Urinary problems in women

During your first consultation, the specialist will try to acertain as complete a picture of your issue as possible. For this first appointment, we ask you to bring your 'old' medical data or file, as well as relevant test results (urine and blood tests, old radiography or scans).

During your initial evaluation, you may expect:

• a review of your medical history, test results and your referral letter
• a conversation about the urinary symptoms, abdominal discomfort or vaginal symptoms a discussion about what the normal situation was like before the particular problem arose.
• There will also be inquiries about your general lifestyle and what you hope to achieve with a treatment.

Often, additional tests are recommended. For your convenience, all of these extra tests can be carried out at our hospital.

This concerns, in particular, radiological examinations. Or urodynamic examination: with this advanced test, we measure how the bladder (muscle) reacts when it gradually fills up. All of these tests are non-invasive or at most minimally invasive: hospitalisation is not required.

• Urinary urge symptoms: having to urinate too quickly, too frequently. The individual has insufficient warning time. These are referred to as overactive bladder symptoms.
• Urinary urge symptoms followed by uncontrollable urinary incontinence This is referred to as ‘urge incontinence’.
• Loss of urine after coughing, sneezing and physical exertion. This is referred to as ‘stress incontinence’.
• Mixed urinary incontinence due to both urgency and stress.
• The feeling of vaginal prolapse (due to the sagging of the bladder, uterus or rectum)
• Laborious, weak urine stream
• Frequent night-time urination

After referral, new patients are normally seen for consultation within three weeks. The first appointment is typically with the urologist. For specific prolapse issues, a multidisciplinary consultation hour is scheduled together with the fellow gynaecologist.

• The urologist specialises in the surgical treatment of incontinence and prolapse.
• The gynaecologist specialises in the female genitalia that are also often prolapsed.

After the initial evaluation and after reviewing all the test results, your urologist will suggest a personalised approach to try to eliminate or at least alleviate your symptoms. Treatment usually amounts to finding the most effective therapy that causes as few disturbing side-effects as possible for the rest of your daily life.

Specialist pelvic floor physical therapy or the prescription of certain medications is first tried. Starting with such a cautious approach in many cases facilitates the avoidance of drastic procedures or operations that come with potential complications.

In short, treatment often involves one of the following:

• specialist pelvic floor physical therapy
• oral medication to try to alleviate the symptoms as much as possible, with as few side effects as possible
• injection treatment in the bladder with botulinum toxin (Botox)
• nerve stimulation (though performed at another hospital)
• implantation of the latest model of the sling (‘mesh') for certain types of urinary incontinence
• implantation and suspension with another type of sling ('mesh') for certain forms of vaginal prolapse
• placement of a diaphragm or a vaginal ring
  

Minimally invasive procedures reduce (the risk of) complications, shorten hospital stays and speed up recovery after surgery.

Our department has expertise in the classic ‘open’ surgical prolapse treatment, but is equally experienced in minimally invasive procedures (e.g. robot-assisted keyhole surgery). The problem (urinary incontinence or prolapse) is regularly surgically remedied through a purely vaginal procedure, which is also a less invasive procedure.

As a Urology Department, we regularly take part in clinical trials.As a patient, you will never be obliged to participate in clinical studies. If you do not wish to participate, you will still receive our full attention as well as the gold-standard treatment.

Clinical studies are a form of scientific research into new medications, new combinations of medication or drugs with a proven effect that are tested in new or other situations. Sometimes, for example, a new dosage of the same medicine or a new chronological schedule for the administration of the medicine are applied. Clinical studies are carried out according to very strict scientific guidelines. Their aim is to veify whether new treatments are safe and effective and/or better than the current standard treatment.

• Urologists
• Dr Ronny Goethals (gynaecologist)