Specialties & Services

Pelvic Floor and Urogynecology

Incontinence, pelvic pain, and other pelvic floor problems don’t have to be a way of life. Our urogynecologists (doctors specializing in female pelvic medicine and reconstructive surgery), pelvic floor physical therapists, and other providers help you find relief. Despite common misconceptions, women who develop pelvic floor dysfunction do not have to learn to live with it, which "living with it" can commonly leave women feeling isolated or avoidant, depressed, or embarrassed. Pelvic floor can commonly be impacted by childbirth, heavy lifting, or chronic disease.

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Why choose us for pelvic floor and urogynecology?

BJC HealthCare works with WashU Medicine physicians, BJC Medical Group, and providers across the region to deliver extraordinary care. Our pelvic floor specialists understand the huge impact these conditions have on your quality of life. But you don’t need to feel embarrassed or uncomfortable about getting help. Our specialists are here to provide the treatments and compassionate support you need to feel better. We can address both common and complex pelvic floor problems.

When you turn to us for pelvic floor treatment, you’ll find:

  • Specialized expertise: WashU Medicine board-certified urogynecologists have additional fellowship training in female pelvic medicine and reconstructive surgery, are qualified to provide expert care for the most complex bladder, uterus, vagina, small bowel, and rectum disorders.
  • Nonsurgical therapies: Many pelvic floor disorders improve with nonsurgical treatments such as medication, physical therapy, and behavior modification. Experienced pelvic floor physical therapists and urogynecologists help you regain strength in your pelvic floor and teach you techniques for managing symptoms.
  • Minimally invasive treatments: Your clinical team will use the least invasive techniques possible if you do need surgery for a pelvic floor disorder. Our urogynecologists have extensive experience performing laparoscopic surgery, which uses smaller incisions, so you recover faster and with less pain.
  • Personalized approach: You will experience treatment tailored to your medical needs and personal preferences. Whether you’re concerned about bladder accidents or debilitating pelvic pain, pelvic specialists plan for your goals and lifestyle.
  • Collaborative care: The urogynecology team works with your other doctors, including your primary care physician, OB-GYN, colorectal surgeons, gastroenterologists, and other specialists, to coordinate your care. Addressing both common and complex pelvic floor problems.

What are pelvic floor disorders?

Pelvic Floor Disorders: Common in Women of All Ages

They’re not the kind of moments you discuss at the dinner table. But they happen every day to millions of women nationwide.

  • Urine leaks when you cough, laugh, or exercise
  • Trouble having regular bowel movements
  • Feelings of fullness, discomfort, or pain in your vagina

These can be the signs of a pelvic floor disorder.

Time takes toll on important muscles

Your pelvic muscles form a sling that holds up your bladder, uterus, and other pelvic organs. Childbirth, pregnancy, obesity, or simply the passage of time can weaken these muscles.

The result often is incontinence, or being unable to control when you go to the bathroom. Also, one or more of your pelvic organs may drop into or out of the vagina. This is called pelvic organ prolapse.

It’s estimated that 20% of U.S. women have a pelvic floor disorder. The condition is more common with age.

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Other signs of a pelvic floor disorder include:

  • A feeling of heaviness, fullness, or pulling in the pelvis
  • A sensation that something is falling out of your vagina
  • Urgent or frequent need to urinate
  • Difficulty having a bowel movement or emptying your bladder

Talking with your healthcare provider about these problems can help you get treatment. Lifestyle changes, such as avoiding caffeine or losing weight, may help improve symptoms. Medicine may also help.

Other therapies include pelvic strengthening exercises known as Kegels. For women with more severe symptoms, a device called a pessary can be placed into the vagina to help support the pelvic organs. If these treatments don’t help, surgery is an option.

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Our highly trained team of specialists offer advanced treatments as well as compassionate, personalized care.

Pelvic floor disorders testing and treatments

You don’t have to live with incontinence, prolapse, or pelvic pain. A variety of treatment options are offered for these conditions and provide relief from your symptoms. When necessary, a range of minimally invasive procedures are available to treat stress incontinence, uterine prolapse, and bowel incontinence.

Non-surgical treatments like medications or lifestyle changes are typically explored prior to considering surgery. Other non-surgical pelvic floor disorder treatments include:

Pelvic floor physical therapy

Pelvic floor exercises, such as Kegel exercises, help strengthen your pelvic floor muscles, so you have more control over them.

Biofeedback

We use a special device with sensors to measure contractions and relaxations of pelvic floor muscles as you do exercises.

Surgical treatment

  • Vaginal pessary: A pessary is a device that fits inside your vagina to support your pelvic organs. It can help with pelvic organ prolapse and urinary incontinence.
  • Laparoscopic surgery: A surgical technique in which a thin, camera-equipped surgical device is inserted into the abdomen or pelvis through one ore more small incisions.
  • Transvaginal surgery: Surgery performed through the vagina.

Medications

Botox, estrogen, or anti-inflammatories

Testing

  • Cystoscopy and urodynamic testing for urinary or bladder issues.
  • Defecogram or anal-rectal manometry for fecal and rectal disorders.

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