About Us

A board-certified urogynecologist specializes in the diagnosis and treatment of female urologic and pelvic problems. Urogynecology is a specialty area, so these physicians have more experience in treating these conditions. The conditions most frequently treated include:

• Incontinence: leaking of urine or loss of bladder control
• Overactive bladder: urge to urinate more frequently
• Prolapse: weakening of the pelvic floor muscles that causes the vagina and uterus to drop down
• Emptying disorders: difficulty with urination or bowel movements
• Pelvic pain or discomfort

A urogynecologist is board-certified in female pelvic medicine and reconstructive surgery and is also board-certified in general obstetrics and gynecology. After completing a residency in obstetrics and gynecology, they complete a three-year fellowship in urogynecology, also known as female pelvic medicine and reconstructive surgery, focusing specifically on pelvic floor disorders.

There are few physicians in the Louisville area who have had this fellowship training and are board-certified in female pelvic medicine and reconstructive surgery. The University of Louisville School of Medicine is also one of about 50 programs in the U.S. to offer this fellowship program and train the future of urogynecology.

The pelvic floor refers to the muscles, ligaments, connective tissue and nerves that help support and control the functioning of your bladder, uterus, vagina and rectum. 

Loss of support may lead to loss of bladder or bowel control, difficulty emptying your bladder or bowels and downward falling or bulging of your pelvic organs. Your pelvic floor can be affected by many things, but common causes of damage include childbirth, repeated heavy lifting, straining for bowel movements, some chronic diseases and surgery. Pelvic floor disorders often interrupt everyday activities such as exercise, shopping, travel and intimate relations.

Urinary incontinence is the uncontrolled loss of urine that is bothersome enough to affect your quality of life.

Urinary leakage has many possible causes, but it most commonly falls into two main categories:

• Stress urinary incontinence (SUI) is the loss of urine as a result of physical activities that increase abdominal pressure. These activities include sneezing, coughing, laughing and straining when performing exercises like abdominal crunches or lifting objects. This increase in abdominal pressure leads to an increase in the pressure within the bladder, which behaves like a balloon filled with liquid. The rise in bladder pressure then forces the urethra open and urine loss occurs. Urine loss with stress incontinence often feels like a squirt, which can be small or large depending upon the amount of liquid in the bladder at the time and the holding strength of your urethral muscle. Common risk factors for stress incontinence include having had a vaginal delivery, previous pelvic surgery, radiation treatment to the pelvis, increased abdominal pressure due to respiratory conditions like chronic coughing, constipation, obesity and heavy lifting. In some cases there is also inherited weakness of the supportive connective tissue of the pelvis.
• Overactive bladder is urgency and frequency of urination either with or without actual urine leakage. Overactive bladder may awaken you from sleep more than once or twice a night. This condition may be due to actual spasms of the bladder muscle or increased sensitivity of the bladder. Urge incontinence is usually associated with a strong, almost overpowering sense of a need to urinate with concern that you will not be able to make it to the bathroom in time. These bladder spasms often happen when your bladder is not very full and can be triggered by hearing or feeling running water, cold air or even arriving at home and putting your key in the door. Occasionally it is caused simply by a particular amount of urine in the bladder. Overactive bladder typically leads to leakage of larger amounts of urine and is harder to control than stress incontinence. Typically, we don’t know what causes overactive bladder although there can be triggers (as noted above) or damage to the muscles or nerves that supply your bladder.

As you age, it is quite common to experience relaxation of the support of your bladder, vagina, uterus or rectum, especially if you have had children by vaginal delivery. 

This can be normal, but if it becomes bothersome it may cause a sense of pressure or bulging in your vaginal area. Sometimes you can even feel or see a bulge outside of your vagina.

• Loss of support for your bladder, known as a cystocele may contribute to urinary leakage, difficulty in starting your urine flow or even trouble emptying your bladder. 
• A rectocele occurs when your rectum presses into the space of your vagina and can cause similar symptoms of difficulty starting or completing a bowel movement. 
• Uterine prolapse, or vaginal prolapse if you have had a hysterectomy, can affect your bowel or bladder function or simply cause sensations of pressure.  

Urogynecologists are experts in treating many different causes of loss of stool control. 

Commonly, you can manage this by paying attention to your diet, bowel habits and muscle strength. Although in some cases, your loss of control may be due to actual damage of your anal sphincter muscle that occurred at the time of a vaginal delivery. If you experienced a known tear to this muscle at childbirth, you may need surgery to repair the muscle.