Gynecology

We use the latest technologies to bring you high-quality diagnostics and minimally invasive surgeries. Then we combine that with the expert and compassionate care from our providers and nurses for a friendly, supportive healthcare experience. Whether you just need a well-woman checkup or you’re struggling with something more serious like urinary incontinence, we’re here to help. No matter your age or health issue, we’ve got a team ready to assist.

Conditions We Treat

Gynecologic conditions can be a frustrating experience for anyone, which is why we at Central Maine Healthcare work hard to get you feeling healthy again quickly. Our gynecology specialists offer treatments for several issues, and we prioritize using less invasive treatments whenever possible. If necessary for full recovery, we offer surgical treatments that are based on the newest research evidence paired with the latest technology. We always offer techniques that are the most minimally invasive, which offer benefits such as less pain, fewer complications, and a quicker recovery time. We want to get you back on the road to health as quickly as possible with the highest level of satisfaction.

Endometriosis

At Central Maine Healthcare, we understand how frustrating it is to deal with the effects of endometriosis. Our caring gynecologists want to help you get back on the road to feeling healthy and pain-free once again. That’s why we offer the latest in diagnostic and surgical technology, as well as prioritize treatments that are minimally invasive. It’s our goal to do everything we can to ensure your endometriosis is significantly lessened so you can get back to living well.

If you’ve been having pelvic pain, you might be wondering if it’s endometriosis. This frustrating condition occurs when the tissue that typically grows on the inside of the uterus migrates to the outside of the uterus and grows there. The typical cycle for endometrial tissue follows the path of your menstrual cycle, expanding, contracting, then expelling tissue with your period. But when this happens on the exterior of your uterus, it’s not effective and can instead be very painful.

Diagnosing Endometriosis: Your gynecologist will decide what diagnostic tool is the best based on your symptoms. These techniques for diagnosing might include:

• Pelvic exam: A simple exam to see if the provider can feel the endometrial tissue growing outside of the uterus in the form of cysts or scar tissue and where it might be attached.
• Ultrasound: Either an external or internal ultrasound to create a visual of where the endometrial tissue might be in your pelvic cavity.
• Magnetic Resonance Imaging (MRI): An MRI will help get a clearer picture of how endometriosis is affecting you and how extensive it is.
• Laparoscopy: Typically done by a surgeon, a laparoscopy involves a tiny incision during general anesthesia. An instrument is inserted that allows the provider to see inside your abdomen. In some cases, the endometriosis can be surgically corrected that day.

Treatment for Endometriosis: At CMH, we want you to feel your best and achieve your fertility goals. Your provider will discuss the various treatment options with you and together, you’ll investigate the extent of your endometriosis and start with minimally invasive options to see how your body responds. In many cases, a combination of treatments will help achieve a pain-free experience and other fertility improvements. Treatments might include:

• Pain medication: Typically, this will include over-the-counter pain relief such as NSAIDS (Advil) or naproxen sodium (Aleve). If these don’t help, other options will be explored.
• Hormone therapy: This treatment varies and can include options such as taking birth control pills, progestin therapy, or treatments that block certain hormones.
• Surgery: For those wanting to conceive or reduce surgical effects, laparoscopy is a type of surgery that removes the endometrial tissue areas while keeping all reproductive organs intact. For severe cases, it might be necessary to remove some or all reproductive organs, though we only use this treatment in the rarest situations.
• Fertility treatments: If you are trying to conceive, it might be a good idea to also work with a fertility specialist that can help you achieve a pregnancy and carry it to full term. This treatment would be a great pairing with traditional gynecological care.

Fibroids

The diagnosis of fibroids can feel like a scary experience, which is why Central Maine Healthcare is committed to ensuring you’re supported throughout the entire process. Whether your provider discovered a fibroid during a routine pelvic exam or you’ve got many of the symptoms, we’ll help to get the right diagnosis and work with you to design the best treatment. We offer excellent care combined with the latest technology, ensuring that you’ll get the best results possible. Our gynecologists are highly skilled, compassionate caregivers that will guide you through the process and help you get back to healthy, pain-free living.

Fibroids 101: Fibroids are small to large non-cancerous tumors that grow in the tissue of the uterus. They can grow inside or outside the uterus, or in its walls. About 20-50% of women in the US have at least one, making them relatively common. Not every fibroid is diagnosed and sometimes they don’t cause problems. Only about a third of these fibroids are large enough that they are discovered.

