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 Urogynecologic problems - such as incontinence, pelvic pain, internal discomfort, pelvic prolapse and bladder pain - are not uncommon. Yet, many women can actually be free of these kinds of disorders provided they see a medical professional who understands their complex nature. As results-oriented, board-certified specialists, Drs. Robert L. Harris and Steven E. Speights focus on several specialized care areas. Click on any of the icons below to learn more about our approach to these problems:
- Urinary Incontinence
Female urinary incontinence can be embarrassing and uncomfortable. And surprisingly common. Between 50% and 70% of all women will experience some form of incontinence in their lifetime. But these percentages needn't be so high. Only about half the women who endure regular or persistent incontinence will seek medical help for it. Also, because of the complexities and interdependent nature of the female anatomy, many of these women will receive treatments that might overlook or ignore other important health concerns. Here at Southeast UroGynecology , our approach to your continence problem is scientific and comprehensive, including advanced urodynamic testing not offered by most primary-care physicians. Once we've diagnosed your continence problem, we provide the most appropriate treatment the first time, allowing you to avoid recurrence. As leaders in urogynecologic care, we offer a multidimensional holistic/medical approach to treatment that includes minimally invasive surgery, bowel and bladder retraining, muscle exercises, diet counseling, biofeedback, medications and more.
Overactive bladder is also a common cause of urinary incontinence. Symptoms of overactive bladder include: urinary frequency, urgency, or urge incontinence. In some cases the cause is neurological and in others it may be associated with interstitial cystitis. Overactive bladder dramatically affects quality of life. Though it is readily diagnosed, treatable, and often curable, most people do not discuss the symptoms of overactive bladder with their physicians. Experts estimate more than 20 million people in the United States have overactive bladder. It can cause tremendous social problems, and patients are often unable to leave their homes because of the condition. Many have to go to the bathroom as much as every half hour. Frequent urination is defined as over 10 times within 24 hours and some will go as many as 40 times a day. They often are up eight or nine times a night to urinate, which leaves them fatigued the next day. Patients are often embarrassed by the condition and do not talk about it. Medications are available to treat the condition and behavioral therapy may help as well, but while the medications may be effective they can have side effects such as dry mouth and constipation, which keep patients from using them long term.
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Pelvic Organ Prolapse
Over time, the effects of childbirth, injury or other health issues can cause your pelvic-floor muscles to weaken. When this happens, your bladder, rectum, vagina and uterus can lose their support and begin to "slip," which we know as prolapse (cystocele, rectocele, enterocele, uterine prolapse). You can experience incontinence, vaginal protrusion, sensations of pressure or fullness or feelings of something "falling out." At Southeast UroGynecology at Women's Specialty Center , we can reconstruct your pelvic floor and restore the support your organs need. These are highly specialized techniques that most physicians do not perform, but are often the best options for certain kinds of pelvic support disorders.
Advanced gynecologic surgical problems, including urinary incontinence and pelvic organ prolapse, are increasingly seen as our population ages. There is an increasing awareness amongst women of possible surgical therapies for these problems that may be diminishing their quality of life. As many as one woman out of every nine will undergo surgery for urinary incontinence/pelvic organ prolapse in her lifetime; one-third of these women will require more than one operation.
Southeast Urogynecology is a recognized leader in some of today's most advanced surgical procedures. Below are three examples of minimally invasive pelvic surgeries that Southeast Urogynecologt specializes in:
- Laparoscopic Supracervical Hysterectomy
The Laparoscopic Supracervical Hysterectomy (LSH) procedure uses a thin, lighted telescope-like instrument called a laparoscope, which acts like a video camera, along with small surgical instruments that are all inserted through three to four tiny incisions (less than 1/4 inch each) in the navel and abdomen. Using the instruments, the surgeon carefully separates the uterus from the cervix and removes it through one of the openings. The cervix, the bottom part of the uterus, is left intact. Because this type of surgery does not require the surgeon to make a large abdominal incision, you will not have the same kind of visible scar typical with most traditional, "open" surgeries.
LSH causes less stress to the body than the traditional "open" hysterectomy. It was developed to reduce pain, minimize scarring, and shorten recovery time. The procedure can be done on an outpatient basis, which means a woman can be home resting comfortably within 24 hours and back to her normal activities in less than a week. As with all surgery, hysterectomy involves risk, including potential blood loss, infection and damage to other internal organs. For more information on The Laparoscopic Supracervical Hysterectomy see Gynecare's web site at: http://www.lshinfo.com/ .
