Urinary and bladder issues — common for women — cause frustrating disruptions to daily life. If you're living with symptoms that keep you from fully enjoying the activities and people you love, it's time to see a urologist.
While most women are familiar with traditional gynecological care, many women are not informed about when and how urologists can help. The truth is, a trusted urologist can help safeguard your urinary health.
Working in various care settings — including hospitals and private clinics — urologists can treat any part of a woman's urinary systems, including the bladder, kidneys, ureters and urethra.
The five most common conditions are bladder prolapse (cystocele), overactive bladder (OAB), painful bladder, stress urinary incontinence and urinary tract infection.
A bladder prolapse happens when the supportive tissues that would normally hold your bladder in place weaken. When the bladder drops into your vagina, you may feel like something is falling out or experience a sudden heaviness in your pelvis.
Childbirth is commonly considered a risk of bladder prolapse, but other factors can increase your risk, such as:
- A job or lifestyle that requires heavy lifting
- Being overweight or obese
- Experiencing chronic coughing
- Living with recurrent constipation
- Repetitive straining for bowel movements
There are several treatments for bladder prolapse and determining which are right for you depends on the severity of the prolapse. From pelvic muscle exercises to more extensive surgical techniques, a urologist will help guide your decision and create your treatment plan.
Whenever possible, a Tanner urologist will recommend trying the least invasive options first. However, when needed, there are several surgical options:
- A vaginal pessary: This is a removable, fitted vaginal appliance to support the vaginal wall and hold your bladder in place.
- Surgical repair: A surgeon can repair the supportive tissues around the vagina, then reposition your bladder to its normal position. There are newer techniques such as robotic-assisted repair.
An overactive bladder can make you feel a sudden urge to urinate or the need to go to the bathroom more often than usual. You may have an overactive bladder if you urinate eight or more times a day or two or more times at night.
While having an overactive bladder can take a toll on your everyday life, the good news is that urologists can offer a range of solutions:
- Lifestyle changes: Some foods and drinks can affect your bladder and cause you to urinate more often. Taking them out of your diet and adding them back in one at a time can help you see what makes a difference. Schedules to use the restroom at set times and pelvic floor exercises can also be effective.
- Prescription medication: Medication can keep your bladder from squeezing when it's not full.
- Pelvic floor stimulation therapy: Office treatments in which a non-painful stimulating device retrains your muscles of your pelvis and retrain bladder control.
- Botox: Botox relaxes the bladder wall muscle, reducing your urge to urinate.
- Sacral nerve modulation: This is a surgically placed small implant that sends painless electrical pulses to the bladder nerves to reduce bladder frequency and urgency.
Painful bladder syndrome
Painful bladder syndrome (interstitial cystitis, or IC) causes discomfort, pressure or pain in your bladder, lower abdomen or pelvic area. Feeling the urge to urinate before your bladder can fill and urinate more frequently than normal are also signs of painful bladder syndrome.
Like an overactive bladder, Urologists can use a range of treatments to see what's most effective for you, including:
- Bladder stretching: While you're under local or general anesthesia, a doctor can stretch your bladder by filling it with fluid.
- Lifestyle changes: Certain changes, such as stopping smoking, taking steps to reduce your stress or changing your diet, can help alleviate painful bladder symptoms.
- Medications: Over-the-counter pain relievers and several prescription medications can help reduce painful symptoms. Medications placed through a catheter into your bladder to reduce irritation in the bladder wall, and Botox to relax your bladder, are also options.
- Sacral nerve modulation: This is a surgically placed small implant that sends painless electrical pulses to the bladder nerves to reduce bladder frequency, urgency and pain.
- Surgery: When traditional treatment options aren't working for you, your urologist will consider surgical options, such as enlarging your bladder, removing your bladder or rerouting the flow of your urine.
Stress urinary incontinence (SUI)
A weak sphincter muscle or weak pelvic floor supportive structures can result in stress urinary incontinence. SUI is the most common type of incontinence in women under the age of 60.
If laughing, coughing or sneezing cause you to leak urine, SUI is likely the problem. Common causes include:
- Frequent cough
- Loss of pelvic muscle tone from aging or childbirth
- Chronic constipation
- Repeated heavy lifting or high impact sports
Treatment options include:
- Vaginal pessary: This is a removable, fitted vaginal appliance to support the vaginal wall and hold your bladder in place.
- Medications with estrogen: Vaginal creams or suppositories help strengthen your pelvic muscles and tissues.
- Kegel exercises: This is a good way to reduce SUI by making the muscles under your uterus, bladder and bowel (large intestine) stronger. An example would be to pretend you're trying to stop the flow of urine by squeezing your muscles and holding for three seconds, then relax your muscles and repeat. Urologists recommend doing these exercises daily, working up to at least three sets of 10. They can also recommend pelvic floor stimulation therapy to enhance your ability to do Kegel exercises.
- Urethral sling: This is the gold standard minimally invasive surgery that restores the support under the urethra.
Urinary tract infection (UTI)
When bacteria travels through the urethra to your bladder, it can cause a UTI. UTIs are more common in women because women's urethras are shorter than men's and are closer to bacteria sources in the vagina and rectum.
Bacteria cause the lining of the bladder and urethra to become inflamed and irritated. Other symptoms include:
- Burning or pain when urinating
- Pain in your lower abdomen and lower back
- Urge to urinate often
A simple UTI can be treated with antibiotics at home and symptoms can be improved by drinking lots of water to flush the bacteria out of your bladder. However, for more complicated cases, patients sometimes need to be admitted to the hospital for IV therapy.
A urologist will plan a staged approach to preventing UTI's and use protocols for choosing the correct antibiotic to treat them.
When to see a urologist
Although it can be difficult for women to talk about pelvic pain, urinary control issues and infections, seeking the help of a skilled urologist can help you find relief from painful or disruptive symptoms and get you back to the life you love.
To find a urologist, call Tanner's free, 24-hour physician referral line at 770-214-CARE (2273) or select "Find a Provider" at tanner.org/find-a-provider. For more information about Urology services at Tanner, visit TannerUrologyCare.org.