Conditions & Treatment

Conditions We Treat

• Severe vaginal lacerations
• Episiotomy issues
• Infection and abnormal healing of lacerations
• Urinary leakage
• Bowel leakage (gas or stool)
• Constipation
• Painful intercourse
• Vaginal or vulvar pain following delivery
• Fistulas
• Urinary retention

How do you treat childbirth-related pelvic floor disorders?

Treating pelvic floor disorders is often specific to each woman.

We will always consider nonsurgical treatments first, but we work with each patient to provide effective, lasting treatments that meet your individual goals.

Peripartum pelvic floor disorder treatments can include:

• Physical therapy for pelvic muscle weakness, lack of control and pain
• Vaginal creams or ointments
• Antibiotics, if there are signs of infection
• Trigger point injections for vaginal pain
• Medication therapy for bladder and bowel control issues
• Vaginal device (pessary) fitting in the office for pelvic organ prolapse or activity-related urinary leakage
• Procedures to restore anatomy and alleviate pain
• Surgical procedures for urinary and fecal incontinence
• Vaginal, laparoscopic and robot-assisted surgery for reconstruction and repair of pelvic organ prolapse
• Repair of obstetric fistulas

What is pelvic floor physical therapy?

Pelvic floor physical therapy (PFPT) is often one of the primary treatments for postpartum pelvic floor disorders.

Our specialized physical therapists will work with you to improve the function of your pelvic floor muscles based on your individual condition. ‘

Their techniques may include:

• Learning how to contract and relax pelvic floor muscles
• Exercises to stretch tight muscles or strengthen weak muscles

The goal of physical therapy is to help you get back to your normal pelvic floor health and function.

How do I care for my perineum after delivery?

Your perineum, the tissue between the vagina and anus, can be sore following delivery, particularly if you had a tear or your doctor performed an episiotomy.

We recommend keeping the area clean / dry. You can try the following to reduce swelling and inflammation:

• Apply ice packs to the perineum, wrapped in a soft cloth. Ice should be applied for no more than 20 minutes at a time and is most beneficial and soothing during the initial days after your delivery.
• Use a squirt bottle with warm water while urinating or for cleaning the area after toileting. This can help minimize irritation and keep the area clean.
• Take short sitz baths (warm and shallow baths) two to four times per day.
• Take over-the-counter pain medications, such as acetaminophen or ibuprofen, as recommended by your doctor, and limit narcotic pain medications, if possible, as they can cause constipation.
• Place cotton pads soaked in witch hazel in the refrigerator and use them to cool the perineum and perianal area several times per day. Dispose of the pad after it has been used once.
• Keep your bowel moving with a stool softener and/or laxative as directed by your doctor to avoid straining during bowel movements.

Could you explain more about the sitz baths?

A sitz bath is a warm and shallow bath that cleanses the perineum.

All you need is a small amount of warm water in a bathtub or clean shallow basin. You can find plastic kits that fit over your toilet bowl at many stores or pharmacies.

The warm water increases blood flow to promote faster healing and provides relief from itching, irritation, or minor pain.

• Soak for approximately 10 minutes.
• Gently pat yourself dry. Do not rub or scrub to avoid pain or irritation of the perineum.
• Take two to four sitz baths per day until you are fully healed.

Additives such as Epson salt do not provide additional benefits and aren’t necessary to use in your sitz bath. However, if you prefer to use Epson salt, add ½ a teaspoon of salt to every 1 gallon of water.

If you have pain, itching, or swelling, immediately stop taking sitz baths and contact your doctor.