Urogynecology Team Performs Advanced Solutions In-Office for Bladder Dysfunction
When first-round therapies fail patients suffering bladder dysfunction, specialists at Orlando Health Women's Institute Center for Urogynecology provide minimally invasive diagnostic and therapeutic solutions in-office. Diagnosing and treating bladder control issues in the office, rather than the operating room, enhances access and prioritizes patient convenience while expediting relief.

Overactive bladder (OAB) and urinary or urgency incontinence affect more than 40% of women in the United States. When relief is not provided by gold standard, beta-3 agonist medications and pelvic physical therapy, sub-specialty trained urogynecologists at Orlando Health are able to offer patients relief with next-level therapies such as Botox injections to the bladder.
“What differentiates our center is that we offer these injections, as well as diagnostic cystoscopy and sacral neuromodulation, in the office rather than the operating room,” says Sonali Raman, MD, a dual board-certified urogynecology and reconstructive pelvic surgeon at Orlando Health Women's Institute Center for Urogynecology.
“For patients, the downtime is minimal,” she says. “Often, it’s a 30-minute appointment where the actual procedure lasts two to five minutes, and then they’re up and walking immediately after.”
Botox injected into the bladder treats urinary and urge incontinence by relaxing the muscles of the organ. Botox works best for women with OAB who don’t suffer urinary tract infections or urinary retention, and post-void residual is checked before offering the injection. Efficacy ranges from 50% to 80%, reducing a patient’s 10 episodes of urgency to five or even three episodes, for a period of six to nine months.
“Most patients feel the effect immediately and it continues to improve until the two-week mark, where they tend to plateau for the next six or so months before reinjection,” says Dr. Raman.
“Patients tell us it gives them peace of mind knowing they will feel a similar amount of relief every six months. And if a patient has not reached her goals after three injections, we will move toward sacral neuromodulation.”
Orlando Health is dedicated to revolutionizing patient care with outcomes advanced by specialists skilled in the most leading-edge technologies and involved in advanced clinical research and training.
At Orlando Health Women's Institute Center for Urogynecology, patients receive comprehensive care from a team of specialists who are all fellowship-trained and board-certified in urogynecology and reconstructive pelvic surgery (URPS). Physicians treat only women and offer an entire spectrum of evidence-based urogynecologic services, from education, therapy and medication to the most complex, minimally invasive and robