Gynaecology is the medical practice dealing with the female health and its reproductive systems (vagina, uterus and ovaries) and the breasts. It means "the science of women".
Here the consultation for all women health related problems is offered with evidence based treatment and women is also provided with the information which aims to help women make informed decisions about the treatment choices . The most common problems dealt are;
The overactive bladder means that your bladder contracts (squeezes) when you do not want it to.
This is the probable reason for your frequent and urgent need to pass urine. It can also cause leakage of urine because you cannot get to the toilet in time.
We can help you to improve this, providing we have your co-operation and you have determination. The purpose of bladder training is to help you regain control of your over-active bladder by suppressing its contractions.
You must gradually increase the capacity of your bladder and the time interval between voiding (passing water).
Start by voiding every hour on the hour whether you need to or not, from when you get up in the morning until you go to bed at night, but try very hard not to void at any other time, that is, in between your set times. Practice this for 3–4 days. When you feel you have mastered this, gradually extend the time between voiding.
This type of leakage tends to occur when the woman coughs, sneezes, lifts, runs or walks fast.
The leakage is due to a weakness of the pelvic floor that supports the bladder and the urethra (the tube which comes from the bladder to the outside).
You will be given advice on restricting the amount of fluid you drink, stopping smoking, reducing your weight and doing pelvic floor exercises.
In approximately 1 in every 3 women these non-operative treatments are sufficient to cure or make your symptoms very much better.
However, many women still require an operation to improve the quality of their life.
Operations for stress incontinence depend on supporting the urethra. The main operation to cure this type of leakage is Sling operation. Of the patients who have the operation, stress incontinence is cured in 85%, improved in a further 10% and not helped in approximately 5%.
Why have a repair?
As women get older, especially if they have had children, the muscles and supporting tissues of the pelvic floor (around the vagina) can become lax.
This can cause ‘prolapse’ of the walls of the vagina and/or the uterus (womb).
Problems women get with prolapse are:-
• A lump coming down
• Difficulty passing urine
• Difficultly opening bowels
Vaginal operations are usually very good at relieving the symptoms of a lump coming down and have variable effects on urinary and bowel symptoms.
What is a repair?
This operation involves an incision within the vagina and repair of the underlying connective tissue.
• This takes up some of the laxity in the vaginal walls.
• If your womb is prolapsed you may be offered a ‘vaginal hysterectomy’ at the same time.
• Pelvic Floor Exercises for Women
What are pelvic floor muscles?
• They are layers of muscles , helping to hold the bowel, bladder and uterus in place and closing the outlets of the bladder and bowel.
• When you pass urine or have a bowel motion, the pelvic floor muscles relax. After emptying, they tighten again to restore control.
Why do pelvic floor exercises?
• Weakness of the pelvic floor muscles can be a common problem affecting 1 in 3 women by middle age, resulting in incontinence and prolapse.
• This may be due to being overweight, post pregnancy/childbirth, pelvic surgery or simply getting older.
• Incontinence can affect your bladder and/or bowel. So if you: „ leak on coughing, sneezing, laughing or physical exertion „ leak before reaching the toilet „ are of child-bearing years „ are menopausal pelvic floor exercises are for you.
• Identifying the pelvic floor muscles .
Stage 1:
Tighten your back passage – imagine that you are stopping yourself passing wind, focus on the tightening around the opening of the bowel. Do not squeeze your buttocks or leg muscles.
Stage 2:
your vagina and front passage – imagine that you are trying to stop the flow of urine. Focus on this tightening; try to feel the muscles lifting upwards and forwards towards the pubic bone.
Stage 3:
• Do both of the above tightening exercises together and hold this. How many seconds can you hold? Aim for 5 seconds – when you let go, can you feel the muscles relax? If not, you have held too long – try again with a shorter hold. Some women may be able to hold for only 1-2 seconds and others as many as 8-10 seconds. It is important to discover your hold.. Repeat this 10 times – approximately 1 contraction per second.
• Do not expect immediate improvement – so do not give up.
• You need to continue this routine for at least 6 months.
• As the muscle gets stronger you will be able to increase your hold and number of repetitions at each session.
• Do not practice stopping midstream.
• Exercise for life Continue pelvic floor exercise several times per day for the rest of your life in order to keep these muscles fit and healthy.
• If symptoms return increase your daily input again.
• Additional tips Being constipated or overweight can strain the pelvic floor muscles so eat a balanced diet including fruit and vegetables and between 6 and 8 cups of fluid a day.
• Avoid tea, coffee or coca-cola if you suffer from urgency or frequency.
• Tightening the pelvic floor muscles when you lift heavy objects or when you are going to cough or sneeze will help your control.
• If your problem is ‘urgency’, tighten your pelvic floor when you get the desire to empty your bladder, wait until the desire passes before moving.
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