Central Maine Healthcare

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Gynecology

Central Maine Healthcare is dedicated to bringing you the best in gynecological care, right in the convenience of your own community. Whether you choose to work with our Lewiston team at Central Maine Medical Center, our team at Rumford Hospital, or our team at Bridgton Hospital, you’ll be in the best hands.

Central Maine Healthcare is dedicated to bringing you the best in gynecological care, right in the convenience of your own community. Whether you choose to work with our Lewiston team at Central Maine Medical Center, our team at Rumford Hospital, or our team at Bridgton Hospital, you’ll be in the best hands.

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 doctors 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.

Conditions and Treatments

To better understand the conditions we treat, here is some information on a few of our specialties.

  • Endometriosis: We can help determine the extent of your endometriosis with diagnostic technology, then help you decide which treatment is best for you starting with the least invasive options. Together we’ll find the right combination of approaches to get you back to feeling pain-free and healthy once again.
  • Fibroids: If your doctor discovers a fibroid during a pelvic exam or you have symptoms associated with fibroids, we can work with you to reduce the size of the fibroids and help you feel better again. We offer several options for reducing or removing fibroids, as well as pain management and therapies to help with your symptoms.
  • Infertility: We offer sensitive and support care for individuals and couples who are experiencing the struggles of infertility. Our doctors are highly qualified fertility specialists who can help diagnose the cause of infertility and offer treatment options to help you start a family.
  • Gynecologic Cancers: We offer diagnoses and treatment for all types of gynecologic cancers, including cervical, uterine, and ovarian cancers. Our care is compassionate, supportive, and includes the latest technology and treatment options. We’ll be there for you every step of the way.
  • Menopause: This natural process of aging can bring with it a few challenging experiences. Our doctors can help you get through menopause in the smoothest way possible, while ensuring that you avoid certain conditions, so you can maintain your quality of life no matter your age.
  • Osteoporosis: Aging women sometimes get weaker and more brittle bones, leading to loss of mobility and increased discomfort. We offer high-quality screening services to help make sure your bones are plenty strong, as well as the latest in treatment options including preventative support.
  • Pelvic Pain: This uncomfortable issue can be caused by different problems in the pelvic area. Our doctors will listen to your concerns, do some screenings or run some tests, and then help you choose the best treatment option for you. We offer support and treatments for various causes of pelvic pain, featuring the latest in technology and evidence-based care.
  • Urinary Incontinence: This very common condition is effectively treated at Central Maine Healthcare using a full range of techniques, including rehabilitation to strengthen pelvic muscles. We also offer other treatment options to ensure that whatever is causing your problem can be fully addressed.

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.

Endometriosis 101

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

When you come in for your appointment, your gynecologist will decide what diagnostic tool is the best depending on the description of your symptoms. These techniques for diagnosing might include one or more of the following:

  • Pelvic exam: A simple exam to see if the doctor 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): Creating a more detailed visual of what’s going on internally with 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 done during general anesthesia, after which an instrument is inserted that allows the physician to see inside your abdomen. In some cases, the endometriosis can be surgically corrected in the same appointment.

Treatment for Endometriosis

At Central Maine Healthcare, we want you to feel your best and achieve your fertility goals. Your doctor will discuss the various treatment options with you and whether you would like to get pregnant. Together, you’ll investigate the extent of your endometriosis and then start with minimally invasive options to see how your body responds. In many cases, a combination of treatments will help you achieve the pain-free experience that you hope for and any other fertility expectations.

Treatments might include:

  • Pain medication: Typically, this will include over-the-counter pain relief such as NSAIDS (Advil) or naproxen sodium (Aleve). If these medicines don’t help with the pain, 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 to 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 doctor 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

If you’re not sure what fibroids are, you’re not alone. Fibroids are small to large non-cancerous tumors that grow in the tissue of the uterus. They can grow in the walls of the uterus, on the inside of the uterus, and even on the outside. About 20-50% of women in the US have at least one fibroid, making them a relatively common condition. Not every fibroid is diagnosed and sometimes they don’t cause problems. Only about a third of these fibroids are big enough that they’re found by a doctor during an exam.

