Dr Dharamveer Singh

MS, MCh Consultant Urologist

Urogynaecology

At Ajanta Hospital we are having expert urogynecologist physicians who are specifically trained in urology, gynecology and obstetrics who focuses on the evaluation and treatment of non-cancerous conditions concerning the female pelvic organs and their supporting muscles and tissues, as well as pelvic reconstructive surgery.

What medical conditions do urogynecologists treat?

Urogynecologists treat urinary incontinence, fecal incontinence and pelvic floor disorders such as pelvic organ prolapse. Approximately one in three women will experience one of these conditions. Urinary and fecal incontinences involve a lack of control over those functions. The pelvic floor is the system of muscles, ligaments and tissues that support the bladder, urethra, uterus, vagina, small bowel and rectum in the pelvic area. Pelvic floor disorders are conditions involving a weakening of support for those organs, often leading to prolapse. There are various medical conditions that can lead a women to urogynecological conditions:

Stress Incontinence

This may be caused by being overweight, or can appear after menopause, pregnancy or childbirth. You may be able to improve symptoms through weight loss, diet, stopping smoking and regular pelvic floor exercises. Treatments and management If you are referred to the continence clinic, we will discuss your symptoms and lifestyle, then you will be examined and may be referred for physiotherapy. If after three months symptoms have not improved you will be referred for urodynamic or bladder testing. We will investigate your bladder's ability to hold urine and empty it in a normal fashion and helps us decide which treatment will be most appropriate for you.
If lifestyle changes, pelvic floor exercises and physiotherapy have not worked, we may recommend surgery to stabilise the urethra and reduce leakage.

Urgency/Overactive Bladder

The bladder holds 400 - 500mls of urine. An urge to pass urine is often felt when the bladder is half full in order to give you time to reach the toilet. Sometimes this message or urge may become blurred and your bladder will contract, wanting to empty without warning, leaving little time to reach the toilet. Treatments and management

Deferment techniques - helping your bladder to hang on. You can contract your pelvic floor muscles to help calm your bladder when the feeling of urgency develops.
Bladder retraining - This is the process whereby you retrain your bladder to hold a greater quantity of urine and should result in decreasing the frequency of urination. Try and avoid ‘just in case’ visits to the toilet.
Fluid management – you are encouraged to drink 8-10 mugs a day to maintain tissue health and to keep your kidneys filtering. If you are tempted to cut down on your fluids to reduce frequency, then your urine will become more concentrated which will also irritate the bladder. Caffeine may be an irritant to your bladder, so it is a good idea to gradually reduce your intake of tea, coffee, high-energy drinks, and fizzy drinks.
Your GP may prescribe medication – If you are referred to the continence clinic, we will discuss your symptoms and lifestyle, then you will be examined and medications may be changed. If this doesn’t work, you may be referred for urodynamic testing and injections of Botulinum toxin (Botox)

Recurrent UTI

A urinary tract infection (UTI) is an infection in the body’s urinary tract (‘water works’). This includes the kidneys (which make urine), ureters (which take urine from the kidney to the bladder), the bladder (which stores urine) and urethra (the tube which carries urine from the bladder to outside of the body). A UTI occurs when germs from outside the body enter the bladder, multiply and cause an infection. In some cases the germs will move up, out of the bladder and towards, or into, one or both of the kidneys.

Treatments and management :

When you are referred to the gynaecology clinic, we will discuss your symptoms and history, you will be examined and do a urine test.
You may then be referred for a cystoscopy, where the lining of the bladder is examined using a special sort of telescope, and an ultrasound scan.

Pelvic Organ Prolapse