’s Excellence will build a personalized plan for each patient that best suits their needs and symptoms.

  • Kegel Exercises help to strengthen the pelvic floor and reduce symptoms of SUI
  • Medications can help relieve the symptoms of SUI and may be prescribed depending on your medical history
  • For women that have profound pelvic organ prolapse, removable pessaries can be used in the vagina to help suspend a bladder prolapse of uterine prolapse and relieve the symptoms of SUI
  • Periurethral Injection is a simple non-surgical procedure that can help eliminate minimal urine leakage
    • Periurethral Collagen (Coaptite) is a synthetic bulking agent that can be injected into tissue surrounding the urethra to treat symptoms of urinary dribbling. The bulking material helps keep the urethra closed thereby reducing urinary leakage. This procedure is minimally-invasive and can be done more than one time.
  • Minimally invasive surgical procedures to resolve SUI can be done without an overnight hospital stay

Evaluation And Treatment Of Dropped Bladder (Bladder Prolapse)
Women’s Excellence stresses the importance of evaluations of a dropped bladder to help eliminate or avoid urinary retention frequency, pain, and recurring UTIs.

  • Cystocele: Bladder Prolapse, bladder drops/protrudes into vagina. Symptoms: Overactive Bladder (OAB), urinary retention, urinary incontinence, incomplete emptying of bladder, urinary frequency, urinary urgency, painful intercourse.
    Rectocele: Rectal Prolapse, rectum protrudes into vagina, symptoms: constipation, incomplete evacuation of stool.
  • Pelvic Organ Prolapse: Pelvic organ prolapse occurs when a pelvic organ-such as your bladder-drops (prolapses) from its normal place in your lower belly and pushes against the walls of your vagina. This can happen when the muscles that hold your pelvic organs in place get weak or stretched from childbirth or surgery.Many women will have some kind of pelvic organ prolapse. It can be uncomfortable or painful. But it isn’t usually a big health problem. It doesn’t always get worse. And in some women, it can get better with time.More than one pelvic organ can prolapse at the same time. Organs that can be involved when you have pelvic prolapse include the:
    • Bladder (This is the most common kind of pelvic organ prolapse)
    • Urethra 
    • Uterus
    • Vagina
    • Small bowel
    • Rectum

    Pelvic organ prolapse is most often linked to strain during childbirth. Normally your pelvic organs are kept in place by the muscles and tissues in your lower belly. During childbirth these muscles can get weak or stretched. If they don’t recover, they can’t support your pelvic organs.

Comprehensive Bladder Function Testing
Treatment of Interstitial Cystitis
Women’s Excellence offers the following treatments for Interstitial Cystitis depending on the degree of each individual patient’s symptoms, evaluation, and history. Modifying one’s diet to a low-acid/ bladder friendly diet is the first step in controlling symptoms. The second step is oral medications to help relieve symptoms:

  • Oral medications:
    • Elmiron (pentosan polysufate sodium) – Currently the only FDA approved oral medication to treat IC. This medication works to supplement the bladder lining and reduce symptoms in 3-6 months time. It is recommended that the medication not be discontinued or symptoms would likely return.
    • Atarax (hydroxyzine hcl) – A first-generation antihistamine in the same drug family as Benadryl. It works to reduce inflammation by inhibiting mast cell formation in the bladder. It has proven to be very useful for the bothersome nighttime voiding that is characteristic of IC/PBS. It is also an anti-anxiety medication that will help you sleep.
  • Diet – A low acid, bladder-friendly diet is typically the first step in controlling symptoms.
  • Bladder instillation therapy – Women’s Excellence offers a simple procedure to treat the pain and inflammation associated with IC quickly. We recommended the instillations twice a week for an initial period of 6 weeks. These treatments are also given to treat future IC flares fast.
  • Pelvic floor physical therapy – Women’s Excellence refers to a number of pelvic floor physical therapists throughout OaklandCounty. Pelvic floor PT is considered to treat pelvic floor dysfunction that often accompanies IC/PBS. Usually a covered benefit on most insurances.