You might breathe a little easier to learn that fibroids aren’t associated with a higher risk of uterine cancer. Though they aren’t cancerous most of the time, there is the very rare case in which they are cancerous. So, it’s a good idea to see a doctor about yours to make sure you’re cared for correctly. Researchers aren’t quite certain what causes fibroids but are pretty sure that the high levels of estrogen in the uterus is the reason they can grow so quickly and get so large.

Risk and Protective Factors

Certain women are at higher risk for fibroids. Those entering or already 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 any 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. Here are a few of the most commonly reported symptoms, however.

Common symptoms of fibroids:

  • Extra heavy periods or periods that go on for 7 or more days
  • Strange bleeding in between your periods
  • Pain in your pelvis
  • Needing to urinate often
  • Pain in your lower back
  • Painful intercourse
  • A mass that can be felt by your doctor
  • Anemia, caused by the heavy bleeding

Diagnosis of Fibroids

Typically, women discover that they’ve got a fibroid when they go in for their routine health exam. A doctor can feel the solid mass through the abdomen, which then will require more testing for a true diagnosis. After discovering the lump, your doctor will offer other kinds of diagnostic methods including:

  • 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 fibroid’s location and mass 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 physician 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 doctor will possibly take a blood sample to check you for anemia, which will help to test for fibroids as well as determine whether you will need to get help for your overall health, as well.

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 at all 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.

Treatment options include:

  • Pain medicine: Over-the-counter painkillers (Advil, Aleve) can provide significant relief, and if you need more pain relief your doctor can help you find additional options.
  • Surgery: For those who would like to conceive or who prefer a more conservative surgical approach, your doctor 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. Central Maine Healthcare 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 physicians 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

The standard definition of infertility is when a couple has been unsuccessfully trying 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 for your situation.

Symptoms of Infertility

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

These symptoms include:

  • Being 35 or older: As women age, their egg count decreases. There is also a higher chance of eggs being deformed or having 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 during pregnancy. If there are fibroids or polyps making the endometrium act unusual or dysfunctional, then 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, for any reason, the 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 doctors will first take a thorough medical history of both you and your partner. This will help them understand your menstrual cycle, any 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.

Then they might continue with other types of diagnosis and testing, if needed.

These tests might include:

  • Laboratory testing: Your doctor might order blood tests that look specifically at your levels of certain hormones. These hormones are critical for pregnancy or they 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 doctor 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 doctor can look for various issues with your partner’s semen to discover if that might be the cause of the infertility. Factors looked for include 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, so you can start or grow your family in the way that you desire. At Central Maine Healthcare, we offer the best in fertility treatments and a supportive environment and team, including partnering with local specialists to ensure you have a full range of options.

Specifically, we offer the following treatment options for infertility:

  • Medications to increase ovulation
  • Intrauterine Insemination (IUI)
  • In Vitro Fertilization (IVF)
  • Sperm, egg, or embryo donation process support
  • Surrogacy support
  • Surgery to correct physical abnormalities

Menopause

Menopause is a natural part of aging for women and at Central Maine Healthcare 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 doctor 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 as their hormones drastically change giving them symptoms they don’t enjoy.

Symptoms of Menopause

The major sign that you’re entering menopause is that your periods have become very irregular or have stopped completely. Other significant symptoms include:

  • 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 you haven’t had this before. Usually caused by the rapid changes in hormones.
  • Thinning hair and dry skin: Losing hair in the shower or when brushing, as well as having to apply far more lotion than typical.
  • Weight gain: Suddenly all your exercise and healthy eating isn’t maintaining your typical weight.
  • Loss of breast density: Changing breast tissue due to no longer having a biological need to breastfeed.
  • Night sweats: Feeling much too hot in the night, no matter what the temperature is in the room.
  • Sleep issues: Insomnia, being unable to fall back to sleep, or just plain not being able to sleep soundly all night long.
  • Mood changes: Feeling happy at one moment and then sad or upset at another.

