Female Urology

Female Urology Overview:

The subspecialty of female urology concerned with the diagnosis and treatment of urinary tract disorders most prevalent in females (urinary incontinence, overactive bladder, pelvic organ prolapse, reccurent urinary tract infection, and pelvic pain). Expert evaluation of these conditions includes a complete history and physical exam, as well as additional bladder studies such as Urodynamics (i.e. bladder function test), imaging studies (i.e. CT Scan and/or MRI), and cystoscopy.  The Department of Urology at Stony Brook offers comprehensive evaluation and treatment for all female urologic disorders.

Female Urinary TractFor more information regarding female urology, please visit Stony Brook's Women Health Services Webpage
Make sure to like our Womens' Pelvic Health & Continence Center Facebook page by clicking here Facebook

Voiding Dysfunction: 

Voiding dysfunction is an umbrella term for urinary problems and can effect individuals in different ways.  The main symptoms are urinary frequency, urgency, painful urination and/or incomplete bladder emptying. Treatment is aimed at decreasing or eliminating symptoms, and may involve medication or pelvic floor relaxation exercises. Please explore the conditions listed below to learn more.

Common Female Urology Conditions:

 

Urinary Incontinence

Overview
Urinary incontinence is the medical term for accidental bladder leakage. This condition is more common in older women, and is not a normal part of aging.

Symptoms

Stress Incontinence:

  • Leak urine when you laugh, cough, or sneeze
  • Common in women who have had a baby

Urgency Incontinence:

  • Feeling a strong need to urinate suddenly
  • Urge to urinate is so strong that you cannot make it to the bathroom in time

Mixed Incontinence: Having symptoms of both stress and urgency incontinence.

When to see a doctor

If you are experiencing the above symptoms see a doctor to learn more about the treatment options available

Treatments we offer

  • Lifestyle modifications (weight loss, diet, constipation, smoking)
  • Pelvic floor muscle (Kegel) exercises
  • Bladder retraining (following strict scheduled bathroom times)
  • Medicines to relax the bladder
  • Bladder botox injections 
  • InterStim ("Bladder pacemaker")
  • Percutaneous tibial nerve stimulation
  • Surgery (mesh or non-mesh slings)

Helpful Resources on Urinary Incontinence:

Overactive Bladder

Overview
Overactive bladder is the sudden, urgent need to urinate. These sudden urinations may occur at any time of the day.

Symptoms

  • Urinating more than 8 times per day
  • The need to urinate at night
  • Sudden urges to urinate
  • May also be experiencing urinary incontinence (leakage)

When to see a doctor

If you are experiencing the above symptoms see a doctor to learn more about the treatment options available.

Treatments options

  • Lifestyle changes
    • Limit fluid intake to 4-6 glasses (8-ounce) of fluid per day
    • No fluids after dinner
  • Avoid the following:
    • Tobacco
    • Coffee and Tea
    • Carbonated beverages
    • Alcohol
    • Spicy foods
    • Chocolate
    • Acidic fruits (oranges, cranberry, pineapple, etc.)
  • Losing weight to reduce pressure on the bladder
  • Retraining your bladder (following strict scheduled bathroom times)
  • InterStim ("Bladder pacemaker")
  • Percutaneous tibial nerve stimulation
  • Bladder botox injections
  • Surgery

Recurrent Urinary Tract Infection (UTI)

Overview
Urinary tract infections (UTI) occur when bacteria gets into the urethra (the tube that carries urine from the bladder to the outside). These bacteria infections can occur in either the bladder or kidney. A UTI is considered recurrent when the patient experiences an infection more than 2 times in a 6 month period, or more than 3 times in one year.

Symptoms

Bladder Infection SymptomsKidney Infection Symptoms
  • Pain or burning when urinating
  • Frequent / Urgent need to urinate
  • Blood in the urine
  • Fever (Temperature over 99.9°F)
  • Pain in one or both sides of the back
  • Nausea or vomiting

When to see a doctor
Visit your doctor if you are experiencing any of the symptoms above to determine a treatment method.

Treatments we offer
Bladder Infection TreatmentsKidney Infection Treatments
  • 1-5 day course of antibiotics
  • In healthy women, if symptoms are resolved no follow up will be needed
  • In pregnant women, a urine culture will be repeated 1-2 weeks after treatment is ended
  • If symptoms are mild:
    • 1-2 week course of antibiotics
    • Non Prescription medication (Tylenol) or ibuprofen (Motrin, Advil)
  • If symptoms are severe:
    • Hospitalization
    • Given IV antibiotics and fluids

Interstitial Cystitis / Pelvic Pain

Overview
Interstitial cystitis, also called “bladder pain syndrome,” is a condition that causes people to have bladder pain and need to urinate often. This condition is more common in women, and doctors suspect that it is caused from abnormal changes in the lining of the bladder.

Symptoms

  • Bladder pain that gets better after urinating
  • Feeling like you need to urinate (even if you do not actually urinate)
  • Feeling like you need to urinate (even if you do not actually urinate)

Symptoms of interstitial cystitis are different from person to person. Some people might not have symptoms on a daily basis. Some symptoms get worse based on diet, monthly cycles, sitting for a long period of time, or stress.

When to see a doctor

If you have the symptoms listed above, visit your doctor to get an exam and complete a urine test. Other test, such as a cystoscopy, may be performed to see if the bladder is abnormal.

Treatments we offer

  • Bladder training - holding in urine for longer periods of time
  • Physical therapy - to prescribe exercises to relax belly, groin, and buttocks
  • Medicine - pill or liquid forms to heal the bladder lining or to reduce pain
  • Surgery - a small device is placed in the lower back to connect a nerve that goes to the bladder

Helpful Resources on Interstitial Cystitis:

Pelvic Organ Prolapse (POP)

Overview
Pelvic Organ Prolapse (POP) is a a hernia of the pevlic organs (bladder, uterus, rectum). This type of hernia occurs if the muscles surrounding the organs are weakened. It is most common in women after giving birth, or those going through menopause. There are two types of pelvic organ prolapse:

  1. Asymptomatic POP - the hernia has occurred, but no tissues protrude beyond the vaginal opening
  2. Symptomatic POP - the hernia has occurred, and tissues are protruding beyond the vaginal opening

Symptoms

  • Vaginal pressure - while standing, coughing, exercise
  • Feeling heavy in the pelvic area
  • Feeling a bulge in the vaginal opening

When to see a doctor

If you are experiencing the above symptoms see a doctor to learn more about the treatment options available.

Treatments options

  • Pelvic floor muscle strengthening (Kegel exercises)
  • Physical therapy - for a customized strengthening plan
  • Losing weight
  • Vaginal estrogen
  • Vaginal pessary (small, removable device that keeps prolapse inside)

Surgical Options

  • Cystocele Repair - repairs the bladder or urethra
  • Hysterectomy - complete removal of the uterus
  • Rectocele Repair - repairs the rectum
  • Vaginal vault suspension - laparoscopic surgery to repair the vaginal walls
  • Vaginal obliteration - closing of the vagina

Physicians

Jason KimSteven Weissbart
Jason M. Kim, MD
Assistant Professor
Female Urology
Voding Dysfunction
Pelvic Floor Reconstruction
Steven Weissbart, MD
Assistant Professor
Female Urology
Voding Dysfunction
Pelvic Floor Reconstruction
 
Clincial Staff
erin henkesjennie jacobYvonne Kwok
Erin Henkes, NPJennie Jacob, MS, PA-CYvonne Kwok-Lin, NP