​

Urogynecologic Problems and Pelvic Floor Disorders

Urogynecology focuses on conditions that affect the pelvic floor and lower urinary and bowel function in women. The pelvic floor comprises muscles, ligaments, and connective tissue that support the bladder, uterus, and rectum. Changes in this support system, often related to childbirth, aging, or connective tissue changes, may lead to a variety of symptoms that impact daily function and quality of life.

​

The conditions below represent common urogynecologic problems. Each condition is described in general terms to support patient understanding and informed discussion with a healthcare provider.

​

Stress Urinary Incontinence

Stress urinary incontinence is the involuntary leakage of urine that occurs with physical activities such as coughing, sneezing, laughing, or exercise. It is typically related to weakness of the pelvic floor muscles and urethral support structures, which can occur following childbirth or with aging.

​

Overactive Bladder

Overactive bladder refers to a symptom complex characterized by urinary urgency, frequency, and, in some cases, urge incontinence (leakage associated with a sudden need to void). This condition may occur with or without detrusor overactivity and is diagnosed based on symptoms and clinical evaluation.

​

Mixed Urinary Incontinence

Mixed urinary incontinence refers to the presence of both stress incontinence and urgency symptoms. Management generally involves addressing both components through behavioral therapies, pelvic floor muscle training, and other interventions individualized for each patient.

​

Stool Leakage (Fecal Incontinence)

Stool leakage, or fecal incontinence, is the involuntary passage of stool. This may result from weakness or damage to the anal sphincter muscles, nerve dysfunction, or impaired rectal sensation. Conservative and surgical options may be considered based on the severity and underlying factors.

​

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when pelvic organs, such as the bladder, uterus, or rectum, descend into or outside of the vagina due to weakening of the supporting tissues. Symptoms may include a sensation of pressure or bulging, urinary or bowel symptoms, and discomfort during physical activity.

​

Vaginal Dryness

Vaginal dryness refers to inadequate lubrication and moisture of the vaginal tissues, which may contribute to discomfort, irritation, and dyspareunia (pain with intercourse). It can be associated with hormonal changes, including those related to menopause, breastfeeding, or certain medical treatments.

​

Bladder Pain Syndrome / Interstitial Cystitis

Bladder pain syndrome, also known as interstitial cystitis, is a chronic condition characterized by pelvic or bladder pain, urinary urgency, frequency, and discomfort that is not attributable to an identifiable infection. Evaluation and management focus on symptom relief and improving quality of life.

​

General Principles of Evaluation and Management

Evaluation of urogynecologic disorders typically includes a detailed history, physical examination, and selective use of diagnostic testing as indicated. Conservative management approaches — such as pelvic floor muscle training, bladder training, and lifestyle modification — often form the first step in treatment. Additional options may include pharmacotherapy, pessary devices for prolapse support, and referral for specialized urogynecologic care when appropriate.

​