Ramirez Urology

Female Urology

a mother and daughter sitting on a sofa

Urological pathologies in women

In women, the onset of urinary urinary incontinenceincontinence prolapse and urinary tract infections urinary incontinence, prolapse and urinary anatomical and functional reasons:

Among the most frequent are urinary incontinence and prolapse.

The increase in life expectancy has led to an increase in the number of patients suffering from this type of ailments that affect affect greatly affect their quality of life (reduction of physical activity, sexual activity, social relationships and psycho-emotional stress). The tendency to concealment of this problem makes it difficult to makes it difficult to quantify in terms of prevalence.

The treatment recommendation treatment knowledge of the causes and the results of the diagnostic tests performed, which must be individualized for each patient. individualized for each patient.

What is the pelvic floor?

The pelvic floor is an anatomical structure that closes the abdominal cavity in its lower part, providing support for the pelvic organs. support of the pelvic organs and actively participates in the mechanisms of urinary continence and the sexual function. Therefore, its deterioration can lead to urinary incontinence, pelvic organ hernias manifested by the appearance of a "bulge" in the genital area (prolapse) and sexual dysfunction.

These alterations occur more frequently after menopause and are related to obstetric and surgical history, hormonal status, lifestyle habits, physical exercise, obesity, etc.

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What is urinary incontinence?

Urinary incontinence (UI) is defined as the involuntary loss of urine. involuntary loss of urine that causes a hygienic and/or social problem, and that can be demonstrated objectively.

What types of urinary incontinence are there?

Diagnosis

For the diagnosis, it is essential to take a correct complete medical history The history should include the number of deliveries and their characteristics, cesarean sections, fetal weight, pelvic surgeries, age, hormonal status, lifestyle and physical exercise habits, obesity, etc.

A physical examination physical examination, which allows the assessment of the pelvic floor and evaluate the characteristics of incontinence.

Other complementary tests are:

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female urology

Treatment of urinary incontinence

In stress urinary STRESS URINARY INCONTINENCE may benefit from pelvic floor physiotherapychange of lifestyle habits and hormone therapy.

In the vast majority of cases, surgical treatment is required. There are a multitude of techniques abdominal Laparoscopic, robotics or vaginal. The choice of technique must be individualized according to each case and the surgeon's preferences and good results. Dr. Ramirez described the "Colpocervicourethropexy. Simplified retropubic technique" (Actas Urol. Esp., 15-2 (149-153). 1991) with more than 80% of good results ( Arch. Esp. of Urol. 50. 6 (649-654), 1997).

The URGENCY URINARY INCONTINENCE, once other causes such as urinary infection, cystitis, etc. have been ruled out, and after a urodynamic study has been performed, can be resolved with medical treatment (anticholinergic drugs, antimuscarinics, beta-3 adrenergic agonists). These drugs reduce or eliminate the involuntary contractions of the bladder muscle, acting favorably in cases of bladder hyperactivity or of mixed cause.

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What is pelvic organ prolapse (POP)?

A prolapse is the lowering of the pelvic organs as a consequence of the weakening of the pelvic floor. In most cases it is important to treat it because it can generate a multisystemic disease and cause among other things:

What types of pelvic organ prolapse are there?

There are different types of prolapse:

Treatment

Treatment may vary depending on the stage of the prolapse and may be based on conservative medical treatment or conservative medical treatment or surgical surgical treatment.

In most cases the correction of CISTOCELE and RECTOCELE is achieved with surgical techniques through the vaginal route by means of the implantation of meshes designed for this purpose, and in cases of severe prolapse, the fixation of the vaginal mesh. fixation of the vagina to the sacrum (colposacropexy) via laparoscopic robotic or open is of choice because of the good long-term results it offers.