Conditions We Treat

Here at the Pelvic Medicine Centre we treat a range of diseases and conditions of the pelvis including:

 

OVERACTIVE BLADDER

Have you ever felt like you can’t control your bladder like you could when you were younger? Do you wake at night having to use the bathroom or urinate more than seven times each day? These are all common symptoms of Overactive Bladder Syndrome.

Overactive Bladder Syndrome can have a significant effect on quality of life, and affects approximately 15% of the adult population. The management of Overactive Bladder Syndrome involves the exclusion of underlying pathology, however in most cases it can be successfully treated using lifestyle interventions, pelvic floor exercises and bladder training.

Specialists at the Pelvic Medicine Centre provide a range of procedural interventions including Botox and Sacral Nerve Stimulation. Injection of botox into the overactive bladder muscle will relax it and relieve the symptoms of frequency, urgency, nocturia and urinary urge incontinence. The use of sacral nerve stimulation has been widely employed as a treatment for faecal incontinence, however following recent changes in the Medical Benefits Schedule this therapy is now available for patients experiencing urinary incontinence.

PAINFUL BLADDER

Painful bladder conditions are common and Interstitial Cystitis (IC) is one of the main causes. People with Painful Bladder Syndrome or IC suffer pain when the bladder is full and/or have to urinate frequently. The cause is unknown and diagnosis may take several visits to doctors and is predominately based around excluding other possible causes for the symptoms like and infection as there is no conclusive test to prove someone has interstitial cystitis.

Nine out of ten sufferers of painful bladder are women. It can develop at any age, with the onset for most patients around the age of 40 years.

Painful Bladder Syndrome and Interstitial Cystitis are chronic, debilitating syndromes and people respond variably to treatment. There is no cure, but patients may achieve long remissions.

STRESS INCONTINENCE

Have you ever had a small accident when doing something as simple as, sneezing, laughing, walking, lifting, or playing sport? This is called stress incontinence. Stress incontinence is the leaking of small amounts of urine during activities that increase pressure inside the abdomen and push down on the bladder.

Stress Incontinence is more common among women with urinary tract infections, menopause, pre- and post-natal women and younger women who have had children. Stress Incontinence in women is often caused by pregnancy, childbirth and menopause. Pregnancy and childbirth can stretch and weaken the pelvic floor muscles that support the urethra causing stress incontinence during activities that push down on the bladder.

The management of Stress Incontinence involves exclusion of underlying pathology, and can be successfully treated using lifestyle interventions, pelvic floor exercises, bladder training or surgical intervention.

PROLAPSE

Prolapse is a common problem for females of all ages, worldwide. Yet prolapse is one of those conditions that many women are too embarrassed to talk about, even with their closest friends.

The most common symptom of pelvic organ prolapse is the sensation of something bulging into the vagina. Other symptoms may include pressure or discomfort in the pelvic region, back pain and pain during intercourse.
Pelvic Organ Prolapse is caused by weakened or damaged muscles or stretched ligaments due to a number of causes. These may include vaginal delivery of a baby, previous surgeries, obesity, menopause, hysterectomy, straining to empty your bowels or lifting a heavy object.

The two most common POPs we deal with are vaginal prolapse and uterine prolapse. Vaginal prolapse occurs when the top of the vagina drops from its normal place. Uterine prolapse occurs when the uterus falls into the vagina.

Most vaginal prolapses gradually worsen and can only be fully corrected with surgery. However, the type of treatment that is appropriate to treat a vaginal prolapse depends on factors such as the cause and severity of the prolapse, whether the woman is sexually active, and the woman's treatment preference.

Surgical repair is the treatment option that most sexually active women who develop a vaginal prolapse choose because the procedure is usually very effective.

MENOPAUSE

The menopause, also known as 'the change of life', marks the end of the monthly cycle of menstruation in a woman’s life. The average age women go through the menopause is 52, but a woman could start to experience menopausal symptoms between the ages of 45 and 55.

Menopause occurs because as women age they slowly run out of eggs. Some scientists believe this happens to protect women and their children from the dangers of late childbearing. Surgical menopause is menopause that occurs as a result of removal of the ovaries from a woman who is still having periods.

Symptoms of menopause may be managed with lifestyle changes, hormone replacement therapy (HRT) and natural therapies.

HORMONE ISSUES

As you approach menopause, the production of ‘female’ hormones (oestrogen and progesterone) by the ovaries starts to slow down. Hormone levels tend to fluctuate and women may notice changes in their menstrual cycle:

- Cycles may become longer, shorter or totally irregular
- Bleeding may become lighter
- Bleeding may become unpredictable and heavy (seek advice from your doctor).

Eventually your hormone levels will fall to a point where menstruation (periods) will cease altogether and the menopause is reached.

Hormone replacement therapy (HRT or hormone therapy) effectively reduces many of the unpleasant effects of symptoms of the menopause and may be appropriate for short-term use in women with moderate to severe menopausal symptoms.

MALE SEXUAL DYSFUNCTION

Impotence or Erectile Dysfunction is a condition in which a man is unable to obtain an erection or maintain it long enough for sexual intercourse. It is a common condition, occurring in a significant percentage of our population and is often a source of great frustration to the man and his partner. The percentage increases with increasing age, with more than 50 per cent of men aged sixty and over having this problem.

Ejaculation problems such as premature or inhibited ejaculation are also common and can be experienced by up to thirty percent of men.

Most men will experience some type of sexual dysfunction following treatment for prostate cancer and without a supervised rehabilitation programme, this may remain a permanent problem.

The Doctors at the Pelvic Medicine Centre offer a comprehensive service for all types of male sexual dysfuntion.

INFERTILITY

Fertility problems are some of the most common medical dilemmas faced by Australians with approximately 10% of couples needing advice or assistance with their reproductive health. The most common question asked is, “Everyone else gets pregnant, why haven’t we?”

Whether the problem is egg production, sperm production, tube problems or something else, accurate diagnosis of the underlying fertility issue is a key focus of doctors at the Pelvic Medicine Centre.

FAECAL INCONTINENCE

According to the Colorectal Surgical Society of Australia and New Zealand approximately 5% of the Australian population suffer from faecal incontinence, with rates increasing sharply once they reach sixty-five years of age. Continence (or urgency) problems can have a profound impact upon patients with many sufferers experiencing several episodes of leakage a day, where they have to change their clothes, become house bound and unable to confidently engage in social or work related activities. The most common cause of continence problems is injury to muscles or nerves of the anal sphincter through childbirth or rectal prolapse.

The muscles of the pelvic floor, urethral sphincters, bladder and anal sphincter muscles are all controlled by the brain through nerves that run from the sacral area. If dietary intervention proves inadequate, Sacral Nerve Stimulation (SNS) can be an effective intervention.

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