Pelvic Care

Comprehensive and compassionate care for pelvic floor conditions

women in a pool

Your pelvic health. Your quality of life.

Leaks? Discomfort? Pain?

Uncomfortable urinary and pelvic issues don’t stand a chance with help from our expert care teams and a variety of diagnostic services and treatment options.

Very Common. Very Treatable.

UW Medicine offers a range of non-surgical and surgical services to help you find relief from common issues affecting women.

When It's Complicated

Sometimes surgery is the best option to correct a pelvic disorder. Our specialists in urology, urogynecology, colorectal or pelvic reconstructive surgery will create a treatment plan tailored to your needs.

Some of our common services:


Your care is tailored to your needs with diagnostic testing that effectively evaluates and carefully assesses your medical issues:

  • Comprehensive pelvic exams
  • Cystoscopy
  • Bladder residual assessment
  • Multichannel urodynamics
  • Fluoroscopy and MRI defecography
  • Pelvic floor ultrasound
  • Anorectal manometry
  • Electromyographic pudendal nerve testing
  • Peripheral nerve evaluation for neuromodulation
  • Gastrointestinal motility and functional studies

 


The pelvic floor is a group of muscles and their surrounding tissue that forms a sling or hammock across the pelvis and holds the pelvic organs in place so that they can function correctly. A woman’s pelvic organs include the uterus, cervix, vagina, bladder, urethra, small intestine and rectum.

Do you experience urinary leaks with sneezing, laughing or physical activity, or have sudden urges to go but can’t hold it? You’re not alone. Urinary Incontinence in women is very common. In fact, close to 40 percent of women experience it. Take heart: There are lifestyle changes and medical treatments that can stop urinary incontinence.

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Women sometimes lack voluntary bladder control due to a nerve problem. The bladder muscles either become flaccid or "floppy," losing strength and unable to contract and empty; or they become spastic or "hyperactive," contracting automatically and causing accidental urination. This is called neurogenic bladder, and it can be managed.

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If you haven’t had a bowel movement in over three days or pass hard stool with difficulty or pain, consider yourself constipated. Don’t worry, though. It usually lasts a short time, and there are many things you can do to relieve and prevent constipation.

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Feeling the urge to have a bowel movement but being unable to control it can be nerve-wracking. Many who have fecal incontinence don’t tell their doctors because they’re ashamed or believe there’s no remedy. But millions of people have this problem, and there are many effective treatments for it.

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Feeling pressure or a sense of fullness in your pelvic area? Having urination or bowel movement problems? These are some common symptoms women experience with pelvic organ prolapse. That’s when pelvic organs drop from their normal position due to weakness of or damage to pelvic ligaments, connective tissue and muscles.

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Occurring in the lower abdomen area, pelvic pain usually stems from a minor gynecologic disorder related to the menstrual cycle. Sometimes a minor disorder can lead to inflammation and infection of the abdominal cavity, which can be serious. If you’re experiencing pelvic pain, meet with our care team.

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Many routine pelvic floor conditions can be resolved nonsurgically. Our comprehensive offering of nonsurgical treatments includes:

  • Bladder and bowel retraining
  • Physical therapy for the pelvis and pelvic floor
  • Rehabilitation and biofeedback
  • Percutaneous tibial nerve stimulation
  • Medications
  • Pessaries

 


Inform yourself to make the best choices for your health and care with UW Medicine patient education resources.

Get informed

One way to regain bladder control is with bladder retraining. This involves going to the bathroom at set times before getting the urge to urinate, then slowly increasing the time between set bathroom trips as you gain more and more control of your bladder.

Keeping a daily record of your fluid intake and urinary output can help you and your physician assess the frequency of your incontinent episodes and urinary urgency. It can also single out factors that contribute to your incontinence, such as specific types of beverages or physical triggers.

Certain foods and beverages can increase your frequency and urge to urinate by irritating your bladder. Irritation may also cause bladder spasms and lead to urine leakage. Try eliminating irritating foods or replacing them with alternatives. Once your health improves, reintroduce the culprits into your diet one at a time.

You can develop better bladder control and reduce or even stop urine leakage by strengthening your pelvic floor muscles. Kegel exercises target the muscles around the vagina, urethra and rectum, which are used to stop a stream of urine. You can do Kegels anytime while sitting, standing or lying down.


Pelvic floor muscles can sometimes become weak or overworked, resulting in urinary/bowel incontinence or chronic pelvic pain. It can affect men and women of all ages.

The specially trained physical therapists at UW Medicine recognize the emotional toll and limitations of pelvic pain and incontinence. We can address these conditions by helping patients strengthen pelvic floor muscles. We conduct sessions in a private environment where patients learn to regain muscular control, decrease pain and restore their active lifestyles.

Our pelvic floor services help patients with the following diagnoses, among others: levator ani syndrome, tension myalgia, proctalgia fugax, coccygodynia, dyspareunia, vaginismus/anismus, pudendal neuralgia, vulvodynia, vulvar vestibulitis, interstitial cystitis and urethral syndrome.

Treatment includes:

Evaluation and education about the pelvic floor muscles
Exercise recommendations for a home exercise plan
Manual therapy
State-of-the-art biofeedback electrical stimulation
Ultrasound
Recommendations for behavior modifications

A physician's referral is required.


Sometimes surgery is the best option to effectively treat a complicated pelvic floor disorder. Our comprehensive offering of surgical treatments includes:

  • Sling and suspension procedures for urinary and fecal incontinence
  • Urethral and anal sphincter bulking agents
  • Bladder Botox
  • Neuromodulation
  • Artificial urinary sphincter
  • Pelvic organ prolapse reconstruction (including minimally invasive, laparoscopic and robotic)
  • Diverticulectomy
  • Vesicovaginal and rectovaginal fistula repairs

 


Many women experience sexual dysfunction at some point in their lives. Problems with pain, desire, arousal or orgasm may have physical, psychological or pharmacological causes. If your problems last more than a few months or cause distress for you or your partner, come meet with our care team.

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