Urogynecology Services Thousands of women suffer unnecessarily from pelvic floor disorders, such as urinary and fecal incontinence, voiding disorder, pelvic (bladder) pain, overactive bladder and prolapse, which cause embarrassment and affect their quality of life. Women who suffer from these disorders now have an important new healthcare resource available to them at Ob/Gyn Specialists of the Palm Beaches. Dr. Linda Kiley can accurately diagnose and treat pelvic floor disorders utilizing the latest surgical and non-surgical procedures available.

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What is a Urogynecologist?
Urogynecology is a relatively new sub-specialty within Obstetrics and Gynecology dedicated to the care of women with disorders of the pelvic floor, an area that consists of the muscles, ligaments, connective tissues and nerves that support the rectum, uterus, vagina and bladder. In addition to completing medical school, a urogynecologist has additional training beyond residency in the Urogynecology and Reconstructive Pelvic Surgery. This specialized training provides the added expertise needed to understand, diagnose, manage and treat pelvic floor disorders.

What are pelvic floor disorders and who is at risk?
Damage to the pelvic floor organs, tissues and muscles can occur from childbirth, obesity, chronic coughing, heavy lifting, disease or genetic predisposition. Common problems and symptoms
INCONTINENCE
Loss of bladder or bowel control, including urine frequency and urine leakage, which affects more than 11 million American women.
EMPTYING DISORDERS
Difficulty urinating or moving bowels.
PELVIC PROLAPSE
A condition where one or more of the pelvic organs have become displaced from their normal position, usually “dropping” from its original location.
PELVIC OR BLADDER PAIN
This can include painful urination, pelvic discomfort or burning sensations in the region.
OVERACTIVE BLADDER
A frequent need to void, bladder pressure, urgency, urge incontinence or nighttime urination.

How do I know if I should see a urogynecologist?
If you are experiencing prolapse or have had problems with emptying disorders, incontinence and pelvic pain or discomfort, you might benefit from a consultation with Dr. Kiley.

State-of-the-art diagnostic procedures & testing
CYSTOSCOPY
A small, lighted scope is utilized to view the inside of the urethra and bladder in great detail to detect any inflammations, masses or other potential problems.
ULTRASOUND
This procedure uses sound waves to project an internal image that allows us to detect anomalies that can affect the pelvic organs.
URODYNAMIC TESTING
Through a small catheter inserted into the bladder, we can accurately evaluate the urinary tract and its functions, including monitoring the filling and drainage during urination.
INTRAVENOUS PYELOGRAPHY (IVP)
An X-ray examination designed to study the kidneys, bladder and ureters (the tubes which carry urine from the kidneys to the bladder). In this diagnostic procedure, an iodine-based material is injected through an IV. The X-ray tracks the dye’s path through the pelvic organs and allows us to detect and identify abnormalities.
ELECTRODIAGNOSTIC TESTING
Also called electromyography, or EMG, this test uses electrodes placed on the body to evaluate the pelvic floor muscles’ response to electric impulse. This allows us to detect muscle weakness and impaired strength that might be causing incontinence and other pelvic floor disorders.

What treatment options are available?
PELVIC FLOOR EXERCISES
Pelvic muscle strengthening activities, also called Kegel exercises, often alleviate problems of incontinence by improving urethral and rectal functioning. These exercises can also help to prevent prolapse.
MEDICATIONS
Several medical drug therapies are available to treat incontinence. Dr. Kiley will review your options and discuss any potential side effects.
BIOFEED BACK/ELECTRICAL STIMULATION
This therapy delivers a low-voltage, electric current to the pelvic floor to stimulate and strengthen a targeted group of muscles. The therapy is successful in treating stress incontinence and urge incontinence.
PESSARY
Worn like a diaphragm, this device can be used as a temporary or permanent treatment to manage prolapse by supporting the vagina, bladder, rectum or uterus. Pessaries are also designed to treat incontinence.
NEUROMODULATION: A small pacemaker-type electrode is implanted which stimulates the nerves going to the bladder. This helps the bladder to relax and contract more appropriately and therefore tends to reduce the need for frequent urination and episodes of urinary leakage related to urgency. A test neuromodulator is placed first for a few days to determine whether the therapy is appropriate and effective. After this, if a significant improvement is seen, a permanent implant can be placed.
MODIFIED DIET
Dr. Kiley can recommend a healthy diet that reduces bladder irritation and urinary frequency or urgency and constipation.