Pelvic health conditions—which involve the muscles, ligaments, connective tissue and nerves that control the bladder, rectum, uterus and vagina—affect millions of women every year, causing chronic pain, menstrual and/or urinary irregularities, and often interfering with a woman's sexual life.

Many women with pelvic floor dysfunction report problems with bladder and bowel incontinence. In many cases, incontinence can be controlled without surgery. However, surgery or additional rehabilitation may be necessary to restore normal anatomy or mend weakened muscle or tissue.

Treating pelvic health conditions is often a complex, trial-and-error process, requiring a true partnership between a woman and her care providers. The A.C. Richardson Center for Pelvic Health at Piedmont Hospital was established to help women get answers from experts in this special area and find relief from pelvic health conditions.

Diagnosing Pelvic Disorders

Many women with pelvic floor dysfunction report problems with bladder and bowel functions. However, these indications are not always the culprit, so accurate diagnosis is essential.

Symptoms typically associated with pelvic floor dysfunction include incontinence, prolapse, difficulty urinating or moving bowels, pelvic (or bladder) discomfort or burning, frequent need to urinate and difficulty holding back a full bladder.

Typically, pelvic floor prolapse is diagnosed during a pelvic exam. By observing the position of the vaginal walls and cervix, the physician can identify areas of mild, moderate or severe weaknesses in support.

Among women with urinary symptoms, urodynamic studies may help clarify the cause of the symptoms and how they can be corrected. Tests used in urodynamic studies include:

• Cystometry–Evaluates how much fluid the bladder can hold and the strength of the bladder muscles
• Pressure flow study–Measures the pressure and flow of urine that comes out of the bladder during urination
• Urethral pressure profile–Measures the strength and integrity of the urethral sphincter
• Uroflowometry–Measures the flow rate of urination (the speed and amount that is released)

Tests to evaluate bowel incontinence include:

• Anal manometry–Evaluates sphincter function and the coordination with the rectal sensory mechanism
• Anal ultrasound–A method of direct evaluation of the sphincter to identify injury

Tests used to evaluate both bowel and urinary incontinence include:

• Electromyogram and pudendal testing–Measures the contractions of muscles that control urinary and bowel sphincters

A.C. Richardson Center for Comprehensive Pelvic Health

The A.C. Richardson Center for Comprehensive Pelvic Health was first in Atlanta to offer a multidisciplinary approach to evaluate and treat pelvic floor disorders. Specialists in gynecology, urology, colorectal surgery, radiology and physical therapy work together to help women improve and maintain their quality of life through individualized diagnosis and compassionate treatment for a full range of pelvic floor dysfunctions.

The A.C. Richardson Center is located on the Piedmont Hospital campus in the 77 Building. Services are available by physician referral. For more information, call 404-605-2590.

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