The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that supports a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum. Weakened pelvic muscles or tears in the connective tissue can occur when excessive strain is put on the pelvis through childbirth, repeated strenuous activity or pelvic surgery. Other factors that can increase the risk of pelvic floor disorders include repetitive heavy lifting, menopause, chronic disease, tobacco use and family history.

What conditions can a urogynecologist treat?

• Pelvic organ prolapse: One or more of the organs in the pelvis drops down causing a sense of pressure or a bulge in the vagina. It may also cause urinary incontinence, pain or constipation.
• Stress urinary incontinence: Leakage of urine with coughing, sneezing, laughing or any other activity that increases the pressure on the bladder and/or the supporting tissue.
• Overactive bladder syndrome: Frequency, urgency (a sudden and strong desire to urinate that is bothersome) and nocturia (waking up more than once at night to void) with or without urge incontinence (accidental urine loss associated with a sudden and strong desire to urinate).
• Anal and fecal incontinence: Involuntary leakage of gas and/or stool.
• Fistulas: An abnormal connection between two organs (i.e. bladder and vagina or vagina and rectum)
• Complications from third and fourth degree tears following vaginal childbirth

What treatment options are available?

There are a variety of non-surgical approaches as well as surgical options that can help relieve the symptoms associated with pelvic floor disorders. After consultation, you and your physician will work together to find the solution that works best for you, your lifestyle and your overall health.

Why should I see a urogynecologist?

While many of the symptoms and conditions listed above are very common, it is important to know that these are not a normal part of aging or something that women need to put up with. Consulting with a urogynecologist will provide you with specialized expertise to help determine the best way to relieve your symptoms and restore your quality of life.

At Virginia Women’s Center, we are excited to welcome our first urogynecologist, Dr. Tovia Smith. Dr. Smith will work with female urologist Dr. Lonny Green and gynecologists Dr. Elizabeth Roberts and Dr. Louis Thompson to care for women whose qualities of life are being affected by bladder and pelvic health issues.

About Virginia Women’s Center
Since 2006, Virginia Women’s Center has been dedicated to helping women with urinary incontinence and other bladder problems find solutions to restore their quality of life. For more information, visit www.VirginiaWomensCenter.com, or find us on Facebook, Pinterest and Twitter.

Dr. Meghana Gowda urogynecologist at Virginia Urology Women’s Health

If you’re suffering from incontinence, you might feel completely alone, but you most certainly aren’t.

Research suggests that an estimated 21 million women in the United States suffer from incontinence and 1 in 3 women experience occasional bladder leakage.  The good news is, there are many non-surgical ways to fix this potentially embarrassing and certainly uncomfortable problem.  The even better news is Virginia Urology has opened a new specialty practice, Virginia Urology Women’s Health that will focus specifically on urogynecology

Joining the VUWH team is Dr. Meghana Gowda, it’s first female urogynecologist.

“I’m happy to be joining the team at VUWH with a group of colleagues who are all leaders in this field,” said Dr. Gowda. “In my experience, women often continue to suffer needlessly from incontinence. Once the condition begins to interfere with daily routines, it’s time to seek help. Women shouldn’t let it become chronic when there are so many treatments available to them, including medication, behavior modification, and physical therapy.”

Dr. Gowda is back in Richmond (having received her M.D. from MCV – now known as VCU Health Systems) after her residency at New York University School of Medicine and completing her fellowship in female pelvic medicine and reconstructive surgery at Vanderbilt University.

“Virginia Urology Women’s Health is the area’s most inclusive center for women experiencing urologic problems,” said Kent L. Rollins, MD, President of Virginia Urology. “A specialized urogynecology practice brings our patients the most coordinated care possible, as well as the newest in technologies and advanced diagnostics, with our goal being the best outcome for each patient. It also completes our package of services, allowing us to bring the most comprehensive care possible to all of our patients in a cost effective manner. We are delighted to have Dr. Gowda  join our dedicated group of physicians and support staff.”

Urogynecology specializes in urology and gynecology and deals with problems affecting the female pelvic floor.  Rather than seeing multiple specialists, urogynecologists can manage all pelvic floor disfunctions comprehensively.

To make an appointment with Dr. Gowda, call 804-288-0339 or request an appointment through the website.  Dr. Gowda will be seeing patients at three Virginia Urology locations: Reynolds Crossing, St. Francis and Stony Point.

This article is sponsored by Virginia Urology

In an earlier blog post, I reported that I was fortunate to be able to attend the American Urological Association annual meeting in early May. Attendees traveled to San Diego from around the globe to learn about the latest scientific breakthroughs for various urologic conditions. It was a stimulating conference with many new findings and reports. In this part two, I will present information on Botox for overactive bladder and the safety of slings done for stress urinary incontinence.

Botox is the most exciting new treatment for overactive bladder in years and data on its effectiveness was presented at the meeting by Dr. Victor Nitti. Patients who were part of an initial study on Botox could then enroll in an extension study. During this extension study, patients could receive repeat Botox injections over the course of a number of years, if needed. Analysis of large numbers of patients showed very positive results. Not only was Botox extremely effective in decreasing urgency, frequency and leakage, it also remained effective for a long time. Further, when repeat injections were done, the results were just as good and just as long lasting as when they were done for the very first time.

Botox injections can be performed right in our office in a few minutes. Numbing medicine is put into the bladder and there is very little discomfort. While the effects of Botox wear off over time, many patients see dramatic improvement for six to 18 months before noting a decline. At that time, the procedure may be repeated. Read patient testimonials from our own VWC patients who have had Botox for overactive bladder.

Another update from the AUA looked at the safety of slings done for stress incontinence. Stress incontinence is leakage related to exertion, such as a cough, sneeze or exercise. Dr. Anne Suskind and other investigators reviewed 6,698 mesh sling procedures done between 2006 and 2008, as well as 445 non-mesh procedures. They found that complications were extremely uncommon. Many other studies have confirmed the long-term safety and effectiveness of slings for treating urinary incontinence. This is in line with our experience here at Virginia Women’s Continence Center. The sling procedure – done as an outpatient – is minimally invasive. Patients are up and about and driving the very next day. The improvement in quality of live can be enormous – read what some of our own patients are saying.

There are many TV advertisements warning against the danger of vaginal mesh. It is important to understand that the sling procedure, done strictly for urinary incontinence, is not the same as the surgeries that were done with large pieces of mesh for “bladder tacking” or fixing pelvic prolapse. In fact, the sling does not sit under the bladder at all – it is completely under the urethra. In 2011, the FDA declared that manufacturers of the larger mesh kits had to do new studies and get new approval before being allowed to proceed. At the same time, the FDA said that companies did not have to do new studies on slings, with the exception of ongoing studies of the newest design modification of one of the slings. Further information on this can be found here.

These are just some of the new developments in the ongoing diagnosis and treatment of bladder problems. No matter the type of bladder problem you are experiencing, we are ready and willing to find a solution that will restore your quality of life. Make an appointment with Virginia Women’s Continence Center by calling 804.288.4084 and find out for yourself.