Female urology involves the function and disorders of a woman’s bladder and pelvic floor. Many women experience urology problems such as incontinence, pelvic pain, and urinary tract infections during their lives, especially after pregnancy.
Often women don’t realise that there are resources to improve these personal issues and, they may be embarrassed about discussing them. Here at Boston West Hospital we offer advice and care to help improve your quality of life if you are suffering from women’s urology problems.
We have highly regarded consultant urologists who can diagnose and offer a wide range of effective treatment options. At Boston West Hospital they can provide minor urology treatments and utilise the facilities at our nearby sister hospital, Fitzwilliam for more major and complex surgery if required.
Boston West Hospital is also fortunate to have a women’s health physiotherapy specialist who can offer advice on exercises to help improve women’s urology problems including pelvic pain, pelvic prolapse, urinary incontinence, bowel disfunction and, pregnancy and postpartum pain and conditions.
If you have bladder or pelvic floor symptoms that you would like to understand, please call us on 01205 591860 or contact us to book an appointment.
Urology conditions we treat
If your muscles and ligaments weaken then the organs they support including your bladder, bowel or uterus may drop into your vagina. This is known as a bladder prolapse.
A bladder prolapse often happens to women who have had multiple vaginal deliveries or their uterus removed in a hysterectomy. Other reasons for the prolapse of your bladder may be menopausal hormone changes, constipation, chronic coughing and previous pelvic surgery.
Our consultant urologists will recommend treatment based on the severity of your prolapse.
Sometimes doing simple pelvic floor strengthening exercises and avoiding lifting heavy items or straining may help. Alternatively, hormones may be prescribed to help maintain your pelvic muscle strength or, a pessary device inserted into your vagina to help keep your bladder in place. If these treatment options aren’t successful, pelvic floor repair surgery may be recommended.
Incontinence happens when you accidentally release urine. It’s a common bladder control problem that can range from an occasional leak from coughing through to not being able to hold in any urine.
There are three main types of female incontinence:
- Stress incontinence – incontinence when you exert pressure on your bladder such as sneezing, laughing or jogging may cause you to urinate.
- Urge incontinence – not being able to get to the toilet in time when you have a sudden need to urinate.
- Overflow incontinence – when you’re unable to totally empty your bladder and it constantly dribbles urine.
You consultant urologist will investigate the reasons for your urinary incontinence and treatment will be based on their diagnosis.
Treatment options may include: medications, creams, pelvic floor exercises, biofeedback, electrical stimulation, bladder training, pessary insertion and incontinence surgery.
If surgery is required, there are a number of options that will be discussed in detail with you. These include: a tape procedure that will hold up your urethra in the correct position, colposuspension that will lift and stitch the neck of your bladder into position, a sling to support your bladder neck, collagen injections to build your urethra, nerve stimulation to improve nerve signals and, anterior vaginal repair surgery to correct weak muscles in the front wall of your vagina.
Interstitial cystitis (IC)
Interstitial cystitis is a chronic inflammatory condition of your bladder wall that causes long-term pain and the feeling that you need to urinate frequently.
Interstitial cystitis is often diagnosed by a series of elimination of other conditions with similar symptoms. Your surgeon may use cystoscopy to have a look inside your bladder and they may take a biopsy of your bladder to analyse a tissue sample.
Currently there is no cure for interstitial cystitis but treatment can be provided to relieve IC symptoms. Most people are helped by one or a combination of treatments such as: lifestyle changes, physiotherapy, bladder retraining to reduce urinary frequency, medications, TENS unit for pain control and surgery.
If surgery is required this may include: cauterisation to seal ulcers inside your bladder, bladder distension, botulinum toxin injections, nerve stimulation using neuromodulation and bladder enlargement.
Pelvic floor repair
Your pelvic floor muscles support your bladder, vagina and rectum and control your bladder and bowel movements by contracting and relaxing. The muscles of your pelvic floor can become weak, torn or inflamed, especially after giving birth.
Improving the coordination of your pelvic floor muscles can help your bladder and bowel movements. Non-surgical options include biofeedback, medications and relaxation techniques.
If conservative methods are not successful then surgery may be recommended. Your urologist may perform one or more pelvic floor repair surgery procedures at the same time including:
- Anterior pelvic floor repair surgery to strengthen the muscles in the front wall of your vagina and push your bladder and urethra back into place.
- Posterior pelvic floor repair surgery to strengthen the muscles in the back wall of your vagina and push your bowel back into place.
- Hysterectomy to remove a prolapsing uterus.
Urinary tract infections (UTI)
Women are more likely than men to contract a urinary tract infection. Bacteria causes infection and inflammation of different parts of your urinary tract, including your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection).
UTIs can cause pain or burning when urinating, smelly or cloudy urine, needing to urinate suddenly and more often than usual, pain in your lower abdomen, blood in your urine and feeling weary and unwell.
It is important to diagnose and treat a UTI as it can cause serious medical problems if it spreads to your kidneys or into your bloodstream.
Your urologist may send urine samples to the laboratory for testing and culture, perform imaging scans and, use cystoscopy to see inside your bladder and make a diagnosis.
Most UTIs can be easily treated with antibiotics.
Kidney stones can develop in one or both kidneys when waste products in your blood form crystals and build up over time to form a hard stone.
Small kidney stones can pass out of your body undetected when urinating. Large kidney stones can block part of your urinary system including the ureter and urethra and may cause: severe pain in your abdomen or groin, a urinary tract infection, blood in your urine and, kidney damage.
Treatment of kidney stones will largely depend on their size, location and, whether you have a urinary infection. Your urologist may perform:
- Keyhole surgery to remove kidney stones. An endoscopic procedure called ureteroscopy is often used to remove or break up the stones that are lodged in your kidney down to your bladder. We are proud to have the Joint Advisory Group (JAG) accreditation for our endoscopy services.
Vaginal prolapse surgery
Following a hysterectomy, childbirth or the menopause, a vaginal prolapse may occur where the organs inside your pelvis fall or bulge into your vagina wall.
You may be advised on pelvic floor muscle training and lifestyle changes to help manage your vaginal prolapse. Your urologist may recommend vaginal prolapse surgery if you are not planning to get pregnant in the future. If you have a significant prolapse of your uterus you may also be advised to have a vaginal hysterectomy as well.
Most prolapse surgeries are performed via the vagina as this negates the need for surgical incisions to your abdomen. You may have an anterior repair that involves repairing and strengthening weak muscles in the front wall of your vagina and also putting your bladder and urethra back into place. Alternatively, you may have a posterior repair to repair the muscles in the back wall of your vagina and move your bowel back into place.