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Pelvic, Bladder & Bowel Health

Therapies and treatments are available for conditions affecting your pelvis and bladder, such as incontinence, vaginal prolapse and pelvic floor pain.

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Bring back your independence and feel comfortable in your body again. You don’t need to live in silence and discomfort with any condition, and this includes pelvic and bladder issues. Our board-certified urogynecologist is the first and only in the region. From our specialty clinic in Sioux Falls, this care team treats conditions affecting your bladder, vagina, uterus and rectum health.

Childbirth, menopause or muscle strain can weaken your pelvic floor and cause problems such as urinary incontinence, pelvic floor prolapse and pain during sex. Effective urogynecology treatments, exercise, surgery and minimally invasive care options are available.

Urogynecology Medicine

For expert care in pelvic and sexual health, urogynecology medicine includes evidence-based treatments that are a crossover between urology and OB/GYN. Ask your doctor for a referral to see our Avera urogynecology care team.

Pelvic & Bladder Disorders

Typically, issues like pelvic, urinary tract and bowel disorders affect women after menopause, but they can happen to younger women, especially after pregnancy and childbirth.

  • Bladder pain syndrome
  • Constipation
  • Endometriosis: growth of uterine cells outside the uterus
  • Fecal and urinary incontinence
  • Interstitial cystitis (IC): chronic bladder pain condition
  • Overactive bladder (urgency or frequency)
  • Painful intercourse
  • Pelvic organ prolapse and prolapsed uterus: organs in the pelvis move from their normal positions, causing pain and discomfort
  • Pelvic pain and pressure
  • Sexual dysfunction
  • Vaginal dryness and burning

Bowel & Bladder Therapies

These therapies can improve better bladder and bowel control, so you can experience fewer accidents and trips to the bathroom.

  • Nerve stimulation therapies that deliver electrical pulses to retrain the nerves responsible for bladder or bowel control using tools such as:
    • Axonics® therapy
    • Botox treatments
    • InterStim™ therapy
    • Percutaneous tibial nerve stimulation (PTNS)
  • Pelvic physical therapy
    • Specialized treatment for improving strength and function of pelvic floor muscles and tissues that support the bladder, urethra and other pelvic organs

Urogynecology Procedures & Surgery

With extensive training, expertise and surgical experience, an Avera urogynecologist uses advanced technologies including robotic tools that enhance minimally invasive procedures and surgical precision, reducing patient recovery times.

  • Bulkamid procedure: minimally invasive approach to address stress urinary incontinence, when urine leaks during exercise, movement, coughing, sneezing or laughing
  • Female reconstructive surgery for a variety of conditions
  • Hidden scar hysterectomy: least invasive method to remove uterus
  • Laparoscopic and vaginal surgery
  • MonaLisa® Touch procedure: relieve vaginal dryness, burning or painful intercourse

Postpartum Wellness Program

Pelvic floor symptoms are very common among women, especially in the first six months following pregnancy and delivery. Avera’s postpartum wellness program offers personalized care with access to specialists like urogynecologists, colorectal surgeons, pelvic floor physical therapists, wound care specialists and women’s health psychologists.

Talk with your doctor during follow-up visits about any health concerns during postpartum. They can address or connect you to the right care.

Potential Issues After Childbirth

Potential and common issues women may experience following childbirth include:

  • Accidental loss of gas and stool
  • Anxiety and/or depression
  • Breastfeeding complications
  • Infection in the uterus
  • Obstetrical tears
  • Obstetrical fistulas (anal and vaginal)
  • Postpartum hemorrhage
  • Postpartum urinary retention
  • Pain with intercourse
  • Pelvic pain
  • Urinary incontinence

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Pelvic, Bladder & Bowel Health FAQ

Your primary care provider is the best place to turn to with questions about your unique health journey. Check out these frequently asked questions to learn more about urogynecology health.

What is pelvic floor dysfunction (PFD) and what are the risk factors?

PFD involves disorders that affect your pelvic floor, a group of muscles that help support the areas of the pelvis. This includes your bladder, urethra, vagina, uterus or reproductive organs. While the exact cause will be determined by your doctor, common risk factors can include:

  • Childbirth
  • Chronic conditions
  • Muscle strain
  • Obesity
  • Pregnancy
  • Trauma

How common is PFD, and is treatment effective?

Pelvic floor dysfunction affects about a third of women in the United States, making it a very common disorder. From people going through menopause to patients who have experienced childbirth, it can affect patients over a wide age range.