Fibroids aren’t associated with a higher risk of uterine cancer. There is the very rare case in which they are cancerous. So, it’s a good idea to see a provider about yours to make sure you are cared for correctly. Researchers aren’t quite certain what causes fibroids but believe the high levels of estrogen are the reason they grow so quickly.

Risk and Protective Factors: Certain women are at higher risk for fibroids. Those entering or going through menopause have elevated levels of estrogen, which makes them more likely to get fibroids. Other risk factors include obesity. Giving birth to children seems to have a protective effect on women or at least is correlated to a decreased chance of fibroids. If you’ve got at least 2 children that you’ve given birth to, your risk for fibroids is cut in half.

Symptoms of Fibroids: Often, women with fibroids won’t have symptoms. Many others will have a variety of symptoms, with no two women having the exact same experience of how the fibroids make them feel. Some of the most commonly reported symptoms are:

Extra heavy periods Periods that last 7 or more days Unusual bleeding between periods Pain in your pelvis Needing to urinate often

Pain in your lower back Painful intercourse A mass that can be felt by your provider Anemia caused by the heavy bleeding

Diagnosis of Fibroids: Typically, women discover that they have a fibroid when they go for their routine health exam. A provider can feel the mass through the abdomen, which will require testing for a true diagnosis:

• X-ray: This will help to create an image of your pelvis to see if the fibroid is detectable.
• Transvaginal ultrasound: This ultrasound is done through the vagina and creates a more detailed picture of the fibroid inside the pelvis.
• Magnetic Resonance Imaging (MRI): For harder-to-see fibroids, an MRI can produce a finely detailed picture of the pelvic area, including details about the location and size.
• Hysterosalpingography: This is a special x-ray where we use dye to check for any blockages in your fallopian tubes.
• Hysteroscopy: An instrument is inserted into the vagina that allows the provider to look around in the uterus to visually check for fibroids.
• Endometrial biopsy: This test involves a sample of the lining of the uterus to test for abnormal cells that could indicate fibroids.
• Blood test: Your provider may request a blood sample to check for anemia, fibroids and whether you need help for your overall health.

Treatment of Fibroids: The great news is that many fibroids tend to stop growing and even shrink when a woman gets closer to menopause. So, sometimes you may not need to do anything about your fibroids if they aren’t causing you physical pain or any other issues. For those fibroids that are causing problems, there are a variety of possibilities for treatment:

• Pain medicine: Over-the-counter painkillers (Advil, Aleve) can provide significant relief, and if you need more pain relief your provider can help you find additional options.
• Surgery: For those who would like to conceive or prefer a more conservative surgical approach, your provider can carefully remove the fibroids from the uterus tissue. In cases where this isn’t enough, a hysterectomy might be the best course of action.
• Hormone-blocking therapy: Since certain hormones can encourage the fibroids to grow, this medicine helps to reduce those hormones and stop the fibroid in its tracks.
• Uterine artery embolization: This newer treatment option finds the arteries that are providing blood to the fibroid, then they block that artery, so the fibroid can’t receive nutrients or oxygen. This causes it to stop growing and even shrink.

Infertility

When you long to start a family, one of the hardest things to experience is infertility. CMH provides sensitive, compassionate care for those couples who are struggling to conceive. Whether you need help with conception or to ensure that the pregnancy goes to full term, our specialist providers are there to offer support and exceptional skills. We’ve got the best in fertility technology and have the most supportive care providers on our team. Our goal is to help you bring home a new bundle of joy, whether it’s your first or your fourth.

Infertility 101: Infertility is when a couple has unsuccessfully tried to conceive for 12 months or longer. If you’ve been trying to get pregnant and are starting to wonder if something is wrong, we’ll help you determine what the issue is and find the right treatment options.

