Urogynecology

• Stress urinary incontinence: involuntary loss of urine under stress, on coughing, sneezing, laughing and lifting weights.
• Urge urinary incontinence: involuntary loss of urine associated with a very strong urge to urinate.
• Urinary difficulties: feeling of not emptying the bladder completely, with the need to have to push.
• Genital prolapse: feeling of vaginal weight due to the presence of a prolapse of the uterus or vaginal walls.
• Sexual disorders: pain during intercourse.
• Postpartum pelvic dysfunction: problems related to the pelvic floor arising after childbirth (urinary incontinence, fecal incontinence, and sexual dysfunction).

Diagnosis

The diagnostic methods offered include:

• specialized examinations such as urodynamics and/or video urodynamics allow the study of bladder function;
• perineal ultrasonography-also using 3D/4D methods-and magnetic resonance imaging: they allow in-depth study of the pelvic floor;
• other second-level examinations such as cystoscopy.

Treatments

Once the diagnosis is established, it will be possible to intervene through multiple, more conservative therapeutic treatments such as:

• behavioral therapy (diet, bladder training);
• pelvic floor rehabilitation (gymnastics), with possible use of special instrumentation such as biofeedback (BFB) or Functional electrical stimulation (SEF);
• pharmacological treatment;
• posterior tibial nerve stimulation (PTNS) for urge incontinence;
• laser treatments for vaginal atrophy.
  

Or more invasive treatments such as:

• surgeries for prolapse (vaginal, laparoscopic);
• surgeries for stress incontinence (TVT, TVT-O, bulking agents);
• surgeries for urge incontinence (Botox, sacral neuromodulation).
  

Most diagnostic investigations and therapeutic treatments are usually performed on an outpatient basis.

Pelvic floor rehabilitation is recommended for recovery after pregnancy, childbirth or cesarean section. It is also useful for urinary incontinence, fecal incontinence, prolapses,
pelvic pain, constipation, sexual functional impairment.

Counseling can be sought in any age group, from puberty to menopause, especially in stages of female body change. Therapists are professionals who specialize in pelvic floor reeducation.

Through gymnastics and rehabilitation of the pelvic musculature, women will be taught to take care of their bodies and decrease discomfort.