Treatment For Frequent Urination (Over-Active Bladder)
For more information, please click HERE.

Treatment For Recurrent Urinary Tract Infections
We look at Urinary Tract Infections (UTIs) differently. We not only look to help ones symptoms immediately, but we also look to find out why you have gotten the infection in order to prevent another infection from returning. This is what makes the specialists at Women’s Excellence in Bladder Control different. Our center focuses on why something occurs and targets evaluation and treatment to completely treat the problem. We are focused to solve an issue rather than just handle it. Many recurrent urinary tract infections are not even infections at all but rather bladder wall irritations or deficiencies such as interstitial cystitis. If you have a simple bladder infection or chronic recurrent Urinary Tract Infections (UTIs), our specialists can provide you the right therapy and the right diagnostic work-up.

Urogynecological Care
Unlike urologists, who care for both men and women, we cater only to women. We understand that women want to be as discreet as possible when it comes to incontinence and bladder control problems. This is why we created a non-threatening environment to care for these conditions. Women’s Excellence in Bladder Control is a freestanding office that only deals with bladder issues, it is not attached to another office, waiting room, or other patients who have other problems. This allows us to focus solely on your bladder condition until your problem is resolved.

Procedures

Bladder Instillation Treatments for Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS)
IC/PBS is a chronic, painful bladder syndrome primarily found in women. Common symptoms include urinary urgency, frequency, and pelvic pain. IC/PBS is not caused by  bacteria and cannot be treated with antibiotics. IC/PBS is a chronic inflammatory condition of the bladder that is best treated with a combination of medication, lifestyle adjustments, diet, bladder treatments, and pelvic floor physical therapy. For more information, please click HERE.

Botox Treatments for Overactive Bladder
BOTOX is a different treatment option that takes another approach to targeting the source of your overactive bladder: the bladder muscle itself.  For more information, please click HERE.
Colporrhaphy-Anterior and Posterior (Treatment of Cystocele/Rectocele)
Pelvic organ prolapse is a disorder in which the pelvic organs loss their overall support within the pelvic cavity. For treatment of pelvic organ prolapse and associated vaginal wall weaknesses, we provide a multitude of different treatment options. Most of these treatment options are minimally invasive in nature and can be done through either vaginal or minimally invasive abdominal surgical incisions. Cystocele and Rectocele conditions, we can usually use vaginal reconstructive procedures which are called anterior Colporrhaphy and posterior Colporrhaphy.

Comprehensive Bladder Function Testing
Entercoele Repair Vaginal and Abdominal Approaches
An Enterocoele is a term used to generally describe abnormal descent of the small bowel in a deep pouch of Douglas. Rarely, patients are born with a congenitally deep pouch of Douglas, secondary to failure of complete fusion of the rectovaginal septum. More commonly a deep pouch of Douglas is acquired secondary to weakened pelvic floor from multiple pregnancies and deliveries,following hysterctomy and also from long standing chronic straining or activities which put significant pressure on the pelvic floor musculature. An enterocoele is suspected when there is a loss of posterior vaginal wall support or upper vaginal bulging. At Women’s Excellence in Bladder Control, we evaluate everyone with prolapse in a comprehensive manner in order to ensure we have detected this major problem.

Cystoscopy
Cystoscopy is a test that allows your doctor to look at the inside of the bladder and the urethra using a thin, lighted instrument called a cystoscope. At Women’s Excellence in Bladder Control, our providers are able to perform this test in the office to visualize any abnormalities such as ulcerations, tumors or congenial anomalies. For more information, please click HERE.

Graft Augmentation Procedure to Strengthen the Pelvic Floor
Our specialists are experts in the latest methods to treat vaginal wall relaxation with the least recovery and the best outcome. With years of experience using graft augmentation approaches to strengthen the repair, we have become leaders in this type of surgical intervention. We can provide strong and lasting repairs without synthetic mesh. Most cases can be repaired using biologic grafts. If possible we avoid synthetic products (mesh). 

