What is Urogynecology?
Pelvic floor care has been artificially divided into three different medical specialties : gynecology, urology and colorectal surgery. However, pelvic components simultaneously: eg. Prolapse, bladder and bowel control problems can cure simultaneously. Hence treating these problems separately without a thorough assessment of the entire pelvic floor may often be inadequate. Much worse, isolated treatment can often lead to worsening of the condition because of unmasking of a previously hidden problem .
Urogynecology is a super specialty of gynecology that recognizes that the pelvic floor is one. An urogynecologist is a gynecologist who has undergone fellowship training to provide comprehensive and integrated care, including all diagnostics and treatments, both non- surgical and surgical, for your pelvic floor problems.
Comprehensive Treatment for all Pelvic Floor Problems
1. Prolapse (bulging of pelvic floor organs into vagina).
- Non – surgical treatment : Pessary, physiotherapy.
- Surgical Treatment : Advanced vaginal and laparoscopic reconstructive surgeries.
2. Incontinence of urine (urine leakage): Comprehensive management for stress urinary incontinence (SUI), urgency incontinence (UI), mixed incontinence, overflow incontinence.
- Non- surgical treatment : Behavioral modification, pelvic floor exercises, physiotherapy with biofeedback and electrical stimulation, medications.
- Minimally invasive procedures: Bulking agent injection for SUI and Botox injection for urgency incontinence.
- Surgical treatment: Urethral slings and Bruch colposuspension for SUI and sacral neuromodulation for UI. Advanced surgeries for refractory UI are also performed at our centre. We are one of the few centres in the country to offer sacral neuromodulation for UI.
3. Urgency, frequency and nocturia (increased frequency of urination).
4. Hematuria (blood in urine).
5. Voiding Dysfunction (incomplete bladder emptying).
6. Recurrent urinary tract infection.
7. Bladder pain syndromes.
8. Chronic pelvic pain.
9. Urethral diverticula.
10. Colorectal motility disorders including constipation and fecal incontinence.
11. Neurological conditions: Bladder and bowel control problems resulting from neurological conditions.
12. Multidisciplinary and long term management of menopause.
13. Fistulas: rectovaginal, vesicovaginal and other complex urogenital fistulas.
14. Sexual dysfunction.
15. Vaginal agenesis.
16. Vulvar problems.
17. Surgical complications resulting from urogynecological surgery including mesh erosion.
We offer comprehensive diagnostics including
- Advanced urodynamics: We are one of the very few centres in the country to use air- charged catheters and to provide urethral pressure profiles. Dr. Hegde is one of the country’s top urodynamic experts.
- HD cystoscopy which offers enhanced visualization of the bladder and urethra in the OPD setting.
- 2D dynamic and 3D real- time transperineal and endovaginal ultrasound assessment of the pelvic floor: We are one of very few centres in the world that offer this emerging technology in which Dr. Hegde is an internationally recognized pioneer.
- 3D endoanal real – time ultrasound, the gold standard for diagnosis of anal sphincter injury.
- Defecogram or defecating proctogram, a live X-ray imaging of the defecation process.
- Colonic transit study, an X- ray examination of the time it takes for food to transit from the stomach to the rectum and anal canal.
- Voiding cystourethrogram, a live X-Ray evaluation of the ability of the bladder to store and void urine.
Centre for Physiotherapy and Allied Non- Surgical Treatment
- Comprehensive Behavioral Modification Program including diet and fluid modification, bladder retraining, timed voiding and urge suppression programs.
- Pelvic Floor Exercises.
- Physiotherapy with biofeedback and electrical stimulation with latest urostym technology.
Often rigorous comprehensive conservative management may be all that you require to get relief from your pelvic floor problems.
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