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Women's Pelvic Health

August 26, 2014 1:29 PM with Dr. Janet Tomezsko

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Pelvic health is often not an area women are comfortable discussing with their doctor; however, issues like urinary incontinence and pelvic prolapse can be very common. Janet Tomezsko, MD, Female Pelvic Medicine and Reconstructive Surgery at NorthShore, will answer questions on women’s pelvic health, from pelvic pain to pelvic floor disorders. Submit your questions early.

Brenna (Moderator) - 1:08 PM:
Our chat Women's Pelvic Health will begin at 1:30. You can submit questions now or at any point during the chat. Please only submit your questions once.

  Debra (Winnetka) - 1:29 PM:
What can you do if you have pelvic prolapse? Is surgery the only option?
Dr. Janet Tomezsko (NorthShore)
There are different options for the treatment of prolapse based on how extensive the prolapse has become. Surgery is NOT the only option. There is also an office treatment called a pessary that supports the dropped vaginal wall, like a tampon. And also pelvic floor physical therapy can help by strengthening the muscles.

  Maria (Evanston) - 1:33 PM:
Can pelvic floor exercises prevent prolapse? What exercises should be doing? Are they able to do myself or can my gynecologist show me?
Dr. Janet Tomezsko (NorthShore)
There is evidence that pelvic floor exercises (like Kegel's) can help prevent problems, but it is not definitive. You can do them on your own. Your gynecologist can show you how and confirm you are doing them correctly. We believe there are benefits in doing exercises to strengthen the pelvic floor even if it may not prevent all problems.

  Anonymus (Evanston) - 1:38 PM:
I don't think I'm old enough to be having incontinence problems. I'm only in my early 30s and not pregnant or have had children but when I lift something or cough, I almost alwAys have leakage. I'm so embarrased by it. What could be causing this? How can you treat it?
Dr. Janet Tomezsko (NorthShore)
Urinary incontinence can affect women of any age even if she has not had children. Usually urine leakage with lifting or coughing is due to stress incontinence, a weakness in the urethra or pelvic muscles. And the cause is usually multifactorial. Full evaluation would be performed by a physician. There are often several treatment options based on what is found to be wrong. Treatments range from pelvic floor muscle strengthening to minor surgery.

  Stacy (chicago) - 1:46 PM:
could surgery for prolapse affect my sex life in a bad way?
Dr. Janet Tomezsko (NorthShore)
Most patients with large prolapse feel that surgery helps their sex life in many ways. There is a small chance of pain after surgery, just like after having a baby. It is most often temporary.

  Paula - 1:52 PM:
What is recovery after surgery for pelvic prolapse like? Does it invovle a long hospital stay? Is this something that insurance normally covers?
Dr. Janet Tomezsko (NorthShore)
Most patients stay overnight after surgery. Some surgeries may require 2 nights in the hospital. There are many different types of surgeries for prolapse. Depending on the surgery you may be tired for days to 2-3 weeks. You may need to take off 1-4 weeks of work. We restrict heavy lifting and exercise for 12 weeks. Most insurances cover the surgery.

  Mary - 1:58 PM:
My mom has had issues with pelvic prolapse. She has had 5 kids. Are you more likely to have issues the more kids you have? Is this something that will happen to me because it happened to her?
Dr. Janet Tomezsko (NorthShore)
There are many factors that are involved in the development of pelvic prolapse. Childbirth and genetic factors are involved. Nothing is definitive though. Many things may increase your risk, but do not guarantee that you will develop a problem.

  Linn - 2:04 PM:
Are there early signs of pelvic prolapse? What are they? Is it better to address it early before organs shift out?
Dr. Janet Tomezsko (NorthShore)
Prolapse can be felt by the patient or seen on exam by your Gynecologist. If a patient has no symptoms, nothing needs to be done. We hope that strengthening the pelvic floor muscles can help prevent it from getting worse. Surgery is not done unless a patient is significantly symptomatic.

  Camila (Skokie) - 2:10 PM:
What is the pelvic floor? Should I be strengthening it before I have my baby? I'm currently 3 months pregnancy.
Dr. Janet Tomezsko (NorthShore)
The pelvic floor are the muscles that support the vagina, bladder and rectum. They are called the Levator Muscles. The pelvic floor also includes some supporting ligaments for the vagina and uterus. Kegel exercises help strengthen the pelvic floor. All women should do them, at all stages of life they may help.

  Parker (Glenview) - 2:15 PM:
Are bowel issues related to pelvic disorders?
Dr. Janet Tomezsko (NorthShore)
Some bowel symptoms may be caused by or associated with pelvic floor disorders. Constipation is commonly seen in patients with problems. But it may not be caused by the pelvic floor problems. Chronic straining may cause pelvic floor problems.

Brenna (Moderator) - 2:15 PM:
There are 15 minutes left in this chat. Please send your final questions.

  Audre (Oak Park) - 2:18 PM:
Is medication the best way to control overactive bladder?
Dr. Janet Tomezsko (NorthShore)
For some patients with Overactive Bladder medications are the only good treatment option. For many others medications are an option, but there are also non-medication options such as bladder retraining, physical therapy and other options.

  N - 2:23 PM:
Is incontinence just a normal part of aging?
Dr. Janet Tomezsko (NorthShore)
Urinary incontinence is common, NOT normal.

  Audre (Oak Park) - 2:25 PM:
Is overactive bladder a result of menopause?
Dr. Janet Tomezsko (NorthShore)
No. It is not a result of menopause but often it is worsened by the low estrogen levels of menopause.

  cindy (Chicago) - 2:28 PM:
Are there lifestyle changes that you can make to try to prevent prolapse?
Dr. Janet Tomezsko (NorthShore)
Yes. Obesity worsens prolapse symptoms, so weight loss helps. Avoiding chronic coughing and chronic constipation may help also. Chronic heavy lifting may worsen symptoms also.

Brenna (Moderator) - 2:28 PM:
This will be the final question of today's chat.

Brenna (Moderator) - 2:30 PM:
Thank you all for your participation today. And thank you Dr. Tomezsko for taking the time to answer so many great questions. If you have further questions or wish you make an appointment with Dr. Janet Tomezsko to discuss your pelvic health, please visit her Find a Doctor profile.
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