Find A Physician

Return to As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds Overview

More on As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds

Newsroom

Return to As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds Overview

More on As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds


Research and Clinical Trials

Return to As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds Overview

More on As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds

Clinical Services

Return to As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds Overview

More on As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds

As Pelvic Floor Disorders Rise, New Subspecialty of OBGYN Responds

NEW YORK (May 28, 2014)

Doctors are increasingly being called upon to diagnose and treat pelvic floor disorders in women of all ages. In fact, it is estimated that one-third of premenopausal women and up to 45% of postmenopausal women are afflicted with this common condition.

"Ten percent of women who have had children are going to develop some sort of problem with either urinary incontinence or prolapse of their pelvic organs," said Carmen J. Sultana, M.D. Aging has also been shown to play a role in the troublesome condition. "Given the aging of our population, complaints related to pelvic floor disorders are increasing," said Tirsit S. Asfaw, M.D.

Carmen J. Sultana, M.D.
Carmen J. Sultana, M.D.

In an attempt to meet the needs of this increasing patient population, the American Board of Medical Specialties identified Female Pelvic Medicine and Reconstructive Surgery as a subspecialty in obstetrics and gynecology in 2012. "The new name reflects that what we do in urogynecology encompasses more than surgery," said Dr. Sultana. "We address all of the female patient's issues, including problems with intercourse, issues with intimacy, leakage of urine, and depression," said Dr. Asfaw.

The symptoms of pelvic floor disorders range in type and severity, but can include urinary retention or frequency, waking frequently at night to urinate, sinking of the vaginal wall (prolapse), fecal incontinence or loss of bowel control, recurrent urinary tract infections, pelvic floor or bladder pain, and pain with intercourse. However, many women hide their symptoms because they are unaware that there are effective treatment options. Other patients have been dissuaded from seeking care due to negative press about surgical repairs or simply thinking that they can't be helped. Fortunately, urogynecologists have a range of treatment options available for women with pelvic floor disorders.

Tirsit S. Asfaw, M.D.
Tirsit S. Asfaw, M.D.

"We understand the path she's been on, the effects that childbirth have had on her. We also understand the intimacy problems she might be having with her partner. We try to put things in perspective and draw on specialists in other disciplines as necessary," said Dr. Asfaw.

Modes of treatment include pessary use, robotic, abdominal, and vaginal reconstructive surgery, as well as medical and surgical treatment for urinary incontinence. Both Drs. Asfaw and Sultana advocate a conservative approach first. "Not every woman needs surgery and each approach is unique to that person and their condition," said Dr. Asfaw. Dr. Sultana agreed. "We want (patients) to understand that there are subspecialists in this area and that there are newer treatments coming out all of the time."

Since urogynecologic problems are among the most common conditions that women face, both doctors emphasize that gynecologists and primary care physicians should be asking certain questions during routine examinations. "We screen for heart disease and cervical cancer; we should also screen for incontinence, prolapse, and other recurrent genitourinary issues that can make a big change in a woman's life." said Dr. Asfaw.

Currently, doctors at NYP/Weill Cornell are conducting studies examining why changes occur in the pelvic floor during pregnancy and how genetics may play a role in prolapse. Dr. Asfaw is particularly interested in pelvic organ cross-sensitization. "A lot of patients have pelvic pain ... In the past, patients just lived with the pain, essentially. But we now understand that the nerves talk. The nerves of the bladder talk with the nerves of the colon, the uterus, and the nerves in the pelvic area. When one area is inflamed, for whatever reason, by the time the message gets to the brain, the brain doesn't know where the message is coming from. It sends inflammatory mediators to everything," explained Dr. Asfaw.

As the population continues to age, Drs. Asfaw and Sultana predict that the field of female pelvic medicine and reconstructive surgery will also expand. "It is clear that we will not be able to meet the needs of the aging female population without more practitioners in this subspecialty," said Dr. Asfaw.

  • Bookmark
  • Print

    Find a Doctor

Click the button above or call
1 877 NYP WELL


eNewsletters

Newsroom



Top of page