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Female Urology

Female Urology

The subspecialty of female urology is concerned with the diagnosis and treatment of urinary tract disorders most prevalent in females. These include urinary incontinence and pelvic floor prolapse, voiding dysfunction, recurrent urinary tract infection (UTI), urethral syndrome and interstitial cystitis (IC). Expert evaluation of these conditions includes a complete history and physical exam, as well as additional bladder studies such as Aerodynamics (i.e. bladder function test), imaging studies (i.e. CT Scan and/or MRI), and cystoscopy. The Department of Urology at Stony Brook offers comprehensive evaluation and treatment for all female urologic disorders. An explanation of each disorders is provided in the following paragraphs.

What is incontinence?
Incontinence is the involuntary loss of urine. It is further defined as either stress (e.g. leakage with straining, coughing, or sneezing), urge, mixed, overflow, functional or reflex incontinence. It can be embarrassing, uncomfortable, and can limit activities required in daily life. There are various options available for treatment of urinary incontinence. Current therapies include dietary changes, scheduled voiding, bladder retraining, pelvic muscle exercises, biofeedback, electrical stimulation therapy, medication, periurethral bulking agents (e.g. collagen implants) and minimally invasive surgery (e.g. open abdominal anterior urethropexy, or sling can be done completely vaginally).

What is voiding dysfunction?
Voiding dysfunction can affect individuals in different ways. The main symptoms are urinary frequency, urgency, painful urination and/or incomplete bladder emptying. Treatment is aimed at decreasing or eliminating symptoms, and may involve medication or pelvic floor relaxation exercises. What is a recurrent urinary tract infection? Recurrent urinary tract infections (UTI) may be generally defined as three or more infections within one year. This may be idiopathic (i.e. no obvious cause) or related to a urologic disorder such as stones, tumor, ineffective bladder emptying or reflux (when urine flows back to the kidney). It is important to identify the cause of recurrent infections to ensure proper antibiotic therapy in order to break the cycle of infection.

What is interstitial cystitis?
Interstitial cystitis (IC) is a urologic syndrome characterized by excessive urinary urgency, frequency, nocturia (i.e. 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 work 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. Our specialists at Stony Brook Urology offer all evaluation and treatment options currently available.

What is urethral syndrome?
Urethral syndrome is a condition that often exists as a component of interstitial cystitis. It is a condition that causes pain in the urethra during urination or independent of urination. Treatment may include oral medication, or local estrogen replacement therapy.

Department of Urology Physicians treating these conditions: Ruth Ann Miles, MD

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