Patient Care

Conditions Treated

Bladder Disorders

Interstitial Cystitis (Painful Bladder Syndrome): Now commonly referred to as painful bladder syndrome, this is a chronic disorder that involves inflammation and swelling of the inner lining of the bladder, which usually results in pelvic pain, abdominal pain, and urinary urgency or frequency. There is usually no sign of infection associated with these symptoms.

Chronic Cystitis: This is a chronic disorder involving inflammation of the bladder that is usually caused by a bacterial infection or urinary tract infection. Causes include bladder/pelvic floor irritants like medications, spermicides, lubricants, or catheter insertion. Radiation therapy can also lead to cystitis.

Urinary Retention: The inability to empty the bladder possibly due to an enlarged prostate (men) or cystocele/rectocele (women). Symptoms often include abdominal pain/discomfort, lower abdominal bloating, difficulty initiating urination, weak urine flow, and constant feeling of urgency. Complications may include chronic urinary tract infections and permanent kidney or bladder damage.

Urinary Incontinence:
1. Stress Incontinence: Losing urine when there is an increase in intra-abdominal pressure, like during coughing, sneezing, jumping, or lifting.
2. Urge Incontinence (Overactive Bladder): Losing urine when you have the strong urge to urinate. This can also occur after touching water, or upon hearing running water.
3. Mixed Incontinence: A mixture of symptoms of both stress and urge incontinence.

Urethritis: Inflammation of the urethra, usually caused by a bacterial infection.

Nocturia: The need to urinate two or more times during the night, with or without incontinence.

Bladder Prolapse (Cystocele): This occurs when the front wall of the vagina weakens (often due to childbirth or surgery) and is no longer able to support the bladder. The bladder then descends into the vagina, often causing urinary symptoms and possible discomfort.

Urethral Prolapse (Urethrocele): This occurs when the tissues around the urethra (tube where the urine passes through) weaken and cause it to descend into the vagina. This may often occur with a cystocele and be accompanied by the same symptoms.

Uterine Prolapse: This occurs when the pelvic floor muscles and ligaments stretch and are no longer able to support the uterus. This causes the uterus to descend into the vagina and sometimes protrude outside of the vagina. Symptoms may include urinary difficulties, low back pain, vaginal pulling or pressure, and difficulty with bowel movements.

Urethral Hypermobility: This refers to too much movement in the urethra during certain activities, causing it to temporarily prolapse into the vaginal canal. This may or may not be accompanied by leakage.

Cancer Survivorship

Lymphedema: A condition where excess lymphatic fluid collects/pools in the extremities or abdomen due to damage in the lymphatic drainage system to the affected area.

Adhesions: Fibrous bands that form between tissues, organs, and other structures that are not normally connected, following surgery, chronic inflammation, or infection. These may be accompanied by pain, decreased range of motion, and compromised organ function.

Radiation Fibrosis: This is a common side effect of radiation treatment, resulting in scarring and hardening of skin and underlying tissues. This may appear immediately following a radiation treatment or months following. It may be accompanied by pain, range of motion limitations, and lymphedema.

Frozen Shoulder Syndrome: Severe limitation in range of motion in all directions of shoulder movement, often caused by scar tissue and adhesions following mastectomy.

Bowel Disorders

Constipation (Slow-Transit): This is when bowel movements become difficult, less frequent, and less productive. Constipation is typically characterized by having 2 or more the following for at least 3 months:

  • Straining during a BM >25% of the time.
  • Hard stools >25% of the time.
  • Incomplete evacuation >25% of the time.
  • Two or less BMs in one week.

Diarrhea: This is when you experience an increase in stool frequency and looser consistency of stools.

Fecal Incontinence: Leakage or inability to control/delay a bowel movement until you can reach a toilet.

Rectal Urgency: Sudden urge to have a bowel movement.

Incomplete Evacuation: This refers to the sensation that you must have another bowel movement soon after a bowel movement, but you have difficulty passing more stool the second time.

Irritable Bowel Syndrome (IBS): This is a disorder of the gastro-intestinal tract that may result from imbalances in gut flora or a communication disorder between the brain and the GI tract. It is often accompanied by chronic pain and fatigue and is a diagnosis of exclusion. There are four different classifications of IBS: IBS-D (diarrhea predominant), IBS-C (constipation predominant), IBS-A (alternating stool pattern), and IBS-PI (post-infectious IBS).

