Baylor Scott & White Texas Urogynecology Associates

Bowel incontinence

Bowel incontinence is the loss of bowel control, leading to an involuntary passage of stool. This can range from occasionally leaking a small amount of stool and passing gas to completely losing control of bowel movements.

Constipation

Constipation is most often defined as having a bowel movement less than three times per week. It usually is associated with hard stools or difficulty passing stools. You may have pain while passing stools.

Cystocele

A prolapse or bulging of the bladder into the vagina is called a cystocele.

Enterocele

Prolapse or bulging of the small intestine into the space between the rectum and vagina is known as an enterocele.

Interstitial cystitis

Interstitial cystitis is a long-term (chronic) inflammation of the bladder wall.

Overactive bladder

Urge incontinence (commonly known as an overactive bladder) is the strong, sudden need to urinate due to bladder spasms or contractions.

Rectovaginal fistula

Abnormal connections from a tract between the rectum and vagina is called a rectovaginal fistula. It causes the passage of gas or fecal material in an uncontrolled manner from the vagina.

Urinary incontinence

Urinary incontinence (also known as bladder incontinence) happens when you are not able to keep urine from leaking from your urethra, the tube that carries urine out of your body from your bladder.

Uterine prolapse

Uterine prolapse describes falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal.

Vaginal vault prolapse

This is a condition that occurs in women who have previously undergone hysterectomy in which the ligaments that normally hold the upper vagina in place have torn or weakened and allow the upper vagina to fold down into itself, or to protrude through the vaginal opening.

Vesicovaginal fistula

Abnormal connections between the bladder and the vagina, resulting in uncontrolled loss of urine from the vagina is called a vesicovaginal fistula. 

Vestibulitis

If vulvodynia localized to the vulvar region, it tends to be associated with a highly localized “burning” or “cutting” type of pain referred to as vestibulitis.

Sexual dysfunction overview

After many years of experience delivering quality care to women, our providers have discovered that sexual dysfunction is highly prevalent among our female patients. We realize that this is often an uncomfortable topic for many women. With this in mind, we make it our goal to assist women in achieving renewed sexual health and happiness by offering treatment and consultation in a comfortable and confidential environment.

Sexual difficulties may begin early in a person's life, or they may develop after an individual has previously experienced enjoyable and satisfying sex. A problem may develop gradually over time or may occur suddenly as a total or partial inability to participate in one or more stages of the sexual act. The causes of sexual difficulties can be physical, psychological or both.

Diminished arousal function

This is described as poor lubrication, possibly resulting from insufficient excitement and stimulation, hormonal changes or medications.

Diminished sexual desire

Decreased libido may be caused by a decrease in the normal production of estrogen or testosterone. Diminished sexual desire may also be a result of aging, fatigue, pregnancy or medications.

Orgasm dysfunction

A persistent delay or absence of orgasm following a normal excitement phase.

Bladder instillations

Bladder instillation is a therapy offered to manage symptoms of Interstitial Cystitis (IC). Some find it helpful to get medicine inserted directly into their bladders. A series of these instillations is usually done in the office. Treatments can be one to two times a week for six to eight weeks.

Botulinum toxin (Botox)

Botox relaxes the bladder muscle. This allows more urine to be held in the bladder before you have to go to the bathroom. Botox injections are usually performed at the clinic. You do not need general anesthesia or a hospital stay. You can usually drive yourself and can return to work immediately after the procedure. Most people do not find these injections painful. Your provider uses a small camera and needle to inject Botox into the bladder wall. Ask your provider if Botox is right for you.

Cystoscopy

Cystoscopy is a procedure that lets your doctor look inside of your urethra and bladder using a special camera, called a cystoscope. Cystoscopy is a short procedure that can be done in the office with little pain. You will often be able to watch the images on the screen while it is being done. It takes about 10 to 20 minutes to set up and five minutes to complete the procedure.

MonaLisa Touch

MonaLisa Touch utilizes fractional CO2 laser for the treatment of certain gynecologic conditions such as vaginal atrophy (thinning of the vagina that occurs in the absence of estrogen and causes symptoms of vaginal burning, irritation, and dryness) and lichen sclerosis. The laser treatment helps restore gynecologic health by generating new collagen, elastin and vascularization. Generally three treatments are provided, six weeks apart.

Pelvic floor therapy (PFT)

PFT is a technique that allows us to assess your pelvic floor muscle function. The muscles may be weak or tight. The goal is to have the best muscle function possible. Most women find that pelvic floor muscle exercises (Kegels) help improve symptoms. For the best effect, work with a trained provider to learn the techniques. It may take three to six months of regular pelvic floor muscle exercise to see results.

Peripheral nerve evaluation (PNE)

The basic evaluation (also referred to as peripheral nerve evaluation or PNE) is typically used to evaluate patients with bladder control problems. It is initiated through a simple, in-office procedure, during which the lead is placed in the upper buttock.

Tibial nerve stimulation therapy

There are many nerves involved in bladder function. Nerve stimulators help control these nerves, reducing the need to urinate often. Tibial nerve stimulation is similar to acupuncture. A small needle is inserted near a nerve in the ankle and connected to an external device that delivers small pulses to the nerve. Each treatment lasts approximately 30 minutes, and you would typically receive 12 treatments one week apart. After the first 12 weeks, your provider will evaluate your response to treatment and determine if additional treatments are necessary.

Urethral bulking agents

In this procedure, a substance is injected near the urethra to ’’bulk up" the walls. This works well when a sphincter muscle that circles the urethra weakens. There are different types of bulking agents. This outpatient procedure is usually done in the office. It is low risk and allows you to continue to be active immediately, but wears off after several months. The injections will need to be repeated.

Urodynamics study

Urodynamics is a series of tests that evaluate how well your bladder, urinary sphincter and urethra work. These tests focus on how well the bladder fills and empties. Urodynamics tests examine what the bladder and urethra are doing if urine leakage occurs. For example, the tests can show if involuntary bladder contractions (spasms) are causing urinary incontinence. The results of this study assist your Urogynecologist in determining which treatment options will be most effective for you.

Vaginal pessary

A pessary is a silicone device inserted into the vagina. It is similar to a diaphragm. Pessaries push the urethra closed to help control urine leakage. They still allow you to urinate normally when you need to. Some women wear a pessary only when they exercise. Others leave it in all the time.