The subspecialty of female urology is concerned with the diagnosis and treatment of those urinary tract disorders most prevalent in females. These include urinary incontinence and pelvic floor prolapse, voiding dysfunction, recurrent urinary tract infection, urethral syndrome and interstitial cystitis. Expert evaluation of these conditions includes a complete history and physical exam. Urodynamics (bladder function test) and imaging studies may be required to fully evaluate the urinary tracts. Additional bladder studies such as cystoscopy may be necessary.
Incontinence is an involuntary loss of urine. It is further defined by type as either stress (leakage with straining, coughing, sneezing), urge, mixed, overflow, functional or reflex incontinence. Treatment is dependent on the type of incontinence. Current therapies include dietary changes, scheduled voiding, bladder retraining, pelvic muscle exercises, biofeedback, electrical stimulation therapy, medication, collagen implants and minimally invasive surgery.
Voiding dysfunction can take many forms. The main symptoms are urinary frequency, urgency, painful urination and/or incomplete bladder emptying. Treatment is aimed at decreasing or eliminating symptoms. Treatment may involve medications or pelvic floor relaxation exercises.
A recurrent urinary tract infection (UTI) may be generally defined as three or more infections within one year. This may be idiopathic (no obvious cause or related to a urologic disorder such as stones, tumor, reflux (urine flows backwards toward the kidney) or ineffective bladder emptying. Treatment is aimed at identifying the cause and/or proper antibiotic therapy to break the cycle of recurrent infection.
Urethral syndrome is a condition involving pain at the urethra that can occur during urination or without regard to urination. Treatment may consist of oral medication or local estrogen replacement therapy. Urethral syndrome may exist as a component of interstitial cystitis.
Interstitial cystitis (IC) is a urologic syndrome characterized by excessive urinary urgency, frequency, nocturia (nighttime urination) and pain in the lower abdomen and/or perineum. It can occur at any age, however, the median age at diagnosis is between 42 and 46 years. The cause of IC is unclear. It is believed to be related to irregularities in the bladder lining and/or an allergic/immune response. IC can severely affect an individual's quality of life. Promising developments in the treatment of IC include medications, such as Elmiron, which works to restore the normal function of the bladder lining. Other drugs with calming effects on the bladder may also be helpful. Bladder instillations with dimethyl sulfoxide (DMSO) have achieved variable success. Hydrodistention of the bladder under anesthesia is a common therapeutic and diagnostic procedure. In the most severe cases, surgery including denervation, urinary diversion and augmentation cytoplasty may be performed. All of these evaluation and treatment options are available at South Delhi Urology Clinic.