Symptoms of Infertility: While the most obvious symptom is the inability to get pregnant, you can get checked long before you want to get pregnant. Other issues with women’s or men’s reproductive health can be signs of a problem that could cause infertility:

• Being 35 or older: As women age, their egg count decreases. There is also a higher chance of eggs being deformed or issues that could cause a problem with conception.
• Menstrual periods that aren’t regular: Regular cycles fall between 21 and 35 days apart. When a woman bleeds too often or not often enough, it could be a major sign that ovulation isn’t happening or isn’t happening at predictable times.
• Fibroids or polyps on the endometrium: The endometrium is the lining of the uterus where a fertilized egg attaches and grows. If fibroids or polyps are making the endometrium act unusual or dysfunctional, a fertilized egg can’t attach easily or at all.
• Issues with pelvic infections or STIs: Infections in the female reproductive organs can cause scarring to the fallopian tubes. This makes those tubes close, blocking the way for sperm to get to the eggs for fertilization.
• Semen abnormalities: If a male partner has had his semen checked or has had infertility issues in the past, ineffective or dysfunctional semen could be a cause of infertility.

Diagnosis of Infertility: Our providers will take a thorough medical history of you and your partner. This will help them understand your menstrual cycle, previous pregnancies, red flags for hormonal issues and any previous health problems that might impact fertility. They’ll also do a physical examination to see if there are any obvious physical clues. They might continue with other types of diagnosis and testing, if needed:

• Laboratory testing: Your provider might order blood tests that look at levels of certain hormones. Some hormones are critical for pregnancy or some could inhibit conception.
• Transvaginal ultrasound: This ultrasound picture is taken by way of the vagina, where it can capture a detailed view of what’s going on inside your uterus and fallopian tubes. This can help your provider determine if you might have cysts, fibroids, or polyps that could be causing problems or blocking critical areas for conception.
• Hysterosalpingogram (HSG): This is a special type of x-ray that can detect issues in the fallopian tubes and determine if they might be blocked.
• Semen analysis: Your provider can look for various issues with your partner’s semen to discover if that might be the cause of the infertility. This includes semen volume, the concentration of sperm to fluid, the sperms’ ability to move correctly, and if the shape and structure of the sperm looks healthy.

Treatment of Infertility: There are many ways we can help you overcome infertility. At CMH, we offer the best in fertility treatments and a supportive environment and team, partnering with local specialists to ensure you have a full range of options:

Medications to increase ovulation Intrauterine Insemination (IUI) In Vitro Fertilization (IVF)

Sperm, egg, or embryo donation support Surrogacy support Surgery to correct physical abnormalities

Menopause

Menopause is a natural part of aging for women and at CMH we want to support you through this process as best we can. While most women will naturally go through menopause at the biologically right time and without many issues, there are challenges that can pop up for some women. It can be helpful to have a provider who can help you get the diagnostic testing and treatments needed so you can always feel your best, no matter your age.

Menopause 101: Typically, you’re considered to be in menopause when you haven’t had a menstrual period in 12 months or longer. The process of your menstrual cycles ending is a natural part of life and usually occurs during your 40s or 50s. While it is a natural process, it can be uncomfortable for some women.

Symptoms of Menopause: The major sign that you are entering menopause is that your periods have become very irregular or have stopped completely. Other significant symptoms:

• Hot flashes and chills: Suddenly needing to put on a sweater and then a while later pulling it off because you’re very hot.
• Vaginal dryness: Especially if this is new, usually due to rapid changes in hormones.
• Thinning hair and dry skin: Losing hair in the shower or when brushing or having to apply far more lotion than typical.
• Weight gain: Suddenly exercise and healthy diet aren’t maintaining your typical weight.
• Loss of breast density: Change in breast tissue due to no longer needing to breastfeed.
• Night sweats: Feeling too hot in the night, regardless of room temperature.
• Sleep issues: Insomnia, being unable to fall back to sleep, or not sleeping soundly.
• Mood changes: Feeling happy at one moment and sad or upset at another.

Conditions that Can Accompany Menopause: The drastic changes in hormone balance and the aging process can contribute to other conditions. Always attend your regular wellness checkups and screening exams so that your provider can catch and treat an issue early:

• Osteoporosis: Women who have gone through menopause tend to lose bone density and are at risk for osteoporosis, it is a risk. If you develop this condition, your bones will be thin and brittle, making falls dangerous. Make sure to get screened regularly.
• Cardiovascular disease: After menopause, your estrogen decreases, causing your cardiovascular system to be more at risk of issues like heart disease. Make sure to eat healthy, exercise and check in with your provider if something is concerning.
• Urinary incontinence: With aging comes a loss of elasticity in your pelvic tissues. You might not be able to control your bladder as easily, and find that sneezing or jumping causes a strong urge to urinate. This can be strengthened through physical therapy, pelvic floor exercises and hormone solutions prescribed by your provider.
• Weight gain: Menopause is often a significant cause of weight gain, as your metabolism starts to slow down. Be sure to exercise, eat healthy, and talk with your provider about strategies that might help if you have concerns about weight gain.
• Sexual dysfunction: Vaginal dryness can make intercourse uncomfortable or painful. Decrease in certain hormones can also lead to a loss of libido. Talk with your provider if you experience these issues, as there are some remedies and treatments that can help.

