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Female Urology

Female urology is a urology subspecialty concerned with the diagnosis and treatment of common female urologic conditions. These conditions include urinary incontinence, bladder prolapse (cystocele), voiding dysfunction, recurrent urinary tract infection, urethral syndrome and interstitial cystitis.

Bladder Prolapse (Cystocele)

Bladder prolapse, also known as cystocele, occurs when pelvic floor muscles and ligaments are stretched and/or weakened to allow the bladder to sag into the vagina. In severe cases, the bladder can appear at the vagina's opening or protrude through it.

Causes of bladder prolapse include:

  • Stress on pelvic muscles and ligaments during childbirth
  • Heavy lifting
  • Chronic coughing
  • Constipation
  • Obesity
  • Menopause
  • Frequent straining during the passing of stool
  • Previous pelvic surgery

Women who have had multiple pregnancies or deliver children vaginally are at a higher risk for bladder prolapse. In rare cases, bladder prolapse may be a congenital condition.

Click here to learn more about the risk factors and treatment options for bladder prolapse.

Symptoms:

  • Frequent or urgent urination
  • Leakage of urine
  • No bladder relief following urination
  • Frequent urinary tract infections
  • Discomfort or pain in the vagina, pelvis, lower abdomen, groin or lower back
  • Heaviness or pressure in vaginal area
  • Pain during sexual intercourse
  • Tender or bleeding tissue protruding from the vagina

Tests:

Typically, bladder prolapse is detected during a thorough pelvic exam. In some cases, the condition may be diagnosed with a voiding cystourethrogram, a procedure that utilizes a series of x-rays during urination to visualize the shape of the bladder and obstructions to urine flow.

Treatments:

Kegel exercises are recommended for cases of mild bladder prolapse. These are designed to strengthen the pelvic floor muscles. For more advanced cases, estrogen replacement therapy, electrical stimulation, biofeedback or vaginal support devices may be recommended. Surgery may be performed in severe cases.

Urethral Syndrome

Tests:

Urethral syndrome may be diagnosed through urine or urethral swab tests, exams for sexually transmitted diseases or cystoscopy or urethroscopy. A cystoscopy or urethroscopy are usually performed when the symptoms of urethral syndrome persist without a diagnosis.

Treatments:

The first line of treatment for urethral syndrome is medication. Antibiotics may be prescribed if the condition exists due to an undetected infection. It is also reccommended that patients avoid products that may irritate the vaginal and urinary tract area. Surgery is only recommended if structural problems are causing the condition.