Treatment for women’s urological conditions include:
Once we rule out causes of infection (for example, stones and abscesses, which are rare), we can offer non-antibiotic medications which help to decrease the number of UTIs you get. In general, we like to avoid the use of antibiotics, but if necessary, we can give them in limited amounts or a decreased dose. We use evidence-based medicine to help guide our treatment plans with you.
Overactive Bladder (OAB)
We always start with an in-depth review of your medical and surgical history, your lifestyle, and your medications. This information helps to guide us on what treatments will be effective for OAB. Everyone is different, and we make clinical decisions together. We initially offer conservative management, which can be dietary and lifestyle changes. We can then discuss medications, which are known to be effective. Other options include non-invasive percutaneous tibial nerve stimulation (PTNS) which involves minimal current to the nerves in your bladder through an electrode in your ankle. Another option is injection of botulinum toxin (Botox) into your bladder, or the placement of a nerve stimulator into your back to help "calm the bladder down."
Stress Urinary Incontinence (SUI)
In terms of treatment, there are always two categories to choose from when it comes to SUI - conservative or surgical. For conservative options, we can help you get started on a physical therapy regimen to help strengthen your pelvic floor, or can offer you some devices that you can insert to prevent leakage. For surgical options, we perform mid-urethral slings (MUS) (suprapubic and transobturator), as well as autologous fascial slings. Options include using a synthetic or biologic graft. Generally, this procedure is performed in an outpatient setting and you can go home the same day.
Pelvic Organ Prolapse (POP)
We offer a range of options for patients with POP from conservative to surgical. These include pessary placement, robotic sacrocolpopexy, colpoclesis, transvaginal sacrospinous ligament fixation, and pessary placement. We do not place transvaginal mesh. We can discuss if you are interested in hysterectomy (removing your uterus).
Treatment of fistulas require excision of the fistula and repair of the area. We have extensive experience in the repair of fistulas and the surgical approach can be transvaginal or open surgery. In complex patients with multiple surgeries or a history of radiation/chemotherapy, we utilize a multi-disciplinary approach to repair.
Urethal Diverticulum (UD)
Depending on the size of the UD, they can be observed or can be removed surgically. This can be performed in an outpatient setting and you can go home on the same day.