InterStim Peripheral Nerve Evaluation Test (PNE)
InterStim Therapy for Urinary Control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments. The peripheral nerve evaluation (PNE) is a simple office based test to determine if you have a good response with low level testing. If the PNE is successful a permanent convenient implant like a pacemaker will be placed to help control your bladder problems.

Interstim Therapy from Medtronic
We know that overactive bladder, urinary retention issues and general bladder control problems can consume your thoughts-and alter your life. If you’ve tried behavioral modifications and medications without any success, don’t lose hope! Millions of women experience bladder issues at some time. That is why the specialists at Women’s Excellence in Bladder Control use our expertise in sacral nerve stimulation to provide an innovative overactive bladder treatment for our patients who have failed or could not tolerate more conservative treatments. We have an in-office test that can determine if you are a candidate for this therapy. Interstim is FDA approved since 1997, and covered by the majority of insurances, with over 60,000 patients treated nationwide.” If you think Interstim may be an option for you as your symptoms are interrupting your lifestyle, contact us for an appointment. For more information, please click HERE.

Minimally Invasive Surgery
We specialize in the most minimally invasive methods to treat your bladder control problem. It is one of the most important factors in our treatment plan. We only deviate from the least invasive approach when a lesser invasive approach will sacrifice the patients likely outcome. What does that mean to our patients? It means that by being a patient at Women’s Excellence in Bladder Control they will get the most convenient, least recovery approach every time, NOT once in a while. It means that our patients can be confident in our treatment approaches because they are the most current, utilize the latest technology and most of all statistically provide the best outcomes. How can we achieve this? The specialists at Women’s Excellence in Bladder Control are experts in the latest methods to control these disease processes with the least recovery. For more information, please click HERE.

Pelvic Floor Muscle Strengthening and Relaxation
Pelvic floor weakness is a severe problem which can result in lack of sensation with intercourse, pelvic organ prolapse and urinary incontinence It can be dealt with mechanically (with surgery) or physiologically (with pelvic floor muscle strengthening). After an adequate assessment of the pelvic floor and vaginal vault, we can determine which method would be best for you and determine whether a mechanical surgical method may be needed along with pelvic floor strengthening.

Pelvic Ultrasound
Ultrasonography provides the best, most cost effective and accurate way to identify the pelvic organs without the use of radiation and is used extensively by the specialists at Women’s Excellence in Bladder Control to make the most effective diagnosis and treatment plan for your condition. For more information, please click HERE.

Perineoplasty
Vaginal introital repair (also known as perineoplasty) can be performed in order to tighten the vaginal entrance. Some women experience a lack of sexual stimulation secondary to the total breakdown of the perineal body or the tissue supporting the space between the rectum and vagina.

Periurethral Injections For Urinary Dribbling (Coaptite)
Periurethral injections is a therapy using bulking agents composed of synthetic materials, bovine collagen, or autologous substances augment the urethral wall and increase urethral resistance to urinary flow.  For more information, please click HERE.

Potassium Sensitivity Test
A potassium sensitivity test (PST) is a simple office procedure performed by a specialist of Women’s Excellence in Bladder Control that will test the bladder for interstitial cystitis/painful bladder syndrome (IC/PBS). IC/PBS is a chronic disease of the bladder that can cause pelvic pain, pressure, or discomfort. For more information, please click HERE.

 

 

Sacrocolpopexy (Full Pelvic Reconstruction)
Our specialists understand that surgery is often the best treatment option to repair pelvic prolapse, including vaginal vault prolapse. Once we obtain the history of your problem, perform a physical exam, evaluate the architecture of your pelvic organs with ultrasonography and interpret testing of your bladder function, we can determine the best way to completely repair the prolapse.

Stress Urinary Incontinence
Stress Urinary Incontinence is the leakage of urine during activities that increase abdominal pressure such as coughing, sneezing, laughing or other physical activities.  For more information, please click HERE