Osteoporosis

Just because you’re aging doesn’t mean that your quality of life should decline. At Central Maine Healthcare, we want to help you stay active and healthy throughout your lifespan no matter your age. Osteoporosis is a condition that some people experience when they are 65 or older, and we offer a full range of treatments to help keep you strong.

Osteoporosis 101: While it seems like bone is totally solid, it is actually living tissue that is constantly broken down and then rebuilt back up again by your cells. As we age, this process slows down and for some people stops working correctly. Osteoporosis is when the bone isn’t built back up again. This makes bones weak and brittle, causing many symptoms, especially the heightened possibility for fractures to happen.

Risks for Osteoporosis: Since osteoporosis is all about how dense or thick your bones are, some people are more at risk than others. Women tend to get it more often than men, simply because their body frames are smaller and there is less bone tissue to work with. After menopause, hormone changes also cause bone breakdown at faster rates then pre-menopause, making women ages 65 and older more at risk. Smaller boned women, especially those who are white or Asian, tend to get osteoporosis at higher rates.

Symptoms of Osteoporosis: Osteoporosis starts long before you notice symptoms. The foundation for future osteoporosis depends significantly on lifestyle. As we age, bone density issues accelerate and become a real problem once we are over 65 years old.

• Height loss: Caused by a general loss of bone tissue, vertebrae compress causing a loss of inches.
• Stooped posture: Osteoporosis tends to affect the spine the most, causing a loss of structure and support. Those with osteoporosis can start to get a “hunched back” that causes them to stoop over while sitting and walking.
• Back pain: The loss of support in the spine and the stooped posture can contribute to back pain. It’s also possible to have a fractured vertebra caused by osteoporosis that could make the back hurt.
• Easy bone breakage: If a fall easily causes a bone to break or if an everyday task causes a bone fracture, it’s likely connected to osteoporosis.

Diagnosis and Treatment for Osteoporosis: We recommend women 65 years and up come for a bone density scan. This state-of-the art screening is painless and takes less than 15 minutes. The osteoporosis specialist will take low dose X-rays of the lower back and one hip. The scans will be reviewed and sent to your primary care provider who will discuss the findings and help you decide which treatment option is best. This may include medication and changes in diet and lifestyle. CMH has physical therapists who have specialized training in treating osteoporosis who help patients treat issues such as back pain and postural changes.

Prevention of Osteoporosis: While osteoporosis is related to old age, there are things you can do to reduce your risk significantly while you’re younger. Here are a few things to consider doing to keep your bones fit and healthy throughout your life.

• Exercise: Bone density is directly impacted by exercise, especially exercises that build muscle strength (weight training), high impact (walking, running and skiing), and encourage balance (such as yoga and tai chi).
• Reduce sedentarism: Sit less and move more. Exercise is important, and so is activity. Get out and do fun things you enjoy. Start hobbies that involve physical activity, such as hiking, walking outside or sports.
• Get enough calcium and vitamin D: Calcium and vitamin D are both very important nutrients for your bones. Not getting enough of these can be a big issue in osteoporosis.
• Eat enough protein: Protein is the building block of our bodies and our bones, so it’s important to always get enough through your diet.
• Check your medications: Some medications can cause a loss of bone density, so check with your provider to see what risks you might have.
• Ask about other medical conditions: Other types of medical conditions, such as cancer and celiac disease, are associated with an increased risk of osteoporosis. Check with your provider to see what your risk is and how you can reduce it.
• Reduce alcohol consumption and quit smoking: Excessive amounts of alcohol can impair bone regeneration, so make sure to drink moderately throughout your lifespan. Tobacco has also been associated with osteoporosis, so it’s a great idea to quit smoking if you can. Talk with your provider to get help setting yourself up for lifelong health.

