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Urogynaecology and Pelvic Floor Disorders

Our Womens Health Center provides assessment, investigations and treatment for women with a variety of different conditions associated with the bladder and pelvic floor, such as: urinary incontinence, urinary tract infection, urinary retention and difficulties in passing urine, uterovaginal prolapse, overactive bladder, bladder pain and interstitial cystitis. Read more about these conditions here.

Assessing and treating urinary incontinence

Urge urinary incontinence is an involuntary loss of urine associated with urgency or strong desire to void. When you void, the muscles in your bladder contract to help you to pass urine. When you have urine incontinence, you lose control of these muscles and leak urine involuntarily.  It is a very common condition. There are three types of urine incontinence: Stress incontinence, urge urinary incontinence and mixed urinary incontinence (see below). Stress incontinence is the leakage of urine when you cough, sneeze, laugh or exercise. This happens when there is a rise in intra-abdominal pressure, and your water pipe (also called urethra) and pelvic floor are not strong enough to prevent the urine leakage. There are various ways to treat urinary incontinence, such as pelvic floor exercises and in some cases, surgery.

Mixed urinary incontinence is a combination of both stress and urge urinary incontinence. Mixed incontinence is when you have symptoms of both stress and urge incontinence meaning you may leak urine if you cough or sneeze, and also experience very intense urges to pass urine.

Overactive Bladder (OAB)

An overactive bladder is a condition characterized by urinary urgency (this is when you have a very sudden and intense need to pass urine), usually accompanied by increased daytime frequency and/or nocturia (waking up at night to pass urine), with urinary incontinence (OAB-wet) or without (OAB-dry), in the absence of urinary tract infection or other detectable disease.

Treatment of overactive bladder include: Lifestyle Changes, Drugs, Bladder Botox® (botulinum toxin) Treatments, Nerve Stimulation using a pacemaker to control your bladder, and surgery

Urinary Tract Infection (UTI)

Urinary tract infections (UTIs) can affect different parts of your urinary tract, including urethra, kidneys and your bladder (known as cystitis). Mild cases of bladder infection can improve naturally over a few days or may be easily treated by antibiotics. But in more serious cases, UTIs can cause kidney infections.

Symptoms of cystitis (bladder inflammation) include:

  • pain, burning or stinging when you pass urine
  • needing to pass urine more often and urgently than usual
  • pain low down in your stomach
  • feeling generally unwell, achy, sick and tired
  • urine that’s dark, cloudy or strong odour
  • Blood in the urine
  • Difficulties passing urine

Uterovaginal Prolapse

Uterovaginal Prolapse happens when a woman’s pelvic floor is stretched and weakened such that they are unable to provide support for the uterus, bladder and bowel. This causes the front, back and/top of vagina, to slip down into or protrudes out of the vagina. Uterovaginal Prolapse is more common in women who have had many children, or those who are post-menopausal. Many of the symptoms can be treated with exercises and or using pessaries, but in some cases surgery might be necessary.

Symptoms of Uterovaginal Prolapse may include:

  • a feeling of heaviness around your lower stomach and genitals
  • a dragging discomfort inside your vagina
  • feeling like there’s something coming down into your vagina – it may feel like sitting on a small ball
  • feeling or seeing a bulge or lump in or coming out of your vagina
  • discomfort or numbness during sex
  • problems urinating (see urinary incontinence above).

Bladder Pain

Bladder pain syndrome is sometimes also referred to as interstitial cystitis or painful bladder syndrome. It is a chronic condition that affects the bladder. It causes bladder pain, bladder pressure or pain in the bladder.

Interstitial Cystitis

Interstitial cystitis signs can change depending on the individual who has the condition. The exact causes of interstitial cystitis are not known. Unlike when someone has a UTI, interstitial cystitis cannot be treated with antibiotics because it is not an infection. Symptoms can come and go in phases and may include:

  • Pain in your pelvis
  • A persistent, urgent need to urinate
  • Frequent urination, often of small amounts
  • Pain or discomfort while the bladder fills and relief after urinating.
  • Pain during sexual intercourse.