Gynecologic Problems

The following addresses some of the most common urogynecologic & gynecologic issues; click toggle for more information

The pap test is a screening test for cervical cancer and precancerous cervical changes. While the Pap test has drastically reduced cervical cancer rates in the United States, there are still over 12,000 new cases of cervical cancer diagnosed per year and over 4,000 cervical cancer related deaths.

Cervical cancer develops over years from infection with specific high-risk types of human papillomavirus (HPV). HPV infection is very common and will affect most sexually active women in their lifetime. Fortunately, most women will clear the infection on their own without treatment. For those infected with HPV, cervical changes from the virus can result in an abnormal pap test.

Abnormal pap tests are also very common, with about 3.5 million abnormal pap tests reported annually. Abnormal cervical changes detected on a pap test must be monitored and in some cases treated to prevent progression to cervical cancer.

Urinary incontinence is any leakage of urine or loss of bladder control. In the United States, millions of women suffer from urinary incontinence, and its devastating and embarrassing side effects. Billions of dollars are spent on incontinence protection each year.

The two most common types of urinary incontinence are stress incontinence and overactive bladder. Stress incontinence is caused by a weakening of the urethra, the tube that carries urine out of the body. Women with stress incontinence commonly have urine leakage when they laugh, cough, walk, pick up a heavy object or engage in other exertional activities.

Women with overactive bladder, or urge incontinence, often feel a strong need to go to the bathroom but an inability to get there in time. Other symptoms include urinary frequency and the need to urinate several times during the night. Some women with urge incontinence loose urine when they hear running water, change position, or put their key in the door. Overactive bladder is caused by unexpected contractions of the bladder muscle.

The two types of urinary incontinence are treatable ailments however they are treated differently. It is important to obtain an accurate diagnosis from an expert in the field in order to ensure the proper treatment.

Voiding dysfunction is defined as generalized problems emptying the bladder. These can occur in women with neurological issues, pelvic floor problems including vaginal prolapse, and in women with previous pelvic surgery.

Women with voiding problems may have a sensation of fullness in the lower abdomen, a slow urine stream, a need to urinate shortly after urinating, and urinary frequency during the day and night. Many of these problems are correctable and those that are not correctable may be greatly improved.

It is important to properly diagnose and treat voiding dysfunction as these types of problems lead to long-term kidney damage.

Vaginal prolapse is a condition where the bladder, urethra, rectum, or uterus bulges into the vagina. Women with this problem may feel like there is something falling out of the vagina while others sense increased pelvic pressure. The bulging or dropped organs may make it difficult to empty the bladder or the rectum and engage in vaginal intercourse.

The loss of support by the vaginal muscles causes pelvic organs to prolapse. This weakening of the vagina is associated with multiple or difficult childbirth, however, smoking, obesity, aging, menopause, chronic constipation, genetic predisposition, lung disease, and chronic lifting can also be contributory factors. Prolapse can be treated with surgery or by fitting the vagina with a device called a vaginal pessary. Newer techniques and less invasive approaches have greatly improved the number of successful outcomes for women with these problems.

Recurrent urinary infections afflict many, many women and may be due to anatomical problems, menopause, or improper voiding habits.

Painful bladder syndromes are often mistaken for recurrent urinary tract infections. The symptoms can include pelvic pain, urgency, bladder overactivity or pain, and urinary frequency and nocturia. Many painful bladder syndromes can be divided into three categories based on the clinical course. Painful bladder syndromes include the diagnoses of interstitial cystitis (IC) and urethral syndrome.

Cystoscopy is an important part of the evaluation for patients where painful bladder syndromes are suspected. This type of examination will often reveal inflammation and abnormalities in the lining of the bladder, and also helps rule-out other causes of the symptoms. The conclusive cause for painful bladder syndromes is unknown therefore, there is no known cure. Several treatment modalities, including diet and medications, are available to potentially reduce symptoms and cause remission.

The symptoms that accompany urethral syndrome are irritative and include: urinary frequency, urgency and burning, suprapubic pain, and a slow urinary stream. Because these symptoms are so common with other urinary problems, other possibilities must be eliminated.

Abnormal uterine bleeding, usually in the form of heavy or irregular periods or bleeding after menopause, is a common problem, which can decrease a woman’s productivity and quality of life. Bleeding can result from hormonal imbalances, fibroids, polyps, bleeding disorders, medications, cancer or other causes.

Uterine fibroids are very common, occurring in up to 80% of women. While some rare cancers can be confused for uterine fibroids, fibroids are non-cancerous growths in the smooth muscle of the uterus.

Many fibroids do not cause any problems and can be left alone. However, depending on the size and location of fibroids, they can cause pelvic pain or pressure, heavy or irregular bleeding, infertility, or urinary problems. When symptoms from fibroids affect a woman’s quality of life, treatment is recommended.

Fibroids and their symptoms can be treated with medications, intrauterine devices, uterine artery embolization, and surgery.

Ovarian cysts or masses can represent a variety of cancerous and non-cancerous conditions. While the majority are not cancerous, certain risk factors or features of the cyst or mass are more concerning for cancer and should be evaluated by a gynecologist.