Conditions that Can Accompany Menopause

While menopause itself can be a struggle, it’s often the conditions that come later that can be more of a worry. The drastic changes in hormone balance along with the aging process can contribute to these conditions. Always attend your regular wellness checkups and screening exams so that your doctor can catch and treat an issue early.

Here are some other conditions that can accompany menopause:

  • Osteoporosis: Women who have gone through menopause tend to lose bone density. While this isn’t a guarantee that you’ll develop 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 by your doctor.
  • Cardiovascular disease: Estrogen helped to protect your heart while you were young. After menopause, your levels of estrogen will decrease a lot which means your cardiovascular system is more at risk of issues like heart disease. Make sure to eat healthy, exercise, and check in with your doctor 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 or might find that sneezing or jumping causes a strong urge to urinate. This condition can be strengthened through physical therapy, pelvic floor exercises, and hormone solutions prescribed by your doctor.
  • Weight gain: Menopause is often a significant cause of weight gain in women, as their metabolism starts to slow down. Be sure to get plenty of exercise, eat healthy, and keep your weight as balanced as possible. If you have concerns about weight gain, be sure to talk with your doctor about strategies that might help.
  • Sexual dysfunction: Vaginal dryness can make intercourse uncomfortable and even painful. Decrease in certain hormones can also lead to a loss of libido. Talk with your doctor 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 and 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’s actually living tissue that is constantly broken down and then rebuilt back up again by your cells. As we age, though, this process slows down and for some people even stops working correctly. Osteoporosis is when bone tissue is broken down by your cells, but then the bone isn’t built back up again. This makes bones weak and brittle, causing many types of 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 for osteoporosis than others. Women in general 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 with a white or Asian racial background, also tend to get osteoporosis at higher rates.

Symptoms of Osteoporosis

Osteoporosis starts long before you notice the symptoms. The foundation for future osteoporosis problems starts in our younger years and depends a lot on our lifestyles. As we age, bone density issues accelerate and become a real problem once we are over 65 years old.

Once osteoporosis sets in, here are many of the symptoms that might show up:

  • 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 that women who are 65 years and older come in for a bone density scan. This state-of-the art screening is painless and takes less than 15 minutes to complete. The osteoporosis specialist will take low dose X-rays of the lower back and one hip. The scans will then be reviewed and sent to your primary doctor. Your doctor will then discuss the findings with you and help you decide which treatment option works best for you.

Treatment may include medications and changes in diet and lifestyle. Central Maine Healthcare has physical therapists who have specialized training in treating osteoporosis. They help patients in treating 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 whole life.

  • Exercise: Your bone density is directly impacted by how much exercise you get over your lifetime. The best kinds of exercises are the ones that build up your muscle strength (weight training), that are high impact (such as walking, running, and skiing), and that encourage balance (such as yoga and tai chi).
  • Reduce sedentarism: Sit less and move more. Exercise is important, but 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 either 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 doctor to see what risks you might have.
  • Ask about other medical conditions: Other types of medical conditions, such as cancer and celiac disease, is associated with an increased risk of osteoporosis. Check with your doctor 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 doctor about these issues to get help in setting yourself up for lifelong health.

Pelvic Pain

At Central Maine Healthcare, 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 physicians 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 either acute or chronic. If you have a sudden (perhaps sharp) pain that won’t go away, you have acute pain. If it’s more of a constant (maybe dull) pain that lasts for weeks, months, or even years, your pain would be considered chronic.

It’s important to know that the pelvis holds many kinds of organs that are connected to various organ systems. Your pelvic 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 doctor 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, make sure to schedule an appointment with your doctor so you can work together to find the source of the pain.

Types of Pelvic Pain

In women, pelvic pain can often be related to issues with the reproductive health system including the ovaries, uterus, and vagina.

Types of issues that could be causing reproductive-related pelvic pain include:

  • Ectopic pregnancy
  • Miscarriage
  • Ovulation
  • Menstrual cramps
  • Ovarian cysts
  • Uterine cancer
  • Cervical cancer
  • Endometriosis
  • Fibroids
  • Pelvic Inflammatory Disease (PID)
  • Pelvic adhesions (scar tissue)
  • Adenomyosis

As mentioned above, there are other kinds of conditions that could be causing your pelvic pain that are not related to your reproductive organs.

