Allodynia – Allodynia is a term to describe when pain from stimuli, which are not normally painful, will cause pain in the area stimulated. This often occurs in patients with chronic pelvic pain.
Anterior/Posterior Repair – Anterior repair is a vaginal procedure used to correct a cystocele by positioning the bladder into a more normal anatomic position. This surgical procedure is used to treat prolapse of the bladder (cystocele), urethra (urethrocele) or of both the bladder and urethra (cystourethrocele). Posterior repair is used to treat prolapse of the rectum (rectocele) and small bowel (enterocele). An anterior and posterior repair can be performed at the same time if needed.
Augmented Vaginal Reconstruction – When pelvic organ prolapse is severe or has failed a previous attempt at repair, the birth canal will be repaired or reconstructed using natural or synthetic materials to add to, or even replace the patient’s weakened tissues.
Bladder Fistula Repair – A fistula is a small abnormal tract between organs that develops due to infection or injury. First the fistula must be located, then the fistula is removed and then the defect is repaired surgically.
Colpocleisis – Surgical obliteration or closure of the vagina for the treatment of pelvic organ prolapse (POP).
Colporrhaphy – This is a surgery to repair a prolapse in the vaginal wall, such a cystocele, rectocele, or enterocele.
Constipation – The incomplete emptying, inability or straining to have a bowel movement. Constipation is typically associated with hard, infrequent stools.
Cystocele – A cystocele is a hernia that occurs in women when the wall between the vagina and bladder weakens, causing the bladder to prolapse or herniate into the vagina.
Cystoscopy – A physician uses a lighted scope to examine the inside of the bladder while at the same time filling the bladder with water. This procedure gives the physician the ability to visually detect any problems going on inside the bladder. Local anesthetic is used to minimize the discomfort, which is typically almost non-existent.
Dysuria – Pain with urination.
Enterocele – Any prolapse or protrusion of the small intestine into a space between the rectum and vagina.
Fecal Incontinence – Accidental loss of stool, which is a common problem that occurs after a difficult vaginal delivery and is also seen with aging.
Hormone Replacement Therapy – Hormones play an important role in bladder and bowel function, pelvic floor support and general well being. The use of hormone replacement therapy must be individualized.
Hysterectomy – Removal of the uterus, including cervix either vaginal, laparoscopically or abdominally. It may include salpingo/oophorectomy, which is removal of the tubes and ovaries at the same time as when the hysterectomy is performed if indicated.
InterStim – The implantable InterStim Therapy system uses mild electrical stimulation of the sacral nerves that influence the behavior of the bladder, urethra, anal sphincters, and pelvic floor muscles. In properly selected patients, InterStim Therapy can dramatically reduce or eliminate symptoms when other therapies have failed.
Interstitial Cystitis – Interstitial Cystitis, also called painful bladder syndrome, is a pain disorder that is typically associated with symptoms of suprapubic pain related to bladder filling and accompanied by symptoms of urinary frequency in the absence of infections. Pain symptoms can include pressure, discomfort and/or burning in the urethral or vaginal areas. There are many stages of this disorder and many therapies – often with remarkable improvement in symptoms.
Intravesical Instillation Therapy – Various medications (cocktails) are placed in the bladder with a catheter to heal the inflamed, painful bladder.
Kegel’s – Kegel’s are pelvic floor exercises used to treat urinary and fecal incontinence, as well as prevent pelvic organ prolapse.
Neuromodulation – Electrodes are used to stimulate the nerves that control the bladder. Mild impulses are what the patient feels.
Nocturia – Frequent urination during the night. More than twice a night is abnormal.
Overactive Bladder (OAB) – This is an increase in urinary frequency (more than eight times a day) with or without urge incontinence (leakage with an urge so strong you cannot make it to the bathroom in time). Behavior modification and medications treat this problem with a high degree of success.
Pelvic Floor Electrical Stimulation – Vaginal and/or anal probes that generate an electrical pulse to the pelvic floor that can be used to complement other treatment therapies to treat urinary urge, stress and fecal incontinence.
