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Treatment for Pelvic Problems Can Improve Quality of Life

Kimberly Kenton, M.D., vividly remembers a 63-year-old female patient who had tolerated leaking urine for many years. Every little bump and jolt let loose a gush of urine. Eventually, even an adult diaper could not protect her from embarrassment, and she had to give up doing some of the things she loved, including rollerblading with her grandkids.  

When the patient found out she could be helped, she sobbed in the exam room. The woman made a major impression on Kenton and was one factor that motivated her to help women with pelvic problems. Kenton is now a urogynecoloist at the Women's Pelvic Medicine Center of Loyola University Health System. "Often, women are told by friends, family, even physicians that leaking urine is normal. It is common, but it shouldn't be considered normal," Kenton said.

Loyola's Women's Pelvic Medicine Center is one of the few places in the country, and was the first in the Chicago area, to offer women the combined expertise of urogynecologists and urologists in one convenient location. Urogynecologists specialize in treating problems involving the complex relationship between a woman's reproductive organs and lower urinary tract. Urologists specialize in treating problems that involve the entire urinary tract.

The team collaborates with other specialists - such as gastroenterolgists, physical therapists and specialists in rehabilitation and pain management - to diagnose and treat the whole person and the entire pelvic region rather than just focusing on specific symptoms. Treatment options may include biofeedback, physical therapy, acupuncture, medications and, in some cases, surgery.

"Quality of life is very important to us, because we know that symptoms can affect a woman's self-esteem, ability to exercise, relationship with her sexual partner and other aspects of life. Sometimes, especially with older women, symptoms can even prevent them from leaving the house," Kenton said.

Kenton sees patients with a broad range of pelvic problems, but the majority suffer from incontinence or pelvic organ prolapse, in which a weakened pelvic floor allows the vagina or uterus to fall out of place. A recent study of HMO documents showed that one out of nine women had surgery for incontinence or pelvic organ prolapse. Unfortunately, 30 percent of those needed a repeat operation - a fact that points to the need to obtain an accurate diagnosis and treatment from the start.

A big risk factor for both incontinence and pelvic organ prolapse is vaginal childbirth, Kenton noted. About a third of women who have given birth vaginally to one child will develop incontinence at some point. The incidence is greater for more births. The exact mechanism is not known, but physicians believe the pelvic nerves and muscles may be damaged when stretched out during childbirth. A lot of women are not symptomatic right away, but may start noticing problems when the stress of childbirth combines with the neuromuscular decline of aging.

"One of the things we most want to understand is how we can identify women at greatest risk before they have babies," Kenton said. She and her colleagues are studying that very issue with a major grant from the National Institutes of Health.

Since physicians at the Women's Pelvic Medicine Center are engaged actively in various research projects, they are able to provide some of the most sophisticated treatment options available. For example, Loyola's center is one of the few places studying a medication that may be effective for treating stress incontinence.

Kenton sees patients at Loyola University Medical Center in Maywood and at Loyola's Center for Health at Hickory Hills. For more information call (708) 216-2180.

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