Non-reproductive health causes could include:

  • Irritable Bowel Syndrome (IBS)
  • Inflammatory Bowel Disease
  • Fibromyalgia
  • Nerve conditions
  • Bladder disorder
  • Kidney infection
  • Kidney stones
  • Hernia
  • Sexually Transmitted Infections (STIs)
  • Appendicitis
  • Pelvis disorder
  • Broken pelvis
  • Urinary Tract Infection (UTI)

Diagnosis of Pelvic Pain

Your doctor will have an initial consultation 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. Then you might need to do blood or urine tests. Your doctor might also schedule an x-ray, an 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 doctor will help you decide what treatment options are best for you.

Treatment of Pelvic Pain

Treatment for pelvic pain comes in all shapes and sizes, depending on what is causing your pain. You might take prescribed medicine, see a physical therapist, have diet or lifestyle changes to make, or need surgery. At Central Maine Healthcare, our healthcare providers offer the most 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 dealing with stress urinary incontinence. At Central Maine Healthcare, 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 talk about treatment options.

Interested in learning more about what Stress Urinary Incontinence (SUI) is? We’ve put together a few questions we get most frequently with answers to help you understand what you’re up against. Feel free to reach out to us at any time if we can help you answer questions and to get 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 will experience in their lifetime. It is not the same condition as Overactive Bladder, also known as Urge Incontinence. With OAB, there is a sudden urge to urinate without any necessary 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.

Here are some common risk factors:

  • Caucasian and Hispanic women have higher risks
  • Obesity
  • Smoking
  • Chronic cough
  • Pregnancy and childbirth, which may affect the pelvic floor muscles, resulting in leakage
  • Nerve injuries to the lower back
  • Pelvic surgery

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 their activities. This may include social activities and physical activities, as well as avoiding sex. If you realize you’re avoiding activities that have been an important part of your life because of SUI, it may be time to talk to your healthcare provider.

Helpful tip: Keep a diary noting when you experience SUI and bring it to your doctor’s visit. This may give the doctor more clues to help determine how to manage the condition.

How is SUI Treated?

Your doctor may be able to help you, or they may refer you to a urologist.

Treatment options will be different for each person. For example, if you are overweight, your doctor 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 doctor 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 doctors 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. Urinary incontinence conditions cause quality-of-life issues. 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.

Common urinary complaints include:

  • Leakage of urine with exercise, laughter, sneezing, coughing, etc. This is known as stress urinary incontinence.
  • The need to hurry to the bathroom after feeling the urge to urinate. This is called urgency/urge incontinence.
  • 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 also have a variety of pelvic anatomical problems.

These issues can include:

  • 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 physicians will work with you to identify symptoms, collect medical history, and provide screening tests.

These diagnostic tests might include:

  • Exam: Physical and neurologic examination of the pelvic area.
  • Cystoscopy: A cystoscopy is a procedure performed by a urologist or urogynecologist. It allows the doctor to look directly inside the urethra and bladder. The procedure takes just a few minutes and once the procedure is complete, the doctor will chat with you about the results and offer recommendations.
  • Urethroscopy: Looking inside the urine channel (urethra).
  • Bladder scanning: This is a non-invasive and painless procedure that measures post-urination residual, which is the amount of urine that remains in the bladder after urination. Patients who may have higher than normal post-urination residuals include females with pelvic organ prolapse, males with prostate enlargement, and patients experiencing urinary retention or overflow incontinence.
  • Urodynamic testing: This is a series of tests that measure the function of the bladder, specifically how it fills and empties. The test helps the urologist diagnose and treat bladder problems.
  • Bladder instillations: Used to help in diagnosing interstitial cystitis.

Treatment for Urinary Incontinence

After you and your doctor have gotten to the root of the problem, you’ll work together to design a treatment plan that will get you back to a healthy state and comfortable life.

