Management of Female Stress Incontinence and Pelvic Organ Prolapse

The co-hosts begin by briefly discussing the workup for pelvic organ prolapse (POP). Dr. Park identifies common symptoms of prolapse and special exams (e.g. Pelvic Organ Prolapse Quantification System or POP-Q and urodynamics) that may be utilized for initial evaluation. She then explains the clinical indications for treatment of isolated POP, in addition to POP with concomitant urinary incontinence.

Drs. Park and Silva then transitioned to cover the management of urinary incontinence. The two co-hosts reveal the benefits of pelvic floor physical therapy and other conservative management options, such as core-centric exercises and weight loss. In length, they elaborate on the benefits and takeaways of using sling procedures versus urethral bulking agents (e.g. Bulkamid). When discussing these topics, the co-hosts bring to light the possible differences in approach between Urogynecologists and Urologists. In regard to urethral bulking agents for treatment of urinary incontinence, Drs. Park and Silva highlight the potential role for stem cell injections. In addition, Dr. Park provides a tip to maximize patient comfort during in-office periurethral injections for urethral bulking. When focusing on sling procedures, Dr. Park highlights her preferred approach and encourages listeners to become proficient in the approach of their choosing.

Lastly, they describe their approaches to treatment of stress urinary incontinence. In their discussion, Drs. Park and Silva consider factors such as patient age, desire for future fertility, and pregnancy. When wrapping up the episode, Dr. Park emphasizes the importance of patient counseling when it comes to management of these conditions, as well as practicing shared decision making to determine the best next steps for her patients.