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All Geisinger locations are open and providing patient care. Please arrive as scheduled for your appointment unless you hear from a member of your care team. We appreciate your patience if you experience any delays during your visit.

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Pelvic floor care (urogynecology)

Urogynecologists (or pelvic floor specialists) are ready to provide comprehensive evaluation and treatment of pelvic floor concerns to help you get back to the things you love.

What are pelvic floor disorders?

The pelvic floor is the group of muscles and ligaments, shaped like a sling, that supports the pelvic organs. In women, the pelvic floor supports the bladder, uterus, vagina and rectum. Pelvic floor issues are common, so don’t be afraid to discuss symptoms with your doctor.

Pelvic floor issues can occur when that group of muscles becomes weakened or damaged. These disorders can include:

  • Pelvic organ prolapse – The uterus, bladder or bowel fall or press against the vagina.
  • Incontinence – This includes urinary (lack of bladder control) incontinence.  
  • Overactive bladder – This involves the sudden need to urinate, sometimes paired with loss of bladder control.
  • Bladder pain syndrome (interstitial cystitis or IC) – This syndrome is marked by pain or pressure in the bladder and pelvic region.

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Symptoms of pelvic floor issues

While both men and women have pelvic floors, women are more likely to have pelvic floor disorders. Common symptoms can include:

  • Urinary issues – Including urinary incontinence, a strong urge to urinate or painful urination.
  • Pressure – Especially in the pelvic region or rectum. Some, especially women with pelvic organ prolapse, may have a heavy feeling in the pelvis or a bulge in the vagina or rectum.
  • Pain – Including pain in the lower back, pelvic region, genitals or rectum. Women may also have pain or discomfort during sexual intercourse. 
  • Constipation – Dry, hard bowel movements or going fewer than three times per week.
  • Muscle spasms – Typically in the pelvis.

Causes of pelvic floor issues

Pelvic floor issues occur when the pelvic floor muscles are weakened. Common causes may include:

  • Childbirth
  • Obesity
  • Heavy lifting or straining
  • Aging
  • Genetics
  • Previous pelvic surgery or radiation treatments

Diagnosing pelvic floor disorders

Our pelvic floor specialists diagnose and treat pelvic floor disorders. Your specialist might:

  • Review your medical history and discuss your symptoms
  • Perform a physical exam, including a pelvic exam
  • Perform a test to evaluate bladder or bowel function
  • Order imaging studies

Pelvic floor disorder treatments

At Geisinger, we’ve brought a variety of specialists together to care for women who have pelvic floor disorders — all in one location. This team includes:

  • Urogynecologists – Obstetrician-gynecologists (or OBGYNs) who have specialized training in treating pelvic floor disorders in women
  • Colorectal surgeons – Surgeons who specialize in the surgical and nonsurgical treatment of conditions affecting the lower digestive tract (small intestines, colon, rectum and anus)
  • Gastroenterologists – Doctors who specialize in treating all the organs involved in digestion, absorption and elimination of waste
  • Women’s behavioral health specialists – Professionals who specialize in treating mental health concerns related to conditions that affect the female reproductive system
  • Physical therapists – Who can help you learn pelvic floor exercises to improve your symptoms
  • Pain management – Doctors who specialize in helping people manage chronic pain

If you have a pelvic floor disorder, your specialist will create a treatment plan that’s right for you. Depending on your situation, one or more of the following treatments may be recommended:

Physical therapy and biofeedback

Kegel exercises, or similar exercises that involve contracting your muscles, may not be enough to treat your condition. Your specialist may also suggest biofeedback therapy. Biofeedback allows your therapist to use sensors to evaluate how you relax and contract your pelvic muscles. After evaluating your muscle activity, your therapist can help you learn how to relax and coordinate the movement of your pelvic floor muscles.
Lifestyle changes

Your specialist may suggest a variety of relaxation techniques, such as yoga, stretching and warm baths, to help relax your pelvic floor muscles. They might also suggest techniques to avoid pushing too hard or straining when you use the bathroom, as well as diet and fluid intake changes.
Medication

Your specialist may prescribe medications to help with urinary urgency or overactive bladder.

If medication doesn't improve your overactive bladder symptoms, other treatment options are available. These include bladder muscle Botox injections, which can be performed in your doctor's office, and another in-office procedure called sacral neuromodulation, which can offer long-term relief from symptoms.

Vaginal pessary

A vaginal pessary is a soft, removable silicone device that’s placed in your vagina to comfortably support areas affected by pelvic organ prolapse. A pessary can also help ease symptoms of urinary incontinence, even during pregnancy.
Percutaneous tibial nerve stimulation

PTNS is a non-surgical treatment, much like acupuncture. During this treatment, a thin needle is placed near a nerve in your ankle called the tibial nerve. Connected to the thin needle is a small device that sends mild electrical pulses through your tibial nerve. These pulses can help ease symptoms of overactive bladder and urinary incontinence.
Surgery

If your symptoms don’t improve with non-surgical treatments, our experienced pelvic floor specialists can help you find relief through surgery. Most surgeries are performed using minimally invasive techniques, meaning less time in the hospital and a quicker recovery time.

The following surgeries may be recommended:

  • Sling procedure – This minimally-invasive procedure is used to successfully treat urinary incontinence associated with activity and exercise.
  • Pelvic floor repair – Using minimally-invasive techniques, such as robotic surgery, your doctor can restore your pelvic floor support and function after a pelvic organ prolapse.

Pelvic floor care at Geisinger

Our pelvic floor specialists offer:

  • The knowledge you need – Our pelvic floor team consists of several specialists — all here to diagnose, treat and help manage your condition. Their focus is on delivering sensitive care, tailored to your specific needs.
  • Care where you live – With locations in central and northeastern Pennsylvania, our team provides consultations and comprehensive pelvic floor care for women, close to home.
  • Comprehensive specialty care – Our pelvic floor specialists work together to provide you with the comprehensive care you need.
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