Our treatment options include:

  • Biofeedback
  • Collagen injections
  • Pubovaginal slings/TVT/TOT
  • Neuromodulation
  • Physical therapy
  • Pelvic reconstructive procedures to correct prolapse and other anatomical defects

We also offer to teach some of our patients self-straight catheterization, when needed. Occasionally, patients need to catheterize themselves on a regular schedule to be able to urinate. Our nurses are available by appointment to provide one-on-one self-straight catheterization instruction to patients. They will show you step-by-step how to perform self-straight catheterization, then have you demonstrate to ensure it is done correctly. You’ll get written instructions to take home in case you need any reminders. Our nurses will also 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 enough gynecological issues, it’s best to have a specific surgery done to speed up your healing. Central Maine Healthcare offers the latest procedures and an array of options for every gynecological issue. Our physicians and nurses are ready to help you make the best choices for your body and life, as well as gently help you heal. Many of our procedures are available as a day-surgery option.

Gynecological Surgery 101

When your doctor and you have been working together to find the cause of your issue and it becomes clear that surgery is the best option, you can rest easy knowing that we offer a wide array of possibilities. We focus on offering minimally invasive surgeries, which are a type of surgical technique that only does the absolute necessary to help your body.

Many times, these surgeries are quick, require short times for healing, and allow you to get back to your life very soon again. 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 doctor to find out specifics about your upcoming surgery.

Types of Gynecological Surgeries We Offer

We want to help you feel better quickly. That’s why we offer the best procedures with the best outcomes. Our physicians and nurses are here for you!

The gynecological procedures we offer include:

  • Endometrial ablations
  • Hysterectomies
  • Laparoscopic tubal ligation
  • Ovarian cyst removal
  • Removal of uterine polyps and fibroids
  • Minimally invasive surgical treatment of incontinence
  • And more – just chat with your doctor about options!

Pelvic Floor Rehabilitation

Central Maine Healthcare knows that one of the best ways to solve incontinence and prolapse is through pelvic floor rehabilitation. That’s why we offer rehab services so that our patients can get the help they need and get back to feeling well and strong again. Our treatment team includes board-certified physical therapists who will work with you 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 too 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

The program includes an assessment by a physical therapist to assess your unique needs. You’ll then be taught specific therapeutic exercises, which will include learning how to strengthen pelvic floor muscles. These lessons will teach you correct muscle isolation and contraction. The program includes biofeedback and surface EMG to measure results, so you can fine tune your training.

Once you’ve got 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 doctor and physical therapist will have you do a few more things to help speed up your healing.

These extra steps include:

  • Keeping a bladder diary. This will help your doctor 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’ve got issues with your pelvic floor, you’ll have the option to schedule a visit with one of our friendly urogynecologists. These specialized doctors 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 super specialized type of gynecology. Doctors first train as obstetricians and gynecologists, then they do further training 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, which causes it to malfunction and put pressure on other parts of the pelvis.

Symptoms of Pelvic Problems

If you’re wondering if you have any pelvic issues, you might have a symptom or two that you’d like to discuss with your doctor. It’s always a good idea to keep notes on the different problems you’re facing, then bring that list with you to your doctor’s appointment.

Here are a few symptoms to keep an eye out for:

  • Frequent and overwhelming urge to urinate, even if you’ve just recently gone
  • Difficulty urinating
  • Any acute (painful/sharp) or chronic (long-term) pain in your pelvis
  • Pain in your lower back
  • Irritable Bowel Syndrome (IBS)
  • Feeling the need to have many bowel movements over a short period of time
  • Difficulty having a bowel movement
  • Sexual intercourse that is painful

How the Urogynecologist Can Help

At your first appointment, the doctor will ask about your personal medical history and your family’s medical history. Then you’ll have a physical exam to see if there are any obvious external signs of what exactly is going on. You might need to have some blood or urine tests done. After a diagnosis is made, your doctor will help you craft a treatment plan that works for your issue and your own preferences.

This treatment plan might include:

  • Diet and lifestyle changes
  • Working with a physical therapist
  • Taking medication
  • Using 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.