Women's Urology - Female Pelvic Medicine Center

Our clinic specializes in comprehensive female urology. This includes sexual health issues, bladder disorders, pelvic disorders, kidney conditions, bladder control, and chronic urinary tract infections (UTIs). We work with patients and their primary care physicians to help evaluate, recommend and treat medical conditions related to the urinary tract and pelvic disorders.

Urologic Specialists is also home to the Urologic Specialists Female Pelvic Medicine Center specializing in comprehensive pelvic floor disorders. This includes the diagnosis and treatment of incontinence and pelvic organ prolapse. Our center takes a comprehensive approach utilizing state-of-the-art technology to diagnose each patient's problem. Treatment is then individualized for each patient. We offer a full spectrum of treatment options ranging from in-office procedures to minimally-invasive and innovative surgical techniques. You do not have to live with urinary incontinence or pelvic prolapse. Dr. Scott Litwiller, Dr. Curt Powell and Dr. Sunshine Murray are physicians dedicated to treating the urologic needs of women. They are fellowship-trained and are recognized experts in the fields of female urology, incontinence and pelvic organ prolapse.

Our goal is to provide you with the highest quality of patient medical care available with a commitment to your satisfaction.

Our nurses and medical staff are fully trained and qualified to assist in your care. Whatever your medical need, we are committed to your good health and quality of life.

Female Urology Services and Conditions:

Votiva Vaginal Rejuvenation

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Pelvic Organ Prolapse

Pelvic organ prolapse is the descending or drooping of the bladder, uterus, vagina, small bowel or rectum outside of the vaginal canal or anus. Symptoms depend on which organ has prolapsed but may include urine leakage, constipation, painful intercourse, vaginal spotting and back pain. Prolapse is caused by anything that increases pressure on the abdomen including pregnancy, obesity, constipation, pelvic cancers and more.

It is important for patients to discuss these problems with their urologist to ensure they enjoy a successful treatment outcome. These problems can be treated successfully, if they are correctly diagnosed and the appropriate therapy is selected. Therapies include:

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Urinary Incontinence

Urinary incontinence, the loss of voluntary control over urinary function, affects more than a third of adult Americans. Stress incontinence happens when you sneeze, cough, laugh, exercise or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.

Urge incontinence happens when you have an overwhelming need to urinate but can’t reach the toilet in time. Sometimes there is no warning before an accidental urine leak. Overactive bladder (OAB) is a type of urge incontinence.

There are three levels of treatment from conservative to surgical that our physicians will work through with you to provide relief for incontinence.

  1. Level one treatment includes physical therapy, dietary modifications including limiting caffeine and alcohol and lifestyle changes like not drinking fluids two to three hours before bed.
  2. Level two treatment includes prescription medications. There are nearly a dozen different medicines that can help calm an overactive bladder.
  3. Level three treatment includes advanced therapies including nerve stimulation or bladder injections with botox.

Interstitial Cystitis

What is it?

Interstitial cystitis is a chronic inflammatory disorder of the bladder characterized by the findings of bladder pain or discomfort associated with urinary urgency and frequency. Interstitial cystitis is also characterized by the absence of a demonstrative infection.

What is the cause or symptoms?

Most commonly in female patients, a long history of recurrent bladder infections can be obtained. This is not always the case but is probably the most common risk factor for ultimately developing interstitial cystitis. In men, the cause of interstitial cystitis is not as clearly noted by history. However, interstitial cystitis in men is underdiagnosed.

How is it diagnosed?

The most common method of diagnosing interstitial cystitis in the United States is looking in the bladder under anesthesia and gently overdistending the bladder. In 60-80% of cases, small red spots representing ruptured blood vessels just under the lining of the bladder will appear, which are called glomerulations. However, these are not always present. About 5-10% of patients also demonstrate ulcers in the bladder, which represents a more painful presentation of interstitial cystitis. Interstitial cystitis in its early phases may be suspected or diagnosed clinically without proceeding with cystoscopy or looking into the bladder.

What are the treatments of interstitial cystitis?

The treatments progress in a logical course beginning with dietary modifications, stress modification, and in some cases pelvic floor physical therapy. Following these measures, the use of medications such as Elmiron, Hydroxyzine, and Amitriptyline are frequently helpful. Bladder analgesics may also be employed. Additionally, the use of intra-bladder medications may be helpful. However, in some patients, these treatments actually will flare the pain. As mentioned earlier, pelvic physical therapy can be of great benefit for patients who demonstrate pelvic floor spasm in response to their bladder discomfort. The use of medications to relax the urgency and frequency to urinate, are frequently employed. Additional treatments for this particular symptom include the use of an InterStim pacemaker or the injection of Botox into the bladder wall. More complex medical management includes use of immune modulators such as cyclosporine. In patients with severe chronic pain, chronic pain management strategies are often employed in conjunction with pain management specialists. In the most extreme cases which have been present for a long period of the time, removal of the bladder may be contemplated.


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