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Glossary of Terms

Adhesiolysis – Scar tissue can form as a result of prior surgery or infections involving reproductive tact, urinary tract or vaginal canal causing severe pain. Adhesiolysis is the surgical procedure used to remove this scar tissue.

Allodynia – Allodynia is a term to describe when pain from stimuli, which are not normally painful, will cause pain in the area stimulated. This often occurs in patient with chronic pelvic pain.

Anterior/Posterior Repair – Anterior repair is a vaginal procedure used to correct a cystocele by positioning the bladder into a more normal anatomic position. This surgical procedure is used to treat prolapse of the bladder (cystocele), urethra (urethrocele) or of both the bladder and urethra (cystourethrocele). Posterior repair is used to treat prolapse of the rectum (rectocele) and small bowel (enterocele). An anterior and posterior repair can be performed at the same time if needed.

Augmented Vaginal Reconstruction – When pelvic organ prolapse is severe or has failed a previous attempt at repair, the birth canal will be repaired or reconstructed using natural or synthetic materials to add to, or even replace the patient’s weakened tissues.

Bladder – A hollow muscular organ, which acts as a reservoir for urine.

Bladder Fistula Repair – A fistula is a small abnormal tract between organs that develops due to infection or injury. First the fistula must be located, then the fistula is removed and then the defect is repaired surgically.

Colpocleisis – Surgical obliteration or closure of the vagina for the treatment of pelvic organ prolapse (POP).

Colpopexy – The abdominal sacral colpopexy is a type of surgery that uses a synthetic mesh that supports the vagina by suturing the mesh to the sacrum.

Colporrhaphy – This is a surgery to repair a prolapse in the vaginal wall, such a cystocele, rectocele, or enterocele.

Constipation– The incomplete emptying, inability or straining to have a bowel movement. Constipation is typically associated with hard, infrequent stools.

Cystocele – A cystocele is a hernia that occurs in women when the wall between the vagina and bladder weakens, causing the bladder to prolapse or herniate into the vagina.

Cystoscopy – A physician uses a lighted scope to examine the inside of the bladder while at the same time filling the bladder with water. This procedure gives the physician the ability to visually detect any problems going on inside the bladder. Local anesthetic is used to minimize the discomfort, which is typically almost non-existent.

Dysuria – Pain with urination.

Electromyogram (EMG) – A test that evaluates nerve and muscle function of the pelvic floor. This test is often combined with either urodynamics (bladder function tests) or neurodiagnostics (sophisticated tests of nerve function).

Enterocele – Any prolapse or protrusion of the small intestine into a space between the rectum and vagina.

Fecal Incontinence – Accidental loss of stool, which is a common problem which occurs after a difficult vaginal delivery and also seen with aging.

Hormone Replacement Therapy – Hormones play an important role in bladder and bowel function, pelvic floor support and general well being. The use of hormone replacement therapy must be individualized.

Hysterectomy –Removal of the uterus, including cervix either vaginal, laparoscopically or abdominally. It may include salpingo/oophorectomy, which is removal of the tubes and ovaries at the same time as when the hysterectomy is performed if indicated.

InterStim – The implantable InterStim Therapy system uses mild electrical stimulation of the sacral nerves that influence the behavior of the bladder, urethral, anal sphincters, and pelvic floor muscles. In properly selected patients, InterStim Therapy can dramatically reduce or eliminate symptoms when other therapies have failed.

Interstitial Cystitis – Interstitial Cystitis, also called painful bladder syndrome, is a pain disorder that is typically associated with symptoms of suprapubic pain related to bladder filling and accompanied by symptoms of urinary frequency in the absence of infections. Pain symptoms can include pressure, discomfort and/or burning in the urethral of vaginal areas. There are many courses of this disorder and many therapies – often with remarkable improvement in symptoms.

Interstitial Cystitis Diet – This is a diet that is primarily a low acid diet. Acids are an irritant to the bladder causing flare ups in interstitial cystitis. Irritants include, but not limited to, soda, caffeinated products, citrus and carbonated drinks.

Intravesical Installation Therapy – Various medications (cocktails) are placed in the bladder with a catheter to heal the inflamed, painful bladder.

Kegel’s – Kegel’s are pelvic floor exercises used to treat urinary and fecal incontinence, as well as prevent pelvic organ prolapse.

Laparoscopic Surgery - The visual examination of the abdomen by means of a laparoscope. Often called "belly button surgery", endoscopy, or keyhole surgery, it is a surgical technique involving small incisions in the abdomen through which major surgical procedures can be performed.

Neuromodulation – Electrodes are used to stimulate the nerves that control the bladder. Mild impulses are what the patient feels.

Nocturia – Frequent urination during the night. More than twice a night is abnormal.

Osteoporosis – A reduction of bone strength related to age, lack of estrogen, genetics and various medical problems.

Overactive Bladder (OAB) – This is an increase in urinary frequency (more than eight times a day) with or without urge incontinence (leakage with an urge so strong you cannot make it to the bathroom in time). Behavior modification and medications treat this problem with a high degree of success.

Paravaginal repair – This surgery is used to prevent the hyper mobility of the bladder by restoring the bladder and the urethra to its normal anatomical position using its lateral attachments to the pelvic side walls – i.e. muscles.

