Women’s Urology Centre / Female Urology
The Women’s Urology Centre at False Creek Healthcare provides extensive female urology care in a unique environment for women seeking innovative treatment and expertise in areas of urinary incontinence, voiding dysfunction, and bladder pain syndrome (interstitial cystitis).
The Women’s Urology department has been designed to help women reach their optimum health potential. Women who come to our Centre not only receive excellence in expedited care from our team of Urologists, but also access to a multidisciplinary team of physicians and specialists in order to address non-surgical treatment strategies, from expert continence specialist advisors to pelvic floor physiotherapists.
Our mission is to provide the best possible urological care to women in Vancouver, BC. Our goal is to care for you in the way we would want to be cared for if we became ill.
There are a variety of female urology conditions that the Women’s Urology Centre is able to diagnose and treat.
Involuntary leakage of urine. It can be a common and distressing problem, which may have a profound impact on quality of life. Urinary incontinence almost always results from an underlying treatable medical condition but is under-reported to medical practitioners.
What Causes Urinary Incontinence?
Temporary urinary incontinence can be caused or increased by temporary factors such as alcohol, caffeine, bladder irritation, over-hydration and medications. Treatable medical conditions like urinary tract infections and constipation can also cause urinary incontinence. Chronic, or persistent urinary incontinence is usually caused by underlying physical problems and changes. Pregnancy and childbirth, aging and menopause, hysterectomy, painful bladder syndrome (interstitial cystitis), neurological disorders, bladder cancer or bladder stones and obstructions – all can cause incontinence. Once the cause of incontinence is assessed a treatment plan can be created that may include surgical or non-surgical treatment.
Overactive Bladder Syndrome
Symptoms of overactive bladder syndrome include an urgent feeling to go to the toilet, going to the toilet frequently, and sometimes leaking urine before you can get to the toilet (urge incontinence). Treatment with bladder training often cures the problem. Sometimes medication may be advised in addition to bladder training to relax the bladder.
Recurrent urinary tract infections
Recurrent urinary tract infections (UTIs) are common in women. The clinical features, diagnostic testing, and causative organisms are often similar to those of single cases of UTI, although there are additional treatment strategies and prevention measures to consider with recurrent UTIs.
Interstitial cystitis is a chronic inflammation of the bladder wall. It is quite a painful condition due to inflammation of the tissues of the bladder wall. IC is often misdiagnosed as a urinary tract infection. Patients can go years without a correct diagnosis. On average, there is about a 4-year delay between the time the first symptoms occur and the diagnosis is made. The condition is most common around ages 30 to 40, although it has been reported in younger people. Women are 10 times more likely to have IC than men. Symptoms include: Pain during intercourse, Pelvic pain, Urinary discomfort, Urinary frequency (up to 60 times a day in severe cases), Urinary urgency. Many people who have long-term interstitial cystitis are also depressed because of the pain and changes.
Voiding dysfunction is a lack of coordination between the bladder muscle (detrusor) and the urethra. With normal urination, the urethra relaxes and opens when the bladder muscle contracts allowing urine to pass out of the body freely. In those with voiding dysfunction, the urethra does not relax when the bladder muscle contracts making it difficult for urine to pass.
Female Urology Surgery
A variety of surgical options are available to help women with urological problems.
Stress Urinary Incontinence ( SUI) occurs when an increase in intra-abdominal pressure exceeds urethral closure pressure, resulting in the involuntary leakage of urine. This may occur with laughing, exercise, sneezing, or coughing.
Management options for SUI include conservative and surgical treatments. Midurethral sling placement has replaced other procedures (e.g., retropubic colposuspension, bladder neck slings) as the procedure of choice for many women. There are many variations of retropubic midurethral slings as well as the midurethral transobturator tape (TOT), the trans vaginal tape (TVT) and the mini sling (Bard Adjust or Mini-Arc). A midurethral sling is a suburethral sling that is placed at the level of the midurethra in a tension-free manner. These slings are made of synthetic mesh. These procedures take about 15 minutes to perform and can be done with general, spinal or local sedation. Mid-Urethral slings have excellent overall success and durable cure rates. The procedure involves placing a band of sling material directly under the bladder neck or mid-urethra, which acts as a physical support to prevent bladder neck and urethral descent during physical activity. The sling also may augment the resting urethral closure pressure with increases in intra-abdominal pressure.
Intravesical Botox Injections
This procedure is usually used with patients who have been unresponsive to other treatments or have severe symptoms, frequency, urgency and urge incontinence.
» Learn more about intravesical botox injections
Urethral Bulking Agents
Urethral bulking agents are injected underneath the lining of the urethra (water pipe) to add extra bulk to the sphincter and aid closure of the bladder outlet. The procedure is performed under a short general or spinal anaesthetic. Between 2 and 5 millilitres of bulking agents are injected into the side of the urethra, just under the bladder using a special tube called a cystoscope. The procedure will take approximately 30 minutes. In the majority of cases, you will be able to go home on the same day as your procedure.
» Learn more about urethral bulking agents
Cystoscopy is a procedure that is used to look inside the urethra and urinary bladder. This procedure is minimally invasive and is used to monitor, diagnose and treat conditions that affect the bladder and urethra.
» Learn more about cytoscopies
In addition to surgical solutions there are also a variety of non-surgical options for women with urological conditions.
Pelvic Floor Physiotherapy
Specialized Physiotherapy is becoming more established in the treatment of Incontinence and Pelvic Pain, as a first line of defence
Pelvic Floor Dysfunction can be caused by:
- HYPOTONICITY (Weak pelvic floor muscles): contributing to stress incontinence, urge incontinence and pelvic organ prolapse. Incontinence is NOT a normal part of aging.
- HYPERTONICITY (Tight pelvic floor muscles): contributing to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatits.
Pelvic floor dysfunction is diagnosed by specially trained doctors and physiotherapists by using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. They will also assess your ability to contract and relax these muscles. Your bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since these joints can stress your pelvic floor muscles
» Learn more about pelvic floor physiotherapy
Continence Nurse Advisor
To address behavioural and conservative management strategies.
» Learn more about continence nurse advisors
Therapy for interstitial cystitis begins with extensive patient education regarding the chronic nature of the disease and realistic assessments of the condition, prognosis, and potential responses to therapy. Ongoing reassurance and physical and emotional support are important as the diagnostic evaluation progresses and therapies are applied.
» Learn more about intravesical therapy
Imaging (Diagnostic Centre)
Imaging tests include X-rays, ultrasounds, CT scans, and MRI. Our Diagnostic Centre is located in the same building. Your patient advisor will take care of sending the test requisition to our Diagnostic Centre. Following this, the Diagnostic Centre will contact you, schedule a time for your test and give you instructions if preparation is necessary.
» Learn more about diagnostic imaging