20 to 35% of women suffer from gynaecological and/ or urinary problems during the course of their life. Many of these problems are related to the muscle weakness of the perineum. These problems are more frequent in women who have had several pregnancies, those with increased abdominal pressure through straining and those who are menopausal (naturally or surgically) because of the decreased hormonal levels. Weakness of the pelvic floor can present itself with urinary incontinence and/or a pelvic organ prolapse (descent of the uterus and/or bladder and/or bowel in the vagina).
These conditions require a multidisciplinary workup which includes urodynamic testing and occasionally other diagnostic tests such as X-rays and cystoscopy.

Services

The RocklandMD Urogynecology and Women’s Urology Clinic offers diagnostic services and treatment for urinary incontinence, bladder dysfunction, a pelvic organ prolapse (vaginal, uterine, bladder and/or rectum) and problems related to the perineum.
These problems are managed by a multidisciplinary team of healthcare professionals which include physician specialists (gynaecologists, urologists), specially trained nurses and physiotherapists specialized in perineal rehabilitation.

Urodynamic testing

The first visit consists of a questionnaire and physical exam. This is often followed by urodynamic testing.
Urodynamic testing is a procedure done by a trained nurse under the supervision of the physician specialist. The duration of the procedure is approximately an hour. This exam assesses the state of the bladder with its ability to hold and eliminate urine and that of the urethra. Once the procedure is completed, a written report is produced and reviewed by the physician.

The clinic is also intended for women with other urological problems such as fistulas, urethral diverticula, recurrent urinary infections, and interstitial cystitis.

Treatments available
• Exercises to strengthen the pelvic flour
• Prescription of medication
• Endovaginal prosthesis (pessary)
• Surgical correction
• Stress urinary incontinence

In the case of stress urinary incontinence, the surgical procedure most often done is that of inserting as small synthetic band under the urethra. The band provides support to the surrounding tissues and thus prevents urinary leakage when straining. This procedure is done as a day surgery and is usually very well tolerated.

Pelvic organ prolapse

In the event of a pelvic organ prolapse, surgery is an option. The surgery procedure consists of strengthening the surrounding tissues. This is sometimes done by placing a mesh. The procedure is done as a day surgery and is usually very well tolerated.