National Association Center of Excellence for Continence

The Woman's Hospital of Texas is recognized for excellence in urogynecology and is one of less than 20 in the nation to offer a "Center of Excellence" for Continence Care In Women.

Urogynecology is a subspecialty within obstetrics and gynecology that treats women with pelvic floor disorders, such as recurrent bladder infections, urinary or fecal incontinence, and prolapse (bulging) of the vagina, bladder, and/or the uterus and rectum. Our Center of Excellence focuses on restoring quality of life to patients and is staffed by board-certified physicians, physical and occupational therapists, and nurses who are specially trained in treating pelvic floor disorders.

Pelvic Floor Disorders

Women are uniquely susceptible to pelvic floor disorders that may lead to incontinence, prolapse, sexual dysfunction, and lower back pain. These disorders affect women’s pelvic organs -- the uterus (or womb), vagina, bladder, rectum, and the muscles that surround and support them.

Any medical conditions or injuries that have an impact on the health of nerves, such as diabetes, Parkinson’s disease, stroke, back surgery, spinal injury, multiple sclerosis, or childbirth, can also weaken the pelvic floor muscles and ligaments.

Many people are sensitive and embarrassed about their condition or assume it is a natural result of aging or childbirth. But, according to the American Urogynecologic Society, one-in-three women will experience a pelvic floor disorder in her life.


It is not uncommon for women to experience some type of bladder incontinence during their lifetime or voluntary leakage of urine.

  • Stress incontinence – the involuntary loss of urine with physical exertion, including coughing, sneezing, getting up from a chair, laughing, and exercising.
  • Urge incontinence – the loss of urine that occurs with a strong desire to urinate but an inability to get to the bathroom in time.
  • Mixed incontinence – a combination of stress and urge incontinence.
  • Incomplete voiding - a small amount of urine remaining in the bladder after voiding is normal, but a “high post void residual” indicates that the bladder is not emptying as fully as it should.

Available treatments include pelvic floor therapy, physical therapy, and minimally-invasive surgery.


The pelvic organs (bladder, uterus, and rectum) are supported by a complex hammock of muscles, ligaments, and bones. Damage to this support system may result in prolapse. It can be caused by a "falling" cervix, uterus, or the walls of the vagina. Common causes of prolapse, which can also occur through the anal opening, include childbirth, hysterectomy, obesity, aging, chronic asthma, or constipation.

Women with severe cases may feel or see tissues coming out of the opening of their vagina. Women with mild cases experience symptoms that are vague and nonspecific, such as a feeling of pelvic heaviness or pressure either all of the time, after a long day on their feet, or after exercising. While not life threatening, prolapse causes significant quality of life issues. It also commonly occurs with other pelvic floor disorders, including urinary or anal incontinence, constipation, or overactive bladder.

Treatment options for prolapse include the use of watchful waiting, pessaries, or surgery.

Treatment for Pelvic Floor Disorders

The Woman's Hospital of Texas is home to a team of experts in treating pelvic floor disorders, which can be corrected through behavioral physical therapy, surgery, or medication.

Minimally Invasive Surgical and Non-Surgical Treatments

We hold an accreditation as a Center of Excellence in Robotic Surgery (COERS), as well as Center of Excellence in Minimally Invasive Gynecology (COEMIG).

Many patients benefit from minimally invasive surgical procedures. Minimally invasive surgery means less blood loss, faster recovery time, less pain medication, and less scarring. Some procedures can even be done on an outpatient basis. Our center offers the latest minimally invasive surgical and non-surgical treatments for women with:

  • Bladder fistula
  • Pelvic organ prolapse
  • Pelvic or sexual pain
  • Bladder or bowel control issues

Pelvic floor therapy

We also offer non-surgical options for incontinence, bowel problems, and sexual and pelvic pain through our physical therapy department. All of our therapists have extensive post-graduate training in women’s pelvic health. Our clinic provides a clean, safe environment and open communication with therapists is encouraged.

Our team of pelvic therapy specialists will work with you to provide the proper treatment for your condition. Physical therapy is provided for pelvic organ prolapse, pelvic pain, sexual pain, scar pain, and fecal and urinary incontinence. Physical therapy starts with evaluation and based on these findings each patients gets a tailored plan of care designed to meet their goals.

Learn more about pelvic floor therapy