- Tension-free Vaginal Tape Slings
GYNECARE TVT, is a minimally invasive surgical procedure, is appropriate for some women with stress urinary incontinence. The procedure can be performed under local anesthesia and takes only about half an hour to complete. The recovery period following the procedure is short, and patients experience few complications and minimal scarring after surgery. For more information on TVT-O see Gynecare's web site at: http://www.gynecare.com/.
- Prolift
This minimally invasive, transvaginal procedure uses a polypropylene mesh that works like a sling to restore the prolapsed organs to their proper positions. To anchor the sling, the surgeon passes the arms of the sling through the pelvic ligaments using a trochar. Unlike conventional surgeries, Prolift does not reconstruct the pelvic floor by suturing tissue together or sewing the mesh into place, thus making the procedure "tension-free." This typically requires less tissue dissection, shortening recovery time and reducing post-operative pain when compared to conventional techniques. For more information on Prolift Mesh see Gynecare's web site at: http://www.gynecare.com/ .
Interstitial cystitis (IC) is a chronic inflammation of the bladder wall that affects as many as one million women in this country. Because its causes are unknown, IC is often -and incorrectly - diagnosed as a stress-related or psychosomatic problem. But it is very real, especially to those women who experience its symptoms, which include:
- Frequent urination
- The urge to urinate immediately, sometimes accompanied by pain, pressure or spasms
- Pain in lower abdomen, bladder, urethra or vagina
- Pain associated with sexual intercourse
For many IC patients, getting a proper diagnosis is difficult, primarily because it is a process of ruling out other possible disorders that have similar symptoms, such as chronic bladder infections. Jackie Williams, our Nurse Practitioner, is specially trained and skilled in all treatment options for interstitial cystitis. She works closely with our physicians to give you real answers about this difficult problem as well as providing the most advanced treatment options available. If you experience these symptoms, you should know that the vast majority of IC patients can be helped. But, this help may be best administered by urogynecology specialists who are familiar with the detailed diagnostic process and all the best options for alleviating IC's symptoms. And remember, surgery is rarely the right choice for IC.
Most urinary tract infections (UTI or cystitis) occur in the lower urinary tract, which includes the bladder and urethra. Cystitis is caused when the normally sterile lower urinary tract is infected by bacteria and becomes inflamed. Cystitis is very common.
Most of the time, symptoms of cystitis disappear within 24 - 48 hours after treatment begins. Chronic or recurrent urinary tract infection includes repeated episodes of cystitis (more than 2 in 6 months), or urinary tract infection that does not respond to the usual treatment or that lasts longer than 2 weeks.
The elderly population are at increased risk for developing cystitis due to incomplete emptying of the bladder. Also, lack of enough fluids, bowel incontinence, immobility or decreased mobility, having a Foley catheter, and placement in a nursing home, all put a person at increased risk for developing cystitis.
Symptoms often include:
- Pressure in the lower pelvis
- Painful urination (dysuria)
- Frequent need to urinate (frequency)
- Urgent need to urinate (urgency)
- Need to urinate at night
- Abnormal urine color -- cloudy
- Blood in the urine (hematuria)
- Foul or strong urine odor
Fecal incontinence is the inability to control your bowels. When you feel the urge to have a bowel movement, you may not be able to hold it until you can get to a toilet. Or stool may leak from the rectum unexpectedly.
More than 5.5 million Americans have fecal incontinence. It affects people of all ages-children as well as adults. Fecal incontinence is more common in women than in men and more common in older adults than in younger ones. It is not, however, a normal part of aging.
Loss of bowel control can be devastating. People who have fecal incontinence may feel ashamed, embarrassed, or humiliated. Some don't want to leave the house out of fear they might have an accident in public. Most try to hide the problem as long as possible, so they withdraw from friends and family. The social isolation is unfortunate but may be reduced because treatment can improve bowel control and make incontinence easier to manage.
Treatment depends on the cause and severity of fecal incontinence; it may include dietary changes, medication, bowel training, or surgery. More than one treatment may be necessary for successful control since continence is a complicated chain of events.
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