Inflammatory Bowel Disease (IBD): This condition involves a chronic inflammation of all or part of your digestive tract and primarily includes ulcerative colitis, collagenous colitis, and Crohn’s disease. Ulcerative colitis usually develops over time and affects the innermost lining of the colon and rectum. Crohn’s disease can occur anywhere in your digestive tract and spreads deep into tissues. Both of these disorders may lead to abdominal pain, pelvic pain, malnutrition, and be very debilitating.

Pre & Postnatal Wellness

Lumbago (Low Back Pain): In pregnancy, this can be caused by a number of reasons.

  • Weight gain as your body and spine adjust to supporting your growing baby
  • Posture changes as your belly swells and drops, adjusting your center of gravity.
  • Hormone changes, especially toward the end of your pregnancy. The hormone, relaxin, is released to help relax ligaments and joints in preparation for birth. However, this may lead to instability in your spine and pelvis, increasing the work of your muscles to stabilize, and causing low back pain or strain.
  • Muscle separation or diastasis recti, where the rectus abdominis (6-pack muscle) splits down the middle and causes increased back strain and possible pain.
  • Stress can make everything worse!

Sacroiliac Joint Dysfunction: This condition occurs when there is pain or changes in the SI joint. The SI joints are formed by the sacrum and the right and left iliac bones. Dysfunction can occur for many reasons and may result in hip instability, pain at the joint, radiating symptoms down the legs, and lower back pain.

Vulvovaginal Varicosities and Pelvic Congestion Syndrome (PCS): A condition where a woman experiences pain due to varicose veins that have developed during pregnancy and continue to grow in size. Varicose veins develop when valves within veins become damaged and allow the blood to flow backward and pool in the pelvic veins. This is often associated with constant, dull pelvic pain, pressure, and heaviness.

Mastitis: A condition often encountered by breastfeeding moms in which local pain, redness, and swelling develop in the affected breast duct due to a duct blockage. Without treatment, it progresses very quickly into flu-like symptoms and fever, with the potential development of an abscess at the site of a blockage.

Pelvic Pain Syndromes

Chronic Pelvic Pain: This is characterized by pain in the vaginal, rectal, and abdominal areas (between the belly button and hips), lasting 6 months or more. There may or may not be a specific diagnosis that would explain your pain.

Vaginismus: This occurs when vaginal walls (muscle) contract and spasm upon attempted penetration or insertion. Symptoms may range from mild discomfort to excruciating pain.

Vaginitis: An inflammation of the vagina that is usually due to infection. The three main types of vaginitis are bacterial vaginosis (BV), vaginal candidiasis (yeast infection), and trichomoniasis. This usually results in discharge, itching, and pelvic pain.

Dyspareunia: Painful intercourse due to medical and/or psychological causes.

Endometriosis: An abnormal growth of endometrial cells (usually found inside the uterus) that grow and form cysts on other organs in the pelvis. This cell overgrowth may be accompanied by pain, painful periods (dysmenorrhea), and infertility.

Adenomyosis: This has been distinguished as a “different” type of endometriosis, where endometrial tissue (usually lining the inside of the uterus) is found in the myometrium (the thick, muscular layer of the uterus). This is usually accompanied by painful periods and an enlarged uterus over time.

Ovarian Cysts: Fluid-filled sacs that develop on a woman’s ovaries. Many are harmless and painless but often may be accompanied by pain and bleeding.

Coccydynia: Tailbone pain. The causes of tailbone pain are often unknown and may involve the pelvic floor muscles and hip musculature.

Pudendal Neuralgia (PNE or Alcock’s Syndrome): This is a condition in which the pudendal nerve, located within the pelvic floor musculature, is compressed. This often results in significant pelvic pain, genital numbness, and fecal/urinary incontinence.

Prostatitis: Swelling and inflammation of the prostate gland often cause painful and difficult urination. Other symptoms may also include pelvic pain, groin pain, genital pain, and flu-like symptoms (especially during an active infection).

Anal Fissure: A crack or tear in the anus or anal canal, usually caused by trauma (possibly by a large, hard bowel movement). Symptoms usually include pain during and following a bowel movement, bleeding, itching, and discharge.

Prostatodynia: A type of inflammation of the prostate that is not due to bacterial infection. This is characterized as a chronic disorder with the same symptoms as prostatitis that come and go without a pattern.

Levator Ani Syndrome: A condition that results in pain, pressure, and discomfort in the rectum, sacrum, or coccyx that usually worsens with sitting.