Pelvic Pain

At CMH, our patients’ comfort and quality of life is our top priority. If you’re dealing with pelvic discomfort or pain, we’re here to help you find the cause and get the treatment that you need. Our board-certified providers use the latest medical technology and the most up-to-date research to assist women, so they can get back to a pain-free lifestyle.

Pelvic Pain 101: Pelvic pain can be acute or chronic. Acute pain is sudden (perhaps sharp) pain that won’t go away. If it’s more of a constant (maybe dull) pain that lasts for weeks, months, or even years, your pain would be considered chronic. The pelvis holds many organs connected to various organ systems. Your pain might be related to reproductive health, but it could also be connected to your digestive health or elimination system. It could also have something to do with your tendons or ligaments, or other types of issues.

If you have acute pain, make sure to get in to see a provider as soon as possible. If it’s a sharp pain or a sudden pain that really hurts, head to the emergency room to make sure it’s not something dangerous. For chronic pain, schedule an appointment with your provider so you can work together to find the source of the pain.

Types of Pelvic Pain: Pelvic pain can often be related to issues with the reproductive health system including the ovaries, uterus, and vagina.

Reproductive health causes could include:

Ectopic pregnancy Miscarriage Ovulation Menstrual cramps

Ovarian cysts Uterine cancer Cervical cancer Endometriosis

Fibroids Pelvic Inflammatory Disease (PID) Pelvic adhesions (scar tissue) Adenomyosis

Non-reproductive health causes could include:

Pelvis disorder Broken pelvis Fibromyalgia Nerve conditions Bladder disorder

Appendicitis Kidney infection Kidney stones Hernia

Inflammatory Bowel Disease Irritable Bowel Syndrome (IBS) Urinary Tract Infection (UTI) Sexually Transmitted Infections (STIs)

Diagnosis of Pelvic Pain: Your provider will do an initial consult with you to find out more about your symptoms. Some conditions will be simple to diagnose whereas others might take several tests. You’ll discuss your medical history and family history of certain health conditions. You might need to do blood or urine tests, or x-ray, ultrasound or MRI to get a visual of the inside of your pelvis. Once your symptoms and a screening reveal what is causing the pain, your provider will help you decide what treatment options are best.

Treatment of Pelvic Pain: Treatment for pelvic pain comes in all shapes and sizes, depending on what is causing your pain. You might take medicine, see a physical therapist, have diet or lifestyle changes or need surgery. Our providers offer supportive care and minimally invasive techniques to help you get back to feeling healthy and pain-free again.

Stress Urinary Incontinence

Another struggle that some patients have is stress urinary incontinence. We offer a supportive environment and the most effective methods of handling this kind of incontinence. We would love to meet with you to discuss your symptoms and discuss treatment options. Feel free to reach out to us if we can help you answer questions and give support.

What is SUI? Incontinence is a condition of involuntary urinary leakage. Stress Urinary Incontinence (SUI) occurs if there is pressure on the bladder because of physical movement such as coughing, laughing or sneezing. SUI is a common medical condition that an estimated one of three women experience. It is not the same condition as Overactive Bladder, also known as Urge Incontinence. With OAB, there is a sudden urge to urinate without movement.

What are the Symptoms of SUI? The main symptom of SUI is leaking urine. You may leak just a few drops, or you might leak more. There are varying degrees of SUI. In mild cases, leakage may occur when you are exercising or engaged in rigorous activities such as lifting an object. It may also occur after coughing, sneezing, or laughing. Women with more severe SUI may experience leakage with less intense physical movements, such as with standing or walking.

Who is Likely to Experience SUI? Women of any age may experience this condition, but it is more common among older women. Common risk factors are:

Obesity Smoking Chronic cough Pelvic surgery

Caucasian and Hispanic women Nerve injuries to the lower back Pregnancy and childbirth

Generally, anything that weakens the pelvic floor muscles can lead to SUI.

How Does SUI Impact My Life? Women with SUI may feel self-conscious, leading them to reduce social activities, physical activities or sex. If you’re avoiding activities that have been an important part of your life, it may be time to talk to your healthcare provider.
Helpful tip: Keep a diary noting when you experience SUI. This may give the provider clues on how to manage the condition.

