This article was written by Dr. Caroline Elmer-Lyon, Urogynecologist with St. Elizabeth Physicians. She sees patients in Edgewood, KY, Ft. Thomas, KY and Greendale, IN.
Q: What does a urogynecologist do? When should people seek help from a specialty-trained physician?
A urogynecologist is a doctor of female pelvic medicine and reconstructive surgery (FPMRS). These specialists receive fellowship training in non-surgical and surgical treatment of conditions affecting the female pelvic organs and the muscles supporting those organs. As a urogynecologist, we treat health conditions related to the female bladder, uterus, vagina, rectum and pelvic floor. A primary care provider can treat some female pelvic floor or bladder conditions, but if a patient has a condition that doesn’t respond to initial treatment, such as urinary incontinence, stool incontinence, a pelvic bulge, bladder pain that doesn’t respond to treatment for a urinary tract infection, or painful sex, they should seek care from a urogynecologist.
From your perspective as a urogynecologist, what’s the one thing women should be aware of to help prevent pelvic floor conditions or identify problems early?
Our bodies can only be as healthy as we make them. Eat a healthy diet — everything in moderation! Don’t smoke or vape. Stay active and don’t put too much pressure on yourself to reach perfection. If you do these things, you can avoid a lot of pain and problems down the road.
That said, aging is inevitable and can come with some changes to our bodies that do need medical treatment. However, pelvic floor conditions don’t just affect older women. They can affect women during pregnancy, after childbirth, after cancer treatment and those experiencing obesity. And if you are older, don’t just ignore bothersome symptoms thinking they are “part of getting older.” Accidental bladder or bowel leakage and weakened vaginal support can significantly affect body image and quality of life. See a doctor regularly for check-ups and follow up with your doctor early when symptoms first start. That way, we can work together to find ways to treat your symptoms with conservative medical options or safe and effective surgical intervention.
What’s something surprising about your specialty that people might not know?
Everything! Most people are not aware of the complexity of the female pelvis. Everyone thinks of the uterus as being the cause of all pelvic floor problems. But in many cases, it is an innocent bystander to other complex conditions in the pelvis.
The pelvic muscles, nerves and connective tissues are often the source of many pelvic floor conditions, such as overactive bladder, voiding dysfunction, pelvic pain, pelvic organ prolapse, and urinary or fecal incontinence. Our job as a urogynecologist is to figure out what’s going on so we can formulate a unique treatment plan for each patient.
For example, in the office, we can use cystoscopy — a small camera inserted into the bladder — to identify any abnormalities. This procedure guides Botox injections that can calm overactive bladder and urge incontinence. With the bladder, we can also use sacral neuromodulation, a procedure that reestablishes communication between the bladder and the brain to relieve overactive bladder, urge incontinence, and bowel incontinence as well as to help women fully empty their bladder.
To address other issues, we use minimally invasive vaginal surgery to treat prolapse or stress incontinence. Pelvic physical therapy can also help alleviate pelvic pain, both urinary or stool incontinence, prolapse or the effects of vaginal scar tissue.
What is St. Elizabeth doing in the field of female pelvic medicine and reconstructive surgery that is unique or leading edge?
St. Elizabeth Healthcare currently has two fellowship-trained, board-certified FPMRS surgeons who provide a wide range of treatment options — both non-surgical and surgical — for pelvic floor and bladder conditions. We are fully equipped to provide the advanced treatments mentioned above for pelvic floor and bladder conditions, both in the office and operating room. We also have multiple specially trained pelvic floor physical therapists who are essential in treating these conditions.
What is currently on the horizon for your specialty? What advances might we expect in the next few years?
We are always hoping to find better ways to “fix” pelvic floor support issues with newer, more innovative approaches. This is a challenging endeavor, but new technologies and treatments, such as non-mesh-based biologic implants that improve prolapse repair outcomes, are constantly being tested.
To learn more or to schedule an appointment with a urogynecologist at St. Elizabeth Physicians, visit St. Elizabeth Physicians Urogynecology or call (859) 757-2132.