The involuntary loss of urine. Urinary incontinence may occur with laugh, cough, sneeze, sex and standing up, for example. This type of urinary incontinence is called stress urinary incontinence. When the loss of urine is associated with a sudden urge, this is called urge urinary incontinence. Urge urinary incontinence is often associated with overactive bladder symptoms. Some women may experience both types of urinary incontinence.


Overactive Bladder is a condition in which the muscles of the bladder contract unexpectedly causing a sudden urinary urge, frequent urges to urinate and may even experience urinary incontinence related to the urge.


The involuntary loss of flatus and or stool. Fecal incontinence may occur with activity such as exercise but is mostly related to urge. This can be related to vaginal deliveries with third or fourth degree lacerations. It can also be related to Inflammatory Bowel Disease, anorectal lesions and Irritable Bowel Syndrome.


Prolapse is a term used to describe when the anterior, posterior or apical aspects of the vagina have fallen. Risk factors for vaginal prolapse include vaginal deliveries, chronic straining with heavy lifting, chronic constipation, changes in the tissues with aging, and genetics/family history. Prolapse of the vaginal tissues is especially important to evaluate if you have difficulty emptying your bladder or bowel. Some women may experience recurrent urinary tract infections.


Difficulty emptying the bladder well or at all. Urination requires many actions to fall into place at the same time to allow urine to pass. The muscles surrounding the bladder must contract, the urethra must open and relax, and there should be a resulting free flow of urine. Urinary retention can occur if the bladder does not contract well enough, or at all, such as in neurogenic bladder or a bladder under the influence of certain medications. Urinary retention can also occur if the urethra does not relax during urination, or if the urethra is kinked off because of a prolapse, vaginal pessary or tampon.


After delivering your babies, or as you age into your 30s and 40s despite whether or not you have delivered children, you may notice a change in your vaginal tissues. I cannot tell you how many women come to my office, usually under the guise of another problem, and ultimately share with me the difficulties they are having with intercourse. Sexual health is not discussed much in the media, but we have been hearing more about it now than ever before because now we have treatment options.