With the right treatment plan and physical therapy, you can strengthen and improve your pelvic floor muscles. A urogynecologist can help you address pain, incontinence, discomfort and sexual dysfunction. Some physical therapists across the Avera footprint also specialize in pelvic floor therapy.

How can pelvic floor physical therapy help my symptoms?

Ask your doctor if pelvic floor therapy is right for you. At our urogynecology clinic in Sioux Falls and Avera Therapy clinics across our service area, patients can improve their pelvic health. Specially trained physical therapists at many locations offer approaches that include:

  • Behavior techniques
  • Core and pelvic stabilization exercises
  • Electrical stimulation
  • Manual therapy
  • Relaxation and breathing techniques
  • Ultrasound

What is the MonaLisa Touch procedure?

The MonaLisa Touch procedure may be recommended by your doctor if you experience vaginal dryness, burning or painful intercourse. This safe, effective and non-hormonal treatment takes less than five minutes and feels similar to a Pap smear. A laser stimulates collagen production to help the vaginal tissue return to its optimal state with minimal to no discomfort or downtime.

Why do women experience vaginal dryness?

Women with vaginal dryness may experience dryness or pain during intercourse. Vaginal dryness can happen to women in menopause or for those who have had a hysterectomy or were treated for breast or uterine cancer.

The cause is due to a decrease in estrogen, a hormone that provides moisture, lubrication and elasticity. Estrogen can be depleted due to life stages, conditions and other factors such as:

  • Breastfeeding
  • Perimenopause
  • Menopause
  • Hysterectomy or surgical removal of ovaries
  • Some autoimmune disorders
  • Medications or treatments, such as for breast cancer
  • Lifestyle factors such as stress, poor hydration and smoking

Sexual dysfunction can not only affect intimacy with a partner but also cause anxiety and depression. That’s why counseling and physical therapy may be recommended according to the patient’s individual situation.

If I get a hysterectomy, will I experience a lower sex drive after?

Women who have had a hysterectomy may have concerns about their sex drive or hormones. If you do, bring this up with your doctor to learn more about your options. While many women retain their ovaries after a hysterectomy, some women have both the uterus and ovaries removed at the same time. If there is an issue with the ovaries or if there’s a personal or family history of cancer, your doctor may recommend removal.

How can stress urinary incontinence be treated?

Treatments are available to help women who experience uncontrolled urination during exercise or other body movements, such as laughing, coughing or sneezing. One minimally invasive procedure uses a camera with a needle attached to inject a liquid-based, permanent gel into the urethral mucosa (lining membrane of urethra). The gel works like a filler in the urethra making it harder for urine to leak out.

After this procedure, you may resume normal exercise the next day. A touch-up in the future may be recommended if persistent urinary leakage continues.

Can stress cause bowel issues?

Yes it can. When stress is left unmanaged, elevated levels of cortisol can erode and damage the lining of the digestive tract. Cortisol may hinder your body's ability to control bowel contractions, causing you to visit the bathroom too many times or not enough. Ask your doctor about implementing gut-friendly health habits if you need help managing stress.

More Programs and Services

Depending on your health condition, your doctor may recommend additional attention from specialists at Avera. Some services vary by location.

Breast HealthBreast health differs woman to woman. That’s why routine professional and self-exams can help to prevent or catch cancer in the earliest most treatable stages.
Gynecologic OncologyDedicated gynecologic oncologists and surgeons provide specialized treatment for gynecologic cancers such as endometrial, uterine, ovarian, cervical and vaginal cancers.
Physical TherapyTherapeutic exercise and other interventions focus on pain relief and improving posture, strength, endurance, balance, coordination and joint mobility.
Pregnancy & BirthWhen you’re ready to have a baby, you need a care team you can trust by your side. Visit with a prenatal care provider, like an OB/GYN, midwife or family medicine/OB.
Primary CareWhether you see a family medicine physician or an internal medicine specialist, we can help you as your health needs change throughout every age and stage of life during adulthood.
MenopauseHormones like estrogen decrease during perimenopause and menopause, affecting how your body works and bringing on symptoms like hot flashes and mood swings.

Get the Care You & Your Body Need

At Avera, you'll find the women's health services you need for every stage of life, including access to specialized urogynecology care in Sioux Falls, SD. Our compassionate providers are here for you and your well-being, with local clinics in or near your community and convenient telemedicine options for patients across our region.

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