Female Pelvic Health

If you are experiencing symptoms of pelvic floor disorders, Ochsner offers several urodynamic tests to pinpoint the issue. Urodynamic tests look at how well parts of the lower urinary tract, the bladder, sphincters and urethra, work to store and release urine. They give your doctor detailed information about your pelvic floor health, including:

• Ability to start and stop the flow of urine
• Muscle strength
• Nerve function
• Pressure level in and around the bladder
• Urine flow rate
• Urine storage and release

The experts at Ochsner provide comprehensive care for pelvic floor disorders, including:

• Bladder disorders due to spinal cord injuries or neurological conditions
• Fecal incontinence: Accidental bowel leakage or bowel movements
• Genitourinary fistula: An abnormal connection or opening between the uterus or vagina and the bladder, the tubes that move urine from the kidneys to the bladder (ureters) or the tube that allows urine to pass out of the body (urethra)
• Interstitial cystitis/bladder pain syndrome: An ongoing condition that causes pain or tenderness in the lower abdomen and may cause other urinary symptoms
• Pelvic organ prolapse: Weakening of the muscles and connective tissue that support the bladder and other pelvic organs causing the bladder or another organ to drop or press into the vagina
• Rectovaginal fistula: An abnormal connection or opening between the rectum and vagina
• Recurrent urinary tract infections (UTIs): Frequent infections in the bladder, kidneys, ureters or urethra
• Stress incontinence: Accidental urine leakage with activity, including coughing, heavy lifting or sneezing
• Urethral diverticulum: An abnormal pocket or pouch on the urethra that can collect urine and cause infection
• Urge incontinence: A sudden need to urinate right away that can cause accidental urine leakage
• Voiding dysfunction: Challenges fully emptying the bladder that may be caused by muscle issues, a neurological condition or an obstruction

Ochsner pelvic floor health experts also treat complications from previous urinary incontinence treatment, such as mesh erosion or obstruction. Our pelvic floor health specialists can also offer a second opinion.

Non-invasive treatments are typically the first ones used to treat pelvic floor disorders. These include:

• Behavioral therapy
• Biofeedback therapy: A mind-body therapy that can improve physical and mental health
• Lifestyle changes
• Medications
• Pelvic floor physical therapy
• Physiotherapy: Treatment to restore, maintain and make the most of a patient’s mobility, function and well-being

When these are not enough, the Ochsner female pelvic health team offers a wide range of additional treatment options, including:

• Anterior colporrhaphy, also called cystocele repair: A procedure to repair the vaginal wall to reduce stress incontinence
• Bladder instillations, also called a bladder bath: A procedure using a catheter to temporarily fill the bladder with a solution to clean it, which may reduce pain or urgency
• Botox intravesical injections: A medication injected into the bladder or pelvic floor muscles to help them relax to hold more urine or decrease spasms
• Bulking agent injections: Material, such as collagen, injected around the urethra to make it more narrow and decrease urine leakage
• Genitourinary fistula repair: A procedure to close an abnormal connection or opening between the vagina or uterus and the bladder, ureters or urethra
• Genitourinary reconstruction: Surgery to repair problems with the bladder, kidney or reproductive organs
• Neuromodulation: A minimally invasive implanted device that uses electrical stimulation to help control the bladder or surrounding muscles, nerves and tissues to decrease pain or improve function
• Pelvic reconstruction: A group of surgical procedures used to treat pelvic organ prolapse
• Posterior colporrhaphy, also called rectocele repair: Surgery to repair muscles and tissues between the rectum and vagina
• Sacrocolpopexy: A robot-assisted laparoscopic procedure to address pelvic organ prolapse
• Tension-free vaginal tape procedure and mid-urethral slings: A group of procedures where a sling or tape is placed to support the urethra to decrease stress incontinence
• Ureteral reimplantation: Surgery to change the position of the ureters that connect the kidneys to the bladder
• Urinary diversion: A procedure to create a new pathway to pass urine when there is a blockage

The pelvic floor is a group of muscles that support the pelvic organs, including the:

• Bladder

• Cervix

• Intestines

• Rectum

• Ureters

• Urethra

• Uterus

• Vagina

Strong, healthy pelvic floor muscles support the function of pelvic organs and your ability to hold or pass gas, bowel movements or urine.

If you have weak pelvic floor muscles, you may be unable to coordinate and relax properly when you need to urinate or have a bowel movement. These muscles normally tighten and relax to allow for normal bodily functions, but with weak pelvic floor muscles, they remain tense instead of relaxing. This tension means you may have:

• An incomplete bowel movement
• Trouble releasing a bowel movement
• Urine or stool that leaks

Pelvic floor muscle training can aid in strengthening your pelvic floor muscles. Depending on your symptoms and needs, your doctor may teach you some pelvic floor muscle exercises to do on your own, or they may recommend working with a physical therapist. Your doctor may also recommend lifestyle changes, medication, neuromodulation or other treatments to improve your pelvic health and function.