Female Pelvic Medicine - Reconstructive Surgery

Urogynecology Services

Urinary incontinence and pelvic prolapse is a sometimes embarrassing condition that women don’t often discuss with each other or their primary care provider. Many women live with this problem for years before seeking care. But it is a very common problem that is not normal and is often treatable. We understand how difficult it can be to take the step of acknowledging and then taking action to seek treatment. No woman should have to live with urinary incontinence and pelvic organ prolapse. We specialize in the care and treatment of these conditions.

When should I seek help?

No woman should have to live with:

The leakage of urine which:

Prevents activities that you want to do
Causes embarrassment
Began or continued after a surgery

Difficulty or the inability to urinate

Urinary frequency that is not caused by a urinary tract infection

Needing to rush to the bathroom and sometimes not making it

Pain with urination

Frequent bladder infections

Feeling as if something is protruding from the vagina

Difficult bowel movements

Pelvic pressure or heaviness

What are the causes of leaking/incontinence?

Urge incontinence/Overactive Bladder (OAB) - the inability to hold urine long enough to make it to the bathroom

Stress urinary incontinence- incontinence when coughing, laughing, sneezing, running, or other things that put pressure on your bladder

Incomplete bladder emptying - when the bladder chronically remains really full and stretched out - only a small amount of urine overflows from the bladder

Recurrent urinary tract infections

Give us a call to schedule
an appointment
(304) 599-7075

Evaluation and Treatment of UroGynecology Problems:

Urinary Incontinence

Evaluation

When you come for your visit these are some of the types of tests that we may do or offer:

Urinalysis
Urine culture
Measurement of postvoid residual volume (bladder scanning)
Voiding diary
Urine cytology
Cystoscopy
Renal Ultrasound
CT Urogram

Treatment

There are many ways to treat urinary incontinence and depending on your condition, we may offer:

Pelvic floor muscle exercises (Kegel exercises)
Dietary changes (avoid caffeine, excessive fluids, drinking fluids in the evening)
Weight loss (5-10% weight loss can decrease urinary incontinence by 50%)
Bladder training (timed voiding)
Pessary
Medication
Posterior Tibial Nerve Stimulation (Uroplasty)
ApexM
Pelvic Floor Physical Therapy
Biofeedback
Surgery
Information about incontinence products and perineal care
- Iconundies.com (stylish incontinence products)

Other options: (Periurethral bulking, Botox, Interstim–these are not options that our practice offers, but we work closely with other practices who do offer these services)

Pelvic Organ Prolapse

Can happen alone or in combinations:

Cystocele
when the vaginal wall under the bladder sags into the vagina “bladder dropped”
Rectocele
when the vaginal wall on the rectal side bulges into the vagina
Enterocele
when the small intestines are bulging into the vagina
Uterine prolapse
when the uterus sags towards the vaginal opening
Vaginal vault prolapses
when the vaginal wall sags after a hysterectomy
Complete procidentia
when the vagina completely turns inside out and there is a large protrusion outside of the body

Fecal Incontinence (Accidental Bowel Leakage)

Fecal incontinence is the accidental loss of stool or solid, liquid stool or gas
Most commonly caused by childbirth causing anal sphincter weakness
May also be caused by loss of feeling in the rectum, the inability of the rectum to stretch and store stool, or stool that is too liquid or loose
Hemorrhoids
Certain medications
Bowel problems (irritable bowel disease, inflammatory bowel disease, rectal cancer)

Childbirth Injuries

Childbirth via vaginal delivery can affect the muscles and nerves of the pelvic floor and cause:

Pelvic prolapse
Urinary incontinence
Fecal incontinence
Pelvic/perineal pain
Non healing of episiotomy or vaginal tear

Usually after a few months the initial symptoms improve and no further treatment is required but if not, conservative treatments can usually improve these symptoms especially in women who would like to have more children.

Fistula (abnormal connection between bowel or bladder and the vagina) is a very rare but serious condition causing uncontrolled leakage of urine or stool. Fortunately, this can usually be repaired as an outpatient procedure through the vagina and there are few long term consequences.

Hospital Based Urogynecology Surgery

Dr. Capelle performs surgical procedures primarily at Mon General Hospital but can also care for patients at Ruby Memorial Hospital if that is a patient’s preference or if that hospital is “in network” for a patient's insurance.

Pubovaginal Sling (PVS)
Dr. Capelle performs this surgery for women with stress urinary incontinence (leaking when the bladder is stressed with laughing, coughing, sneezing, exercise). The PVS is a “sling” of mesh or tissue placed like a hammock under the bladder neck. This keeps the bladder supported to prevent leaking. Learn more