Pelvic Floor Electrical Stimulation – Vaginal and/or anal probes that generate an electrical pulse to the pelvic floor that can be used to compliment other treatment therapies to treat urinary urge, stress and fecal incontinence.

Pelvic Floor Muscles – Are the muscles in the pelvic area that support, protect and help to hold the vagina, uterus, bladder, urethra and rectum in place and to function properly.

Pelvic Floor Rehabilitation – This is a non–surgical program that combines behavioral modification with pelvic floor exercises. The exercises are much more efficient than Kegel’s because it involves biofeedback and electrical stimulation.

Perineoplasty – A surgical procedure to reconstruct the perineal body (the tissue near the opening of the vagina). It can be tightened if vaginal caliber seems too large after vaginal births or can be reconstructed if weak or scarred from prior surgical procedures.

Periurethral injections – If the urethral sphincter is very weak and is not able to close the bladder enough to allow bladder control, then a paste–like material can be injected around the sphincter to “tighten” it. The material can be collagen, small carbon spheres or calcium.

Pessary – A plastic device worn in the vagina to support prolapses of the vagina, bladder, rectum and uterus in place. A pessary can also be used to improve leakage and/or bladder emptying.

Pelvic Organ Prolapse – When the bladder, uterus, vagina or rectum has fallen. Once the fallen organ protrudes past the opening, surgery or a pessary is typically needed.

Pudendal Nerve Block – The pudendal nerve can be the source of neuropathic pain (nerve pain). Blocking this nerve with Novocain and steroids can provide prolonged pain relief.

Rectal Fistula Repair – A fistula is a small abnormal tract between the vagina and the rectum. This often occurs as a result of a traumatic vaginal delivery or a pocket of infection. Surgical repair is typically needed, especially if the fistula is large.

Rectocele – Prolapse or bulging of the front wall of the rectum into the vagina. This often causes difficulty passing stool due to a pocket that the stool gets trapped in.

Retropubic urethropexy – A surgical procedure performed through an abdominal incision or laparoscopically to help support the bladder neck by placing sutures in the vagina to attach it to a ligament or the pubic bone.

Risk Factor - Something that may increase the chance of developing a disease. Some examples of risk factors for cancer include age, a family history of certain cancers, use of tobacco products, certain eating habits, obesity, lack of exercise, exposure to radiation or other cancer-causing agents, and certain genetic changes.

Sacrocolpopexy – This is an uncommon surgical procedure for repairing vaginal vault prolapse and restoring the length and shape of the vaginal canal. This is more likely to happen in women that have had a hysterectomy and is due to the uppermost part of the vaginal vault prolapsing downward. See colpopexy.

Stress Incontinence – The loss of urine when "stress" is applied to the bladder, which happens when coughing, sneezing, laughing or lifting.

Suburethral sling – A surgical procedure where is synthetic or natural material is used under the urethra to support it and prevent stress incontinence.

Suprapubic catheter – During surgery, a catheter placed into the bladder through the abdomen, which is used to drain the bladder. This is needed in the minority of surgeries.

Tension–free Vaginal Tape (TVT) or Tension - free Vaginal Tape - Obiturator (TVT-O) or Tension-free Vaginal Tape-Secure (TVT-S) - A synthetic material is used during a surgical procedure where a sling is formed to support to the mid–urethra to help control stress incontinence. The difference between these three is whether the small incisions are made in the groin or abdominal area or just in the vagina.

Ureters – Are the tubes leading from kidneys, to the bladder.

Urethra – This is a single tube that carries urine from the bladder out of the body. The sphincter that is involved in bladder control surrounds the mid portion of the urethra.

Urethral Diverticulum – This is an abnormal sac - like pocket that develops off the urethral and is associated with infections and urethral pain.

Urgency/Frequency Incontinence – See overactive bladder.

Urinalysis – A test performed in the office to check the chemicals and cells in urine. Typically used to rapidly diagnose a bladder infection and determine if blood is present in the urine.

Urinary Incontinence – Is the inability to control the bladder. It is common to a very slight degree in many patient’s, but is considered a significant problem when it limits your life or requires pads or change of clothes or underwear on a frequent basis.

Urinary Retention – This is when the bladder is unable to empty itself to a point that there is over 100 cc’s (3.5 ounces) of urine left over in the bladder after urinating. Symptoms include a slow, intermittent stream and at times bladder infections.

Urine culture – Urine is collected and sent to a lab to determine whether a urinary tract infection is present. It is considered the “gold standard” in diagnosing a bladder infection.

Urodynamics – A test that uses a small catheter inserted in the bladder to fill the bladder with water to study the function of the bladder and urethra during filling and urinating. This tells us about the bladder as well as pelvic floor muscle functions.

Uterine Ablations – A simple outpatient procedure that burns the lining of the uterus away to stop or control problems with heavy periods.

Uterine Prolapse – Prolapse of the uterus into the vagina.

Vaginitis – Various infections or inflammation of the vagina that can result in abnormal vaginal discharges, odor or symptoms of itching or burning.

Voiding – The elimination of urine out of the body.

Vulvar Pain – This term is used to describe pain in the area of the vaginal opening. This pain may include burning, itching, redness or cramping and/or pressure.

Vulvodynia – This is a pain syndrome that involves vaginal or vulvar pain. This pain may occur just with sex or it can become nearly continuous, that is unprovoked by sex, tampons or direct pressure.

 

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