Non-cancerous cysts or masses can include simple cysts, endometriomas, dermoid cysts, hemorrhagic cysts, ectopic pregnancy, abscesses or fluid filled fallopian tubes. Some of these condition may resolve on their own with monitoring, while others require surgery.

Up to 10% of women will undergo surgery in their lifetime for an ovarian cyst or mass. Sometime this is emergent surgery in the setting of ovarian torsion (twisting of the ovary), hemorrhage, or ectopic pregnancy, but more frequently, the surgery can be planned in advance with your gynecologist.

Pelvic pain is a common condition that many women think they have to live with. Some women may experience pain that resolves over a short period of time, while others experience chronic pain that lasts 6 months or longer. Pain may occur with the menstrual cycle, sexual activity, bowel movements, urination, or exercise or it may be constant, regardless of activity.

Pelvic pain can occur from a variety of causes including gynecologic (infection, endometriosis, fibroids, adenomyosis, pelvic congestion), urologic (infection, painful bladder syndrome/interstitial cystitis, kidney stones), gastrointestinal (irritable bowel syndrome, chronic constipation), musculoskeletal (pelvic floor muscle spasm, hip injury), psychological (depression, anxiety, abuse history), and neurologic (neuralgia, complex regional pain syndrome). Often several of these components contribute to a woman’s pelvic pain.

Depending on the cause of pain, treatment may include dietary changes, physical therapy, hormonal medication, neurologic medication, pain medication, injections, devices, and surgery.

Endometriosis is a condition where tissue similar to that in the inner lining of the uterus (endometrium) grows outside of the uterus. This tissue can cause bleeding, inflammation, and scarring.

Some women with endometriosis have no symptoms, while others have pain or trouble getting pregnant. Pain can occur before or during monthly periods, during or after sex, with urinating or having bowel movements, or may become constant.

Conditions We Diagnose & Treat

Gynecologic and Urogynecologic conditions treated by Dr. Jaenicke:

  • Abnormal bleeding (heavy or irregular periods)
  • Abnomral pap tests, colposcopy and LEEP
  • Bartholins’s Cysts
  • Bladder pain
  • Complex pelvic pain
  • Congenital pelvic abnormalities
  • Cystitis
  • Edometriosis
  • Fecal incontinence
  • Female Incontinence:
    • Stress urinary incontinence
    • Overactive bladder
    • Urge incontinence
    • Urinary frequency
  • Fibroids
  • Fistulas
  • Hematuria
  • Menopause
  • Ovarian cysts
  • Pelvic Floor disorders:
    • Vaginal prolapse
    • Cystocele (bladder prolapse)
    • Uterine prolapse
    • Enterocele
    • Rectoele
    • Cervical hypertrophy
    • Pessary management
  • Pelvic muscle dysfunction
  • Polycystic ovarian syndrome
  • Sexual dysfunction
  • Urinary retention and hesitancy
  • Urinary tract infections
  • Vulvar dystrophy
  • Vulvodynia

Conditions We Diagnose & Treat

Gynecologic and Urogynecologic conditions treated by Dr. Jaenicke:

  • Abnormal bleeding (heavy or irregular periods)
  • Abnomral pap tests, colposcopy and LEEP
  • Bartholins’s cysts
  • Bladder pain
  • Complex pelvic pain
  • Congenital pelvic abnormalities
  • Cystitis
  • Edometriosis
  • Fecal incontinence
  • Female Incontinence:
    • Stress urinary incontinence
    • Overactive bladder
    • Urge incontinence
    • Urinary frequency
  • Fibroids
  • Fistulas
  • Hematuria
  • Menopause
  • Ovarian cysts
  • Pelvic floor disorders:
    • Vaginal prolapse
    • Cystocele (bladder prolapse)
    • Uterine prolapse
    • Enterocele
    • Rectoele
    • Cervical hypertrophy
    • Pessary management
  • Pelvic muscle dysfunction
  • Polycystic ovarian syndrome
  • Sexual dysfunction
  • Urinary retention and hesitancy
  • Urinary tract infections
  • Vulvar dystrophy
  • Vulvodynia

Procedures & Services

  • Advanced minimally invasive pelvic reconstruction and anti-incontinence procedures
  • Advanced minimally invasive hysterectomy myomectomy, and ovarian/tubal surgery
  • Advanced hysteroscopy for diagnosis and treatment of bleeding, fibroids, polyps.
  • Advanced urodynamics
  • Complex benign gynecological surgery
  • Cystoscopy
  • Labial and perineal reconstruction
  • Reconstruction of the vulva
  • Pelvic floor rehabilitation and physical therapy
  • Vaginoplasty

Well Woman Screening Exams

Annual exams, breast exams, HPV vaccines

Your examination will include a pelvic examination and possibly a urine examination. Depending on your individual problem, other tests may also be necessary. These may include:

  • Laboratory testing
  • Cultures
  • Biopsy
  • Cystoscopy
  • Hysteroscopy
  • Urodynamics
  • Ultrasound
  • X-ray studies

Dr. Jaenicke is dedicated to providing a full range of gynecologic, urogynecologic and pelvic reconstructive surgical services for women of all ages. For more information on the conditions listed below and the services provided, please call the office at 606.324.7351 to make an appointment or speak with our knowledgeable staff.