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    No, It’s Not “Normal” and You Don’t Have to “Live With It” - Treating Incontinence, Pelvic Pain and More

    Amanda Phelps-Jones, WHNP-BC WHNP-BC of the Pelvic Health and Wellness Center at The Women’s Hospital 11/16/2016

    Incontinence, pelvic pain and other issues should not be considered “normal” or something you simply “have to live with.”  Pelvic health problems happen to many women, and are often related to pregnancy and childbirth, weakening pelvic muscles and tissue changes related to menopause and aging, and several other causes.
    The Pelvic Health and Wellness Center at The Women’s Hospital (PHWC) provides specialized services for women’s bladder and pelvic health. Our goal at the PHWC is to help women live a healthier, full and confident life. I am a board certified Women’s Health Nurse Practitioner, which means I’ve had additional training in the unique health needs of women—from puberty to menopause and beyond.
    Below I’ll describe the testing and treatments we offer for a variety of conditions and problems.

    Women’s Health Physical Therapy
    This is physical therapy (PT) specifically for pelvic health in women.  This specialized PT treats conditions like urinary or fecal incontinence, pelvic pain, interstitial cystitis, painful intercourse, and other problems that are related to the pelvic floor.
    At the PWHC, we have two specialized physical therapists that provide PT services.  These treatments are used along with the medical treatments that I or another provider may recommend.

    Urodynamic Testing
    Urodynamic testing helps determine how well the muscles of the bladder work, and can help differentiate different types of incontinence.  The testing is minimally invasive, and the information from these tests help us guide treatment plans.  My colleague, Janet Lank, RN, has many years of experience in helping diagnose women’s bladder and urinary issues, and she performs these tests in our office.

    Chronic Pelvic Pain Management
    Chronic pelvic pain is defined by consistent pain in the pelvic area that has lasted three months or more.
    Common causes include:•Interstitial cystitis, or painful bladder syndrome

    • Endometriosis
    • Vulvodynia
    • Post-childbirth complications
    • Post-surgical complications

    We have a variety of treatment options that we use based upon each woman’s unique needs and conditions.

    Interstitial Cystitis Management
    Interstitial cystitis (IC) is a condition of the bladder that is often a diagnosis of exclusion.  This means that it is diagnosed after other things have been ruled out, so IC can often be overlooked.
    Symptoms are pain with a full bladder, urgency to urinate, and frequent and painful urination. It hurts when you go, and it hurts when you don’t go—pain is the key symptom.
    We treat IC in many ways, including educating about dietary changes, modification of bathroom habits, medication, physical therapy and more.

    Pelvic Organ Prolapse Management
    Pelvic organ prolapse management is about helping women whose bladder or uterus is no longer adequately supported by her pelvic floor.
    The bladder can’t function or empty properly if it’s not supported; the uterus, if not supported, can lead to bladder and other issues.  Women who are experiencing prolapse may have discomfort and a variety of symptoms.  It is important to note that women who have had a hysterectomy may still have prolapse issues.
    We manage these prolapse issues in a variety of ways, including a pessary, physical therapy, and ultimately surgical intervention.

    Pessary Fittings and Maintenance
    A pessary is a supportive or space-filling device that helps to hold the bladder or uterus up and in place, to help manage the prolapse issue.  It is made of silicone, and is inserted vaginally. We provide the initial fitting, and patients can be taught to manage the pessary at home.  We provide ongoing help as needed. A pessary is an option for women who either cannot have surgery or do not wish to do so.
    Women with prolapse can still have sexual activity with some types of pessaries.

    Bladder and Fecal Incontinence management
    Incontinence can have incredibly significant effects on the quality of a woman’s life.  The constant fear of leakage or an ‘accident’ can lead to isolation, depression, and even other unforeseen issues such as loss of physical conditioning (won’t exercise due to leakage), or even increased risk of falling (while rushing to the bathroom).  So, it’s not just an inconvenience—it’s a serious issue.
    We have many options for women who are experiencing either bladder of fecal incontinence, including physical therapy, medications, pessaries, and surgical options.

    How do I make an appointment at PHWC?
    The Pelvic Health & Wellness Center accepts most insurances, as well as Medicare and Medicaid.
    For physical therapy, a physician/provider referral is needed.  However, a referral is not needed to see me, and I do many initial assessments, and can provide referrals to physical therapy.
    To make an appointment call 812-858-5950.
    To learn more, and to watch the PHWC provider videos, visit our website.

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