How is SUI Treated? Your provider may be able to help you, or they may refer you to a urologist. Treatment options will vary for each person. For example, if you are overweight, your provider might recommend weight loss and smokers would be advised to quit smoking. Other treatment options include:

• Pelvic floor muscle training. Your healthcare provider can show you daily exercises to strengthen the muscles of the pelvic floor, which can help reduce SUI.
• Urinary control devices are another possibility. They help reduce pressure inside the pelvis. Your healthcare provider will explain the different options.
• Some women may opt to wear sanitary or incontinence pads. These are a simple solution that may not bother some women.

Is Surgery an Option? Surgery is an option. Procedures are available that can even be done as a same day procedure! Your provider will discuss surgical procedures with you at your appointment.

Are there Medications for SUI? Unfortunately, no. At this time, there are no medications approved for use for SUI. That is because the leakage is happening from the weakness in your pelvic structure.

Urinary Incontinence

At Central Maine Healthcare, we offer compassionate and skillful care for those suffering from bladder issues and urinary incontinence. This condition can be embarrassing and confusing, and we’re here to help guide you through diagnosis and treatment so you can get back to a carefree lifestyle. Our team of friendly providers and nurses are here to assist you with your every need.

Urinary Incontinence 101: Bladder control problems are more common among Americans than Alzheimer’s disease or osteoporosis, and women are twice as likely as men to experience this problem. Even though it’s a common complaint, many people are reluctant to seek help because of embarrassment, and they may also not know that effective treatment is available. As a result, people with bladder control problems may be afraid to socialize because they fear venturing too far from a bathroom. Others are forced to limit physical activities. People lose sleep or experience unpleasant, sometimes painful symptoms:

• Stress urinary incontinence: leakage of urine with exercise, laughter, sneezing, coughing
• Urgency/urge incontinence: hurrying to the bathroom after feeling the urge to urinate
• Chronic urinary tract infections
• Post-prostatectomy incontinence
• Urinary retention (the inability to urinate)
• Difficulty urinating
• Painful urination
• Frequent urination during the daytime (going more than seven times per day)
• Frequent nighttime urination
• The inability to start the stream of urination
• Straining to urinate

Women with and without urinary dysfunction may have pelvic anatomical problems:

• Cystocele: When the bladder drops into the vaginal canal
• Rectocele: When the rectum drops into the vaginal canal
• Enterocele: When the small bowel drops into the vaginal canal
• Uterine prolapse: When the uterus drops into the vaginal canal
• Vaginal vault prolapse: When the uterus has been removed and the cuff of the vagina drops into the vaginal canal

Diagnosing Urinary Incontinence: Our providers will work with you to identify symptoms, collect medical history, and provide screening tests:

• Exam: Physical and neurologic examination of the pelvic area
• Cystoscopy: Procedure performed by a urologist or urogynecologist, allowing the provider to look directly inside the urethra and bladder. This takes a few minutes and once complete, the provider will chat with you about results and offer recommendations.
• Urethroscopy: Looking inside the urine channel (urethra)
• Bladder scanning: Non-invasive and painless procedure measures post-urination residual (urine remaining in the bladder after urination). Patients with higher than normal post-urination residuals include females with pelvic organ prolapse, males with prostate enlargement and patients with urinary retention or overflow incontinence.
• Urodynamic testing: Series of tests that measure how the bladder fills and empties
• Bladder instillations: Used to help in diagnosing interstitial cystitis.

Treatment for Urinary Incontinence: You will work with your provider to design a treatment plan that will get you back to a healthy state and comfortable life:

Biofeedback Collagen injections Pubovaginal slings/TVT/TOT Neuromodulation

Physical therapy Pelvic reconstructive procedures to correct prolapse and other anatomical defects

We can teach self-straight catheterization, when needed. Occasionally, patients need to catheterize themselves regularly in order to urinate. Our nurses are available by appointment to provide step-by-step instruction, and have you demonstrate to ensure it is done correctly. You will get written instructions, and our nurses will check in on you within 48 hours to make sure you’re doing well and to answer questions.

Gynecologic Surgery

Sometimes when you have severe gynecological issues, it’s best to have a specific surgery to speed up your healing. CMH offers the latest procedures and an array of options for every gynecological issue. Our providers and nurses are ready to help you make the best choices for your body and life, and gently help you heal. Many of our procedures are available as a day-surgery option.

