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Female Urology
WHAT IS FEMALE UROLOGY?
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 tract. Additional bladder studies such as cystoscopy may be necessary.
WHAT IS INCONTINENCE?
Incontinence is an involuntary loss of urine. It is further defined by type as either stress (leakage with straining, coughing or 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.
WHAT IS VOIDING DYSFUNCTION?
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 medication or pelvic floor relaxation exercises.
WHAT IS A RECURRENT URINARY TRACT INFECTION?
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, tumour, 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.
WHAT IS URETHRAL SYNDROME?
Urethral syndrome is a condition involving pain at the urethra that can occur during urination or without urination. Treatment may consist of oral medication or local oestrogen replacement therapy. Urethral syndrome may exist as a component of interstitial cystitis.
WHAT IS INTERSTITIAL CYSTITIS?
Interstitial cystitis (IC) is a urologic syndrome characterised by excessive urinary urgency, frequency, nocturia (night time 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.
Drugs with calming effects on the bladder may be helpful. Bladder instillations with dimethyl sulfoxide (DMSO) have achieved variable success. Hydrodistention of the bladder under anaesthesia is a common therapeutic and diagnostic procedure. In the most severe cases, surgery including denervation (resection of nerves of the bladder), urinary diversion (removing the bladder) and augmentation cytoplasty (bladder enlargement) may be performed.
