Female Pelvic Health (HERology™)
Dr. Byers has coined the term “HERology” to describe the urologic conditions that mainly affect women. It is a common misconception that urologists see mostly male patients, but as you know, women pee too! “HERologic” conditions are generally not life-threatening but can severely affect a woman’s quality of life.
- Recurrent urinary tract infections (UTIs)
- Overactive bladder
- Bladder pain
- Vaginal prolapse
Urinary tract (Bladder) infections
This condition is far and away the most common condition we see in “ HER ology.” Literally millions of UTIs are treated each year in the U.S., and the great majority occur in women. This can be a very frustrating condition to treat because UTIs tend to recur after treatment. For more information on UTIs, see our UTI PREVENTION handout.
Bladder pain and Interstitial Cystitis
This is a spectrum of conditions that is defined primarily by bladder symptoms like pain, urgency, frequency and burning in the absence of infection. It frequently follows a UTI but can also occur for no apparent reason. It is caused by a disruption in the protective lining of the bladder and is aggravated by dietary factors, stress, and sex. The good news is treatment is simple and effective. For more information about bladder pain see our Bladder Pain Treatment Plan.
Overactive bladder is a relatively new term that describes frequent urination, urgent need to void when the sensation strikes, and voiding too often at night. Treatment options have increased over the past few decades which is very good news since this is an incredibly common condition affecting millions. For more information see our OAB page.
Urinary incontinence occurs for several different reasons. Two of the most commonly seen in HERology are urge incontinence and stress incontinence. Urge incontinence is a severe form of overactive bladder and is treated with many of the same modalities. Stress incontinence occurs when the urethral support mechanism weakens. Treatment is aimed at improving urethral support by increasing muscle tone through pelvic floor exercises ( “Kegels” ), thickening the urethral support in the vaginal wall with estrogen creams and laser therapy ( FemTouch ), thickening the urethral walls with injections ( Macroplastique ), and supporting the urethra with midurethral slings. Dr. Byers has extensive experience with all of these techniques and enjoys the art and science of tailoring treatment plans for each patient.
Prolapse of the vaginal walls is a very common condition affecting women. It occurs when ligaments and other supportive structures in the pelvis weaken, causing the vaginal walls to bulge down into the pelvic floor. Symptoms may include vaginal pressure, feeling a bulge in the vaginal area, and difficulty urinating. Treatment of mild prolapse with pelvic floor exercises is often effective, whereas more severe cases may require a pessary or surgical repair. Results of prolapse surgery have improved dramatically over the past few decades and recurrence, while still possible, is less likely. Dr. Byers has extensive experience with prolapse repairs using natural tissue such as Xenform, as well as with mesh repairs for more severe cases.