Gynecological Surgery 101: When you and your provider have worked to find the cause of your issue, and surgery is needed, you can rest easy knowing we offer a wide array of possibilities. We offer minimally invasive surgeries, which are typically quick, require short healing times and allow you to return to your life faster. Since every gynecological problem is different and everyone has a unique body, we customize our treatment plans and surgeries to your needs. Check with your provider for specifics about your upcoming surgery.

Types of Gynecological Surgeries We Offer: We want to help you feel better quickly and offer the best procedures with the best outcomes. Our providers and nurses are here for you!

Endometrial ablations Hysterectomies Laparoscopic tubal ligation Ovarian cyst removal

Uterine polyps and fibroids removal Incontinence minimally invasive surgery And more – chat with your provider for options!

Pelvic Floor Rehabilitation

CMH knows that one of the best ways to solve incontinence and prolapse is through pelvic floor rehabilitation. Our treatment team includes board-certified physical therapists who work to strengthen your pelvic floor muscles. You’ll be back to independence in no time!

Pelvic Floor Rehab 101: Pelvic Floor Rehabilitation is a treatment option for patients with urinary incontinence. This includes stress, urge or mixed incontinence, as well as prolapse. It can also help patients that are dealing with constipation or pelvic pain. The muscle groups in the pelvis can become stretched or weak from lack of use or experiences such as childbirth. This makes it hard to keep the pelvic organs in place and causes them to become out of balance. Through pelvic floor strengthening, you’ll learn to retrain these muscles, so they can do their job again. Your organs will function better as a result, including your bladder.

What Pelvic Floor Rehab Looks Like: A physical therapist will assess your unique needs, and you will be taught specific therapeutic exercises, including pelvic floor muscle strengthening. This will teach you correct muscle isolation and contraction. The program includes biofeedback and surface EMG to measure results. Once you have the exercises down, you can practice them at home for even better results. You’ll return to the rehab clinic every week for about six weeks to practice with your physical therapist and measure your results. We offer a flexible schedule of appointments to meet your needs.

Other Things to Know: In addition to the pelvic floor exercises, your provider and physical therapist will have you do a few more things to help speed up your healing:

• Keeping a bladder diary. This will help your provider understand what your bladder and pelvic floor are doing throughout the day, so they can adjust your treatment as needed.
• Following recommendations for your fluid intake. This will also help you reduce incontinence issues and potential embarrassment.
• Following recommendations for your diet. You’ll be advised on potential bladder irritants, so you can work to avoid them to improve your continence.

Urogynecology

When you have issues with your pelvic floor, you’ll have the option to schedule a visit with one of our friendly urogynecologists. These specialized providers focus on both gynecology and urology, which means they understand the female reproductive system and how it relates to issues such as incontinence and prolapse. We offer the best treatment options for our patients, so you can get the specialized care that you deserve.

Urogynecology 101: Urogynecology is a specialized type of gynecology. Providers train in obstetrics and gynecology, then they train further in urology, or the study of the urinary system. This combination focuses specifically on the issues that women often have when the pelvic floor isn’t functioning correctly. These problems typically lead to:

• Urinary incontinence: When a person can’t control their bladder easily.
• Fecal incontinence: When a person can’t maintain control of their bowels.
• Pelvic organ prolapse: When the bladder, vagina, uterus, or rectum “falls” from its proper place, causing it to malfunction and put pressure on other parts of the pelvis.

Symptoms of Pelvic Problems: You might have symptoms that you’d like to discuss with your provider. It’s a good idea to keep notes on the problems you’re facing, then bring that list to your provider appointment. Here are a few symptoms to keep an eye out for:

Difficulty urinating Pain in your lower back Irritable Bowel Syndrome (IBS) Difficulty having a bowel movement Sexual intercourse that is painful

Frequent and overwhelming urge to urinate Acute (painful/sharp) or chronic (long-term) pain in your pelvis Urge to have many bowel movements over a short period of time

How the Urogynecologist Can Help: The provider will ask about your and your family’s medical history. A physical exam will show if there are any obvious external signs of what is going on, and you might need to do blood or urine tests. After a diagnosis is made, your provider will help you craft a treatment plan that is right for you:

Diet and lifestyle changes Physical therapy Medication

Organ-supporting devices Minimally invasive surgery More complex surgery

Together you’ll find a path of healing, so you can feel great and get back to living an independent and carefree life once again.