Bladder Problems, Vaginal Bulges, & Other Symptoms (Pelvic Floor Disorders)

Do you have trouble with an overactive bladder (maybe you go to the bathroom every hour)? Do you lose control of your bladder, peeing when you don’t want to? Do you feel pressure in your pelvis or feel like your vagina, bladder, uterus, or rectum has dropped, causing a bulge or pressure?

You do not have to suffer through these symptoms. They are treatable symptoms that specialists call pelvic floor disorders. A urogynecologist treats these symptoms and conditions and can help you increase your quality of life.

Symptoms

Many women may not have symptoms of pelvic floor problems at first. If, however, you start to develop some of these symptoms, you should not be embarrassed to tell your health care provider about them. 

Symptoms of pelvic floor disorders can include the following:

  • A bulge or something visibly coming out of the vagina
  • Heaviness, fullness, pulling, or aching in the vagina that is worse at the end of the day or during a bowel movement
  • Having a hard time peeing or emptying your bladder completely
  • Leaking pee when you cough, laugh, or exercise
  • Feeling an urgent or frequent need to pee
  • Having frequent urinary tract infections

Any of these symptoms can be embarrassing but you don’t have to continue to suffer with them. You can see a urogynecologist and get treatment.

What Is a Urogynecologist?

A urogynecologist is a specialist who has completed training extra training in both gynecology and urology. Since urogynecologists have training in both specialties (women’s health and urology), they are particularly trained to help women with conditions like these:

All of these conditions can affect a system that is called the pelvic floor. The pelvic floor includes the muscles, ligaments, connective tissue, and nerves that keep the uterus, vagina, bladder, and rectum in place.

When the pelvic floor is torn, weak (from childbirth, for example), or doesn’t work for some other reason, you may experience some of the symptoms above.

What Is the Difference Between a Gynecologist and a Urogynecologist?

Gynecologists treat women’s health issues—pregnancy, period issues, fertility problems, menopause, and others. Urologists may treat UTIs, incontinence, cancer, and male infertility problems, among other conditions.

Urogynecologists see women and focus on symptoms related to urinary incontinence, prolapse, and pelvic floor disorders.

What Causes Pelvic Floor Disorders?

Multiple life events can cause pelvic floor disorders in women of all ages. Pelvic floor disorders can occur in women in their 20s and 30s and women in menopause as well—essentially over the woman’s entire lifetime. Some of the risk factors for pelvic floor disorders are:

  • Vaginal birth
  • C-section
  • Births of more than one child
  • Obesity
  • Chronic constipation
  • Chronic coughing
  • Repeated strenuous activity and heavy lifting
  • Radiation treatment
  • Prior pelvic surgery
  • Aging
  • Genetics

Any of these experiences or conditions may tear or weaken your pelvic floor.

You Are Not Alone

More than one third of women in the US have pelvic floor disorders. Nearly 25 percent of these women have one or more pelvic floor disorders that cause symptoms.

As you get older, these symptoms are more likely.

What Treatments Will My Urogynecologist Offer?

Your urogynecologist will work with you to establish a custom treatment plan, dependent on your symptoms and condition. This could include non-surgical or surgical treatments.

Non-Surgical Treatment

Non-surgical treatments your urogynecologist may recommend could include any of these:

  • Kegel exercises, also called pelvic floor muscle training exercises
  • Referral to a pelvic floor physical therapist
  • Injections for bladder control problems (bladder Botox)
  • Medication
  • Vaginal pessary (A plastic device used to treat some types of prolapse and/or improve bladder control. Your doctor fits you for a pessary and will instruct you on how to care for it.)

Surgical Treatment

If your specialist recommends surgery, it may involve any of the following:

  • Rebuilding pelvic floor support
  • Repairing any prolapse
  • May include removal of the uterus (hysterectomy)
  • Mesh midurethral sling for urinary leakage
  • Damage repair for anal or sphincter muscles

Your specialist may also recommend a combination of treatments for your symptoms/condition.

Do I Have to Be Referred to See a Urogynecologist?

If you need to see a urogynecologist, there is a good chance that your primary care doctor or obgyn can refer you to one. However, a referral is not always necessary and you can make an appointment at your convenience.

What to Expect at an Appointment with a Urogynecologist

At your appointment, your urogynecologist will ask you about your symptoms, timing of your symptoms, and the effect on your quality of life. They will also review your medical history and past events that may have affected your pelvic floor.

Physical Exam

Your urogynecologist will also examine (like a gynecologist) your lower organs. Be prepared for a physical exam.

Next Steps 

If you think you could benefit from seeing a urogynecologist, make an appointment.

It is important for both your mental and physical health to see a specialist for symptoms and conditions like those above. You do not need to suffer in silence from conditions that are both common and treatable.