Urine leaking and uterus prolapse treatment in Chennai

The pelvic floor is a sheet of muscle at the bottom of the pelvis. It holds up the bladder, the uterus and the back passage (rectum), and keeps urine and motion in until you choose to let them out. Pregnancy, vaginal delivery, heavy lifting, a chronic cough, constipation, extra weight and the loss of oestrogen after menopause all weaken it. Three problems follow, often together:

• Urine leaking when you cough, sneeze, laugh, lift or run (stress incontinence).
• A sudden, strong urge to pass urine, and going many times by day and night (urge incontinence, or overactive bladder).
• Something coming down, a ball at the opening, or the uterus coming down (pelvic organ prolapse). The bladder wall, the uterus or the back passage sags into the vagina, worse by evening.

Some women also struggle to hold wind or motion after a difficult delivery (anal incontinence). Each of these has treatment that works.

Diagnosis starts with listening. Dr. Ragavi asks when the leaking happens (with a cough, or with an urge), how often you pass urine by day and night, how many pads you use, how your deliveries went, and whether you strain at motion.

Then a gentle examination in the separate examination room, with a lady attender present. She checks the strength of the pelvic floor squeeze, whether the bladder wall, uterus or back passage has come down and how far, and whether urine leaks when you cough.

The tests are simple: a urine test for infection and sugar; a bladder diary, three days of noting drinks, toilet visits and leaks; an ultrasound scan when needed, to check the uterus, the ovaries and the urine left behind after passing; and blood sugar (HbA1c).

Pelvic floor exercises, taught properly. Most women who say Kegel exercises did not work were squeezing the wrong muscles. Dr. Ragavi confirms during the examination that you are tightening the right ones, then gives a written schedule. Done correctly for three months, they improve stress leaking in most women and help mild prolapse.

Bladder training for the urge type: timed toilet visits with the gap stretched each week, and less tea, coffee and late-evening fluid. Tablets that calm the bladder muscle are added if the urge persists.

Weight and constipation. Losing a few kilograms reduces leaking. Constipation pushes a prolapse down, so fibre, water and a stool softener are part of the plan.

A vaginal pessary. A soft silicone ring placed in the vagina to hold the uterus or bladder wall up. It is fitted at the clinic in minutes and suits women who want to avoid an operation or want more children first.

Oestrogen cream after menopause restores the thinned tissue, eases urgency and dryness, and reduces repeated urine infections. Very little is absorbed, so it suits most women. See also menopause care in Chennai.

Surgery, when the prolapse comes outside, disturbs the bladder or bowel, or you prefer a one-time solution. Dr. Ragavi performs pelvic reconstruction (repairing the vaginal walls and their supports) and vaginal hysterectomy for a uterus that has come down, at the affiliated hospital. See hysterectomy (uterus removal) in Chennai.

Surgery for stress leaking alone (a sling operation) is needed by few women. If you are one of them, Dr. Ragavi explains the operation and where it is done.

Consultation, examination, scans, exercise teaching, pessary fitting and follow-up happen at RV Clinic Madipakkam or RV Clinic Thalambur, whichever is closer to you. If you need surgery, it is done by Dr. Ragavi Vikram herself at Unittas Multispeciality Hospital, which is 21 km from the Madipakkam clinic and 5 km from the Thalambur clinic. RV Clinic is an outpatient clinic. No operation is done at either clinic address.