Urogynecology 2019-01-16T13:02:55+00:00


Graduate doctor at UnB

Specialist in Gynecology and Colposcopy

Post-Graduation in Orthomolecular Practice in Medicine (PUC)

Extensive academic training in Brazil and abroad

Adept of Integrative Medicine

More than 25 Years Dedicated to the Care of Women


Treats disorders such as urinary incontinence


Women during their life may present two pathologies that cause extreme discomfort:


Urinary Tract Infection (UTI) :


When an isolated episode occurs and improves completely with the prescribed medication (usually by the emergency physician) the problem is solved. However, some women have several episodes in months. These patients have recurrent UTIs. In this circumstance, it is essential to consult a specialized doctor who establishes an appropriate treatment for each case with advice on habits, medications, vaccines and hormones. The goal is to prevent new infections and compromise the kidneys.


Urinary Incontinence of Effort:


Some women experience involuntary loss of urine by coughing, sneezing or other effort. Some lose even during intercourse. There are predominantly nocturnal losses and, in other cases, there is an emergency loss in the bathroom.


There are four main causes of urinary loss:


Anatomic: loss of bladder lift.

Hormonal: loss of quality of vaginal and bladder tissues

Muscular: loss of the contraction force of the perineal muscles.

Functional: when the nerves and muscles involved in urination do not act in coordination


There are several effective treatments to treat Urinary Incontinence




To identify the cause or causes of urinary loss requires a detailed consultation and a thorough physical examination. Then some general and specific bladder function tests complement the data for the diagnosis. Once the diagnosis is conceive, is indicated the best treatment for you.

What is interstitial cystitis or painful bladder syndrome ?

It is a condition characterized by pelvic pain related to bladder filling, usually associated with high urinary frequency, usually occurring in women.


The cause of this disease is unknown, and therefore both diagnosis and treatment are difficult. The aim of the treatment of these patients is the control of pain and the improvement of the quality of life. It is not a serious illness or has any serious health consequences.


Therapeutic approaches aim to improve pain through a range of measures ranging from dietary changes to the implantation of sacral electrodes (a form of bladder pacemaker).


What is urinary incontinence ?

There are three types of incontinence :

– Stress urinary incontinence: when there is loss of urine when coughing, laughing, exercises etc.

– Urge incontinence (urge incontinence): it occurs when there is a sudden urge to urinate and the person cannot get to the bathroom in time.

– Mixed urinary incontinence: association of the two previous types.




Genetics, hormones, aging, smoking, overactive bladder, spinal cord injury or diseases of the nervous system, etc.

Approximately 35 % of postmenopausal women suffer from urinary incontinence by making some effort and 40% of pregnant women will experience one or more episodes of urinary incontinence during pregnancy or soon after delivery.





Exercises to strengthen the pelvic floor musclesmay prevent the disease. The exercises consist of contracting the pelvic floor muscles for 10 seconds and then relaxing them for 10 seconds (Kegel exercises). These exercises should be repeated 10 times in three sessions per day. Strengthening these muscles is important for controlling urination.




It is important to emphasize that involuntary loss of urine is not a normal finding of aging and that there are effective treatments that seek to return the quality of life to the patient.

Treatments consist of pelvic floor exercises, medications and surgeries. For cases of overactive bladder there are still other options, such as administration of botulinum toxin directly into the bladder muscle or electrical stimulation of the pelvic nerves (implantation of a “pacemaker” into the bladder).


What are recurring urinary tract infections ?

There are patients (usually women) who are predisposed to the development of urinary tract infections (cystitis). The reasons for this predisposition areunknown, but it seems to be related to failures in the natural defenses of the bladder to the bacterial attack (lack of antibodies in the bladder lumen, failure of natural bladder defense mechanisms such as pH, intravesical protective layers …)


These patients develop pictures of cystitis (intense urethral pain upon urination, frequent and small urination, urinary urgency, and sometimes urinary bleeding) very often. The term repetitive ITU applies to those who have three or more infections per year.