The Women's Pelvic Health and Continence Clinic - Improving Your Health

Your Pelvic Health & Continence. The burden of urinary incontinence, pelvic organ prolapse (e.g. “dropped bladder or uterus”), and anorectal diseases (e.g. gas leakage) are common problems that many women suffer with daily. General risk factors for prolapse and incontinence include: pregnancy, family history, obesity, genetic factors, congenital anatomic factors, connective tissue abnormalities, menopause, pulmonary disease, smoking, and chronic diseases.

Urinary incontinence. As best as we know, approximately 20 million American women have live with urinary incontinence at some time in their lives. However, this number is likely greater because many women are hesitant to discuss incontinence with their health care providers – even when directly questioned. Although up to 30% of women age 30 - 70 have had at least some loss of bladder control, the age range of women seeking treatment for incontinence can be as young as their 20’s and as late as their 80’s and 90’s.

Pelvic Organ Prolapse. Prolapse is a common condition. Although predominantly found in older patients, women in their 20’s and 30’s are also frequently seen and treated for this condition as well. As many as 50% of women who have children will have some type of prolapse in their lifetime. Prolapse may be symptom-free or it may cause a great deal of discomfort and distress.

Prolapse may be referred to by numerous names, including uterine prolapse, vaginal prolapse, pelvic relaxation, cystocele, rectocele, and enterocele. These different types of prolapse are divided into three categories according to the part of the vagina they affect: front wall, back wall or top of the vagina. It is not uncommon to have more than one type of prolapse.

Click on our Patient Info tab and go to the Anatomy section for a more detailed discussion of these terms.

Fecal or bowel incontinence. Although not as frequent a complaint as urinary incontinence or prolapse, fecal incontinence is still a common condition affecting over 20 million people (~7% of the U.S. population). Although it is more common in older patients, women as young as their 20’s can suffer with this problem. Symptoms can include occasional or frequent involuntary loss of gas, liquid or solid stool (feces). Patients may subsequently seek social isolation and can be left feeling self-conscious and embarrassed. However, this is a treatable condition with potentially good results through either non-invasive or invasive treatments.

Therapeutic options available to patients are, in part, dependant on the results of testing that is done by colorectal specialists whom we work closely with in the Texas Medical Center Area. During your office visit with us, we will ask you questions about fecal incontinence to help us determine if a consultation with a colorectal specialist would be an important part of our care plan with you.

Minimizing risk factors for prolapse and incontinence. Below are some suggested methods to potentially diminish your risk for prolapse and incontinence.

• Pelvic floor muscle exercises - When performed correctly. Often performed incorrectly due to a lack of proper education and direct training, patients may not receive the benefit the exercise potentially offers. Talk with your doctor and confirm you are using the right muscles the right way so this exercise can help you.
  
  
• Obesity - Work to lose excess weight. If you’re at your ideal weight, work to maintain it.
  
  
• Excessive straining - Avoid heavy lifting (usually the weight where you are straining).
  
  
• Exercising - Focus on exercises that minimize the downward forces of gravity, e.g., swimming over gymnastics
  
  
• Pulmonary disease - Quit smoking – it is a known irritant to the bladder and a primary cause of bladder cancer. If you have a chronic cough, seek treatment for it.
  
  
• Bowel - Eat a high fiber, low fat diet and stay hydrated to avoid constipation.