Urogynaecology (Bladder Health & Pelvic Floor Dysfunction)

References:

Griebling TL. Urinary tract infection in women. In: Litwin MS, Saigal CS, eds. Urologic Diseases in America. Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, D.C.: GPO; 2007. NIH publication 07–5512:587–619.

Signs & symptoms of urinary tract infection

Infections of the urethra or the bladder are known as lower UTIs. Symptoms of lower UTI include:

• Pain or burning during urination
• Feeling of inability to empty bladder fully
• Needing to pee more often than usual
• Sudden urges to pee
• Pain in lower part of belly
• Cloudy or blood within urine
• Pain during sexual intercourse

If lower UTI is not treated promptly, it may lead to infections of the ureters or kidneys, known as upper UTI. Symptoms of upper UTI include:

• Pain in back or side area
• Fever or chills
• Malaise

UTI should not be taken lightly and you should seek prompt medical attention. Talk to your urogynaecologist to find out more.

Risk factors

Certain factors increase the risk of having urinary tract infection (UTI). These include:

• Multiple sexual partners
• Frequent or intense intercourse
• Diabetes
• Usage of birth control pills
• Blockage in urinary tract
• Incontinence
• Having a history of UTIs

Talk to your urogynaecologists to find out if you are at risk of contracting urinary tract infection, and the prevention methods one should take.

Diagnosis & treatment

Your urogynaecologist will perform a medical history and physical examination to check if there are any changes to your abdomen or kidneys. Certain tests such as urine tests may be prescribed.

Treatment depends on severity of the infection and may include medication of lifestyle changes. Talk to your urogynaecologist to understand more.

Signs & symptoms of urinary incontinence & voiding dysfunction

Common symptoms of urinary incontinence include, but are not limited to:

• Frequent urination
• Weak stream when urinating
• Needing to urinate at night (nocturia)
• Difficulty initiating urination
• Feeling of incomplete emptying of bladder

Depending on the extent to which bladder control is infected, urinary incontinence may lead to total loss of bladder control. If you experience any of the above symptoms, talk to your urogynaecologist. Prompt diagnosis will help in preventing any potential health complications.

Diagnosis & treatment

Your urogynaecologist will look into your medical history and conduct a physical examination. Your doctor may recommend some of the following tests to diagnose your condition:

• Blood tests
• Urinalysis
• Cytoscopy
• Bladder scan
• Radiology imaging, such as ultrasound, CT scan, or MRI

Depending on your medical assessment and condition, your urogynaecologist may recommend treatment in the form of rehabilitation, medication, or surgical intervention. Consult your urogynaecologist to find out more.

References:

Robinson D, Staskin D, Laterza RM, Koebl H. Defining female voiding dysfunction: ICI-RS 2011. Neurourology and urodynamics. Mar 2012;31(3):313-316.

Signs & symptoms of pelvic organ prolapse

Early onset of pelvic organ prolapse may not bring about any symptoms. When a prolapse is further down, common symptoms include:

• Pain during sexual intercourse
• Weak or intermittent urine stream
• Reoccurring urinary tract infections (UTIs)
• Heavy sensation felt in the vagina
• Bulging lump in the vagina or at vaginal entrance
• Feeling of incomplete bladder emptying
• Frequent urination
• Dull backache

If you experience any of the above symptoms, seek medical attention promptly. It is important to consult with a urogynaecologist to understand the treatment and management of the condition.

Diagnosis & treatment

Your urogynaecologist will take your medical history and perform a physical examination. Further tests may also be recommended for a full investigation.

Treatment depends on the type of prolapse, the woman's age, childbirth plans, as well as severity of the condition. In certain cases, lifestyle changes and pelvic floor exercises may be recommended. If non-surgical treatment does not provide sufficient relief from symptoms, surgical intervention may be required. With the advancement of medical technology, minimally invasive surgical techniques are now available which offers minimal scarring and faster recovery time. Talk to your urogynaecologist to find out more.

Tips to improve pelvic health

After giving birth, or as you age, you may notice that your pelvic muscles start to weaken. Here are some ways that can help improve pelvic health:

• Avoid heavy lifting
• Do not smoke
• Maintain a healthy weight
• Perform pelvic floor exercises to strengthen your pelvic floor muscles
• Prevent constipation by drinking plenty of fluids and increasing the amount of fibre in your diet
• If you have chronic cough, seek medical treatment to control coughing

Pelvic floor therapy

Pelvic floor therapy involves a series of exercises that help strengthen muscles supporting the bladder, bowels and uterus. These exercises can help prevent pelvic floor dysfunction.

Try the following pelvic floor exercises:

• Kegels – This exercise involves contracting and holding your pelvic floor muscles for 5 seconds and then relaxing the muscles for another 5 seconds. Do this exercise 10 times and repeat 3 times a day.
• Squats – Bend your knees and push your hips and buttocks out until your thighs are parallel to the ground. Do this exercise 10 times and repeat 2 – 3 times a day.
• Bridges – Lie on the floor with your back flat on the ground and your knees bent. Raise your hips off the ground and hold for 1 – 2 seconds. Do this 10 times and repeat 2 – 3 times a day.

Consult any of our urogynaecologists today for more information.