Pelvic Floor Muscles – Are the muscles in the pelvic area that support, protect and help to hold the vagina, uterus, bladder, urethra and rectum in place and to function properly.
Pelvic Floor Rehabilitation – This is a non-surgical program that combines behavioral modification with pelvic floor exercises. The exercises are much more efficient than Kegel’s because it involves biofeedback and electrical stimulation.
Perineoplasty – A surgical procedure to reconstruct the perineal body (the tissue near the opening of the vagina). It can be tightened if vaginal caliber seems too large after vaginal births or can be reconstructed if weak or scarred from prior surgical procedures.
Periurethral Injections – If the urethral sphincter is very weak and is not able to close the bladder enough to allow bladder control, then a paste-like material can be injected around the sphincter to “tighten” it. The material can be collagen, small carbon spheres or calcium.
Pessary – A plastic device worn in the vagina to support prolapses of the vagina, bladder, rectum and uterus in place. A pessary can also be used to improve leakage and/or bladder emptying.
Pelvic Organ Prolapse – When the bladder, uterus, vagina or rectum has fallen. Once the fallen organ protrudes past the opening, surgery or a pessary is typically needed.
Pudendal Nerve Block – The pudendal nerve can be the source of neuropathic pain (nerve pain). Blocking this nerve with Novocain and steroids can provide prolonged pain relief.
Rectal Fistula Repair – A fistula is a small abnormal tract between the vagina and the rectum. This often occurs as a result of a traumatic vaginal delivery or a pocket of infection. Surgical repair is typically needed, especially if the fistula is large.
Rectocele – Prolapse or bulging of the front wall of the rectum into the vagina. This often causes difficulty passing stool due to a pocket that the stool gets trapped in.
Sacrocolpopexy – This is an uncommon surgical procedure for repairing vaginal vault prolapse and restoring the length and shape of the vaginal canal. This is more likely to happen in women that have had a hysterectomy and is due to the uppermost part of the vaginal vault prolapsing downward. See colpopexy.
Stress Incontinence – The loss of urine when “stress” is applied to the bladder, which happens when coughing, sneezing, laughing or lifting.
Suburethral sling – A surgical procedure where a synthetic or natural material is used under the urethra to support it and prevent stress incontinence.
Suprapubic catheter – During surgery, a catheter placed into the bladder through the abdomen, which is used to drain the bladder. This is needed in the minority of surgeries.
Urethra – This is a single tube that carries urine from the bladder out of the body. The sphincter that is involved in bladder control surrounds the mid portion of the urethra.
Urethral Diverticulum – This is an abnormal sac-like pocket that develops off the urethra and is associated with infections and urethral pain.
Urgency/Frequency Incontinence – See overactive bladder.
Urinalysis – A test performed in the office to check the chemicals and cells in urine. Typically used to rapidly diagnose a bladder infection and determine if blood is present in the urine.
Urinary Incontinence – Is the inability to control the bladder. It is common to a very slight degree in many patients, but is considered a significant problem when it limits your life or requires pads or change of clothes or underwear on a frequent basis.
Urinary Retention – This is when the bladder is unable to empty itself to a point that there is over 100 cc’s (3.5 ounces) of urine left over in the bladder after urinating. Symptoms include a slow, intermittent stream and at times bladder infections.
Urine culture – Urine is collected and sent to a lab to determine whether a urinary tract infection is present. It is considered the “gold standard” in diagnosing a bladder infection.
Urodynamics – A test that uses a small catheter inserted in the bladder to fill the bladder with water to study the function of the bladder and urethra during filling and urinating. This tells us about the bladder as well as pelvic floor muscle functions.
Uterine Ablations – A simple outpatient procedure that burns the lining of the uterus away to stop or control problems with heavy periods.
Uterine Prolapse – Prolapse of the uterus into the vagina.
Vulvar Pain – This term is used to describe pain in the area of the vaginal opening. This pain may include burning, itching, redness or cramping and/or pressure.
Vulvodynia – This is a pain syndrome that involves vaginal or vulvar pain. This pain may occur just with sex or it can become nearly continuous, that is unprovoked by sex, tampons or direct pressure.