UT-FFUFemale Functional Unit
The Female Functional Urology unit addresses different urologic pathologies that require specialised attention, such as the existence of functional disorders that associate urinary incontinence, bladder voiding disorders, pelvic organ prolapse and recurrent urinary tract infections.
For this reason, we have experienced professionals in the field who actively collaborate in the development of diagnosis and treatment protocols for urinary incontinence, including training in benchmark centres at European level and collaboration with different scientific organisations such as the Spanish Association of Urology and the European Association of Urology.
For all these pathologies, we have all the means to conduct a complete and personal study and the ability to apply an individual treatment, including innovative treatments such as intravesical instillations to regenerate the bladder mucosal barrier and thus, decrease the adherence of bacteria to it. In addition, we also have extensive experience in the use of botulinum toxin, a minimally invasive treatment for urinary incontinence and the correction of vaginal prolapse that can be surgically treated using a robotic approach.
Urinary tract infections
Urinary tract infections are the second most common reason requiring medical care. It is estimated that 40% of women over the age of 18 will suffer at least one urinary infection. Urinary tract infection risk factors include sexual intercourse, the use of intrauterine devices (IUDs), menopausal women, and certain diseases such as poorly controlled diabetes.
The choice of antibiotic treatment for urinary tract infections requires taking into account existing resistance to ensure the effectiveness of the treatment. Short-term treatments are usually recommended. Although urinary tract infections usually occur in isolation, women experience recurrent urinary tract infections. Recurrent urinary tract infections refer to cases with more than two urinary tract infections in six months or three in a year’s time, requiring confirmation with a positive urine culture. Although there are usually no causes that trigger recurrent urinary tract infections, anatomical or functional abnormalities of the urinary tract should be ruled out.
Treatment of urinary tract infections includes antibiotic therapy during the episodes of urinary infection along with precautionary measures to decrease recurrence. Precautionary measures include behavioural aspects such as acting on risk factors, avoid urine retention and postcoital micturition. Other measures on which studies have been published assessing their efficacy include topical hormone replacement therapy in postmenopausal women, immunoactive prophylaxis, use of probiotics, cranberry derivatives, D-mannose and intravesical instillations. Although antimicrobial agents have been widely used preventively, precautions should be taken as they can modify saprophytic flora and associate resistance
Urinary incontinence and genital prolapse
Urinary incontinence is defined as any involuntary urination and is a medical, social and hygienic problem that significantly affects the quality of life. It is estimated that it affects 25% of the population although, on many occasions, medical attention is not requested for various reasons such as shame, thinking that it is a normal part of the ageing process, that it has no solution… However, there are now more and more treatments available to cure urinary incontinence, or at least improve the symptoms and quality of life.
We must differentiate between various types of urinary incontinence. It is essential to distinguish between urinary incontinence related to effort and urinary incontinence related to the urge to urinate that cannot be delayed and is usually associated with frequent daytime and night-time micturition. The latter is known as overactive bladder. Each entity will have a specific treatment, as the mechanism is related either to the urinary sphincter and pelvic floor or to the bladder function itself. Sometimes, patients also refer to a vaginal lump, which is a genital prolapse that may be associated with urinary incontinence due to weakness of the pelvic floor.
Among the common risk factors are childbirth, gynaecological surgeries, obesity… The first stages of treatment generally include measures such as weight control, fluid intake adequacy, physical exercises and pelvic floor exercises, individualised according to the patient.
In case of an overactive bladder-urge incontinence, the second step is pharmacological treatment for cases where satisfactory control of symptoms is not achieved. Includes treatments such as the administration of botulinum toxin (BOTOX).
This treatment is applied routinely by the members of the unit in a minimally invasive manner, offering good results regarding symptom control and enabling the interruption of chronic pharmacological treatment.
STRESS URINARY INCONTINENCE
In case of stress urinary incontinence and genital prolapse, surgery is considered to correct pelvic floor disorders.
In our unit we conduct a detailed study of the patient with incontinence and genital prolapse, and we offer diverse treatments and prevention strategies including rehabilitative measures for the pelvic floor along with minimally invasive surgery of the urinary incontinence and correction of pelvic organ prolapse, using the different treatment options with suburethral bands, adjustable slings or artificial urinary sphincter.
PELVIC PAIN SYNDROME
Pelvic pain is a pathology that requires an approach with specialists in the field, requiring individualised study and treatment. For this purpose, we offer the equipment for a detailed diagnosis and to suggest management including the different strategies available including pharmacological therapy, intravesical instillations and botulinum toxin.
(Botulinum toxin and instillations)
Intravesical treatments allow treating various functional urinary pathologies. It includes the administration of botulinum toxin, that enables the treatment of urinary incontinence associated with micturition urgency, via minimally invasive therapy. Botulinum toxin is also used in other urological disorders, such as certain bladder pain syndromes.
On the other hand, intravesical therapy is effective in the treatment of bladder pathologies associated to pain and inflammatory conditions at this level, with the intention of helping to regenerate the protective layer of the bladder mucosa, which can be affected by different infectious and inflammatory processes.