Cystocele :
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also known as dropped bladder. A cystocele occurs when the support between the bladder and vagina has torn or relaxed and allows the bladder to sag into the vagina or even past the vaginal opening.
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Cystoscopy:
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an examination of the inside lining of the bladder. This is accomplished by placing a thin telescope through the urethral opening. The test may be completed in the physician office or in an operating room as an outpatient procedure.
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Electromyogram (EMG):
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a test performed to study nerve & muscle function. This may involve placement of a sticky patch, similar to that used for an EKG, or a fine wire placed (the size of a strand of hair) placed under the skin.
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Enterocele:
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a small bowel herniation. A weakness in the support structure in the upper portion of the vagina allows the small bowel to bulge into the vagina or even past the vaginal opening.
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Hematuria:
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blood in the urine. This may be microscopic or gross (visible with the human eye). Hematuria requires evaluation in most cases.
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Introitus:
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another term for the vaginal opening.
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Menorrhagia:
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excessive vaginal bleeding. This may refer to excessive in terms of number of days, or in amount of blood loss.
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Mid-urethral sling:
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a minimally invasive procedure in which a thin tape is placed as a hammock under the urethra to provide support as a treatment for stress urinary incontinence. Many variations of this surgery exist. In the traditional “retropubic” approach, 2 small (1 inch) incisions are made on the abdominal wall just at the level of the pubic bone. In the obturator approach, 2 small incisions are made at the inside of the upper thigh. In the newest modification, only a small vaginal incision is made. Mid-urethral slings are commonly referred to as a “tvt” procedure. TVT refers to a particular brand of sling. This is akin to using the word “Xerox” to refer to all copy machines.
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Minimally Invasive Surgery (MIS):
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Surgery that is performed without the use of a large abdominal incision. This may include 1 inch or smaller or smaller abdominal incisions, “natural orifice” incisions, such as vaginal surgery, or a combination, such as are used in the midurethral sling. Minimally invasive surgery allows for markedly less post-operative pain, faster recovery, lower risk of infection, better cosmesis (less scarring) and in many cases better results that a large abdominal incision.
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Natural Orifice Surgery (NO SURG):
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Surgeons around the world are now promoting Natural Orifice Surgery. This is surgery performed through one of the natural openings of the body- to allow for less pain, faster recovery, better cosmesis (less scarring) and lower risk of infection. We are proud to state that the physicians of IULTD have been promoting the vaginal approach, a natural orifice approach, for many years.
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Neuromodulation:
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Generally means electrical stimulation of a peripheral nerve, the spinal cord, or the brain for relief of pain. Since urinary urgency or urinary frequency are essentially pain signals, the use of electrical stimulation can alleviate these problems. Current forms of neuromodulation utilized in Urogynecology include functional electrical stimulation (via a probe in the vagina or rectum), Urgent-PC (applied to the tibial nerve – at the ankle), or Interstim (a device like a heart pacemaker is implanted to stimulate the sacral nerve root).
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Neuromodulation 2:
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Neuromodulation is a general term that refers to various treatments which interact with the nervous system to increase or decrease activity to improve function or relieve pain. At the present time, the most common devices are pumps that deliver medication and electrical stimulators that may be applied to the skin surface, inserted through the skin with a small needle or implanted.
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Overactive bladder:
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a condition of irritative bladder symptoms. This includes any combination of urinary frequency, urgency, urge incontinence, and nocturia (night time voiding), and may include bladder pain.
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Pelvic Floor Disorders:
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The pelvic “floor” refers to the supporting structures of the pelvis, mainly the musculature, nerve supply, and also the organs which pass through the pelvic floor: the bladder, vagina, and rectum.
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Pelvic Organ Prolapse:
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prolapse is a general term for a type of hernia in which a pelvic organ (uterus, vagina, bladder, small bowel, or rectum) has lost its structural support and falls or protrudes into the vagina or through the vaginal opening. Often, more than one organ is involved in prolapse.
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Pessary :
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a device worn in the vagina in order to support prolapsed organs and provide symptom relief.
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Pelvic Floor Physical Therapy:
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see Women’s Health Physical Therapist
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Physical Therapy (PT):
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The treatment of physical dysfunction or injury by the use of therapeutic exercise and the application of modalities, intended to restore or facilitate normal function or development. Also called physiotherapy
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Physiatrist:
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A physiatrist (fizz eye’ a trist) is a medical doctor specializing in physical medicine and rehabilitation (PM&R). PM&R focuses on improving function for patients with congenital or acquired impairments or disabilities. Physiatrists may manage the rehabilitation program for patients after stroke, spinal cord injury or an exacerbation of multiple sclerosis, for example.
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Rectocele:
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occurs when the support structure between the vagina and rectum has torn or weakened and allows the rectum to protrude into the vaginal canal or through the vaginal opening.
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Stress incontinence:
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occurs when the support structure between the vagina and rectum has torn or weakened and allows the rectum to protrude into the vaginal canal or through the vaginal opening.
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Urge incontinence:
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the symptom of experiencing a strong need to void followed by a sudden uncontrollable loss of urine. Typically, this involves loss of a large amount of urine.
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Urinary incontinence:
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Involuntary loss of urine.
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Urogynecologist:
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A physician who is a Board-Certified (or Board-Eligible) Obstetrician-Gynecologist, who has completed additional specialty fellowship training in the disorders of the pelvic floor and in pelvic reconstructive surgery. Current requirements include 3 years in Urogynecology fellowship training. At present, Board Certification for Urogynecology does not exist. As a quality check, if you are not an IULTD patient, you should inquire if your physician is fellowship trained.
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Uterine prolapse:
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a condition in which the ligamentous and fascial supports have torn or weakened, allowing the uterus to sag down into the vaginal canal or through the vaginal opening.
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Vaginal Vault Prolapse:
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a condition that occurs in women who have previously undergone hysterectomy, in which, the ligaments which 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.
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Voiding Diary:
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a chart that allows women to keep track of when they urinate voluntarily, when they leak urine, and their fluid intake. The patterns revealed on such achart help us to evaluate voiding, and bladder – control function.
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Voiding dysfunction:
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a problem causing abnormal bladder emptying. Symptoms may include difficulty initiating urine stream, intermittent stream.
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Women's Health Physical Therapist:
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a clinician who specializes in restoration of the function of the muscles and nerve supply to a woman’s pelvis. These muscles affect bladder, bowel and sexual function.
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Urgent PC:
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A new treatment for overactive bladder. This form of neuromodulation applies electric pulses to the nerve over the ankle. As this signal travels from the leg to the brain, it changes nerves next to the bladder control center. The cross communication to the bladder control center turns on bladder reflexes that help overcome overactive bladder symptoms.
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Uroflowmetry:
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A test of bladder emptying. The test involved sitting on a special commode & emptying your bladder as normally as possible. A computerized device under the commode measure the rate of urine flow & the flow pattern.
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Urodynamic testing:
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a test of bladder and urethral function. To perform the test, a very thin catheter is placed into the bladder via the urethra, and another into the vagina or into the rectum. The bladder is filled with water or saline through this catheter. During the test, both catheters take measurements of pressure, sensitivity, and strength of the bladder and urethra. Testing is performed while the bladder is filling, with movement and coughing, and with voiding, or bladder emptying. In addition, an emg to assess periurethral or pelvic outlet muscle function may be performed.
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