Urogynecology at the OB/GYN Center

At OBGYN Center, our board-certified physicians provide a wide range of services for women’s health and wellness, including a specialization called urogynecology. Our providers who focus on this area help manage clinical problems associated with dysfunction of the pelvic floor and bladder.

Dr. Jeremiah McNamara has a special interest in this area and has had specialized training in the accurate diagnosis and treatment of these conditions. Because of Dr. McNamara’s expertise in both urology and gynecology, he can diagnose and treat the full spectrum of these issues, often without the need for outside referrals.

Along with other pelvic floor specialists, Dr. McNamara was recently asked to help design and launch a new, dedicated program at Sky Ridge Medical Center focused completely on pelvic floor dysfunction and pelvic organ prolapse.

“These issues are so common and so undertreated - it really is a shame. Too many women suffer silently with these problems every single day, not knowing that there are many safe and effective treatments available. Leaking urine with laughing or exercise… feeling like pelvic support is changing and causing issues with pressure or pain… issues with difficult or painful bowel movements. The truth is that these things are not normal parts of being a woman – no matter what age you are or how many kids you’ve had. I hope that more women start to seek our assistance with these problems, because we can really help.”
Jeremiah McNamara,MD - Dr. McNamara

Some statistics on Pelvic Floor Dysfunction (PFD)

  • 50 percent of women over age 50 live every day with one or more of the problems caused by pelvic floor dysfunction (PFD).i
  • 1 in 3 of those women with urinary incontinence have some degree of bowel dysfunction.
  • 60 percent of nursing home occupants suffer from fecal and/or urinary incontinence.
  • Surgical repair of prolapse is the most common inpatient procedure performed in women older than 70 years.

PFD is one of the most common conditions Dr. McNamara treats. PFD is a range of issues that arise out of weakness, tightness or other discoordination of the muscles and supportive elements that make up the pelvic floor.

On their path to getting cured, many PFD patients will have to see a gynecologist, a urologist or even a GI specialist in order to get a treatment plan that works for them. By seeing a gynecologist who focuses on urogynecology, a woman can quickly get the answers she’s looking for because that physician understands each of these systems and the complex ways they relate to each other in patients with PFD.

Common PFD issues we treat

Urinary Incontinence:

  • Stress urinary incontinence
  • Urge incontinence
  • Overactive bladder syndrome
  • Recurrent bladder infections

Pelvic Organ Prolapse:

  • Feeling of things “falling down or out”
  • New uncomfortable bulge or fullness in the vagina
  • Known issues with pelvic support that have come back again

Issues with Bowel Movements:

  • Painful bowel movements
  • Accidental bowel leakage
  • Needing to get into different positions or press on the vagina in order to successfully have a bowel movement

Pelvic Pain:

  • Muscular tightness, weakness or dis-coordination that leads to acute or chronic pelvic pain
  • Painful intercourse

Common PFD procedures we perform

Urinary Incontinence:

  • Stress incontinence “Sling” procedure: “Gold Standard” surgery that often completely eliminates stress leaking
  • “Bladder lift” surgery (aka cystocele or anterior repair)
  • Using/fitting disposable or reusable pessaries that help with leaking
  • Medical management of urge incontinence and overactive bladder syndrome
  • Urodynamic testing to get to the bottom of difficult diagnoses

Pelvic Organ Prolapse:

  • Hysterectomy (minimally invasive technique) when necessary
  • Repair of cystocele and/or recto-cele
  • Repair of vaginal vault prolapse
  • Discussion regarding complex surgeries such a colpocleisis or sacrocolpopexy

For more information or to schedule an appointment with Dr. McNamara today, call (303) 788-6657.

i Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A. Am J Obstet Gynecol. 2002;186(6):1160.