Let’s talk about pelvic floor health, say M Health Fairview urogynecology experts
Pelvic floor conditions like urinary incontinence or prolapse are more common—and treatable — than many people realize. To get help, though, we have to talk about it.
The M Health Fairview urogynecology team wants to let people know that safe, non-invasive treatments are available.
“A lot of women feel uncomfortable discussing a pelvic floor disorder with their physician,” said John Fischer, MD, a urogynecologist with M Health Fairview and a professor at the University of Minnesota Medical School. “But these are very common problems. I want people to feel comfortable talking about them and seeking help.”
Fischer shares five things to know about urogynecology, starting with what it is.
Urogynecology is a blend of gynecology and urology
Urogynecology bridges the fields of gynecology and urology. It focuses on pelvic floor disorders such as urinary incontinence, fecal incontinence, pelvic organ prolapse, and bladder and pelvic pain.
The pelvic floor is a group of muscles, nerves and connective tissue that supports the bladder, rectum, uterus, and vagina. When the pelvic floor becomes weakened or damaged—which can occur during childbirth, for example—people may develop issues with bladder and bowel control, in addition to pain or pressure in the pelvic area.
Pelvic floor disorders can be incredibly disruptive to a person’s life.
When to see a urogynecologist
Urogynecologists can help with a number of pelvic floor issues, including:
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Prolapse, which occurs when an organ like the uterus starts to slip out of place. It can cause a heavy feeling or pressure in the pelvis. People might begin to see tissue coming out of the vagina.
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Stress incontinence, which is leaking urine usually with an activity like running, jumping, or laughing.
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Urgency incontinence is frequently urinating and never quite feeling like you’re empty. You might pass just a small amount of urine each time but go 15 times per day and get up several times at night.
Pelvic floor issues can feel isolating, but they don’t have to be.
“We want people to know they’re not alone, and they don’t have to just live with these symptoms,” Fischer said. “There are real treatments available, and we’ll help you find what works for you.”
A variety of treatment options are available
There are many ways to treat pelvic floor disorders, including surgical and non-surgical options. Surgery or pelvic floor physical therapy can be used to correct stress incontinence. Medication, Botox, pelvic floor physical therapy, and neuro-modulation can help address urgency incontinence.
Pelvic organ prolapse may require surgery or non-surgical techniques such as insertion of a pessary to help hold the pelvic organs in place. Surgical treatment for these conditions has evolved. Urogynecologists can do them laparoscopically, which reduces the length of hospital stays and leads to faster recovery times.
“We never walk into the room and say, ‘You must have this surgery,’” Fischer. “We explain all the options—whether that’s pelvic floor physical therapy, medications, pessaries, or surgery—and help the patient decide what’s right for them at this point in their life.”
Treatments have evolved
Long-standing misconceptions surround urogynecology treatments. For example, many patients come in concerned about mesh implants used in prolapse surgery. Fischer acknowledges that mesh got a bad reputation in the early 2000s, when some poorly designed products caused complications.
“Mesh, when used properly, is a very safe and effective tool,” he said. “It’s not for everyone, and we always have alternatives. But it’s important for patients to know that it’s not inherently bad.”
Another frequent topic is estrogen therapy. After the Women’s Health Initiative study was widely misinterpreted in the early 2000s, many people believed estrogen was universally unsafe. That’s not the case, Fischer said.
“Using a vaginal estrogen cream can help restore normal bacterial flora and return vaginal pH levels back to normal,” Fischer said. “It can help with symptoms like vaginal dryness and bladder irritation."
Our team reads – and writes – the research
What sets M Health Fairview apart is the team’s deep involvement in research and innovation.
“Our providers are actively contributing to the science that drives pelvic floor care forward,” Fischer said. “For example, Rahel Nardos, MD, and Cynthia Fok, MD, recently co-authored a study on managing genitourinary syndrome of menopause, and Nissrine Nakib, MD, has been involved in developing new physical therapy tools and treatments for incontinence.”
The doctors are all associate professors with the University of Minnesota Medical School. Their research means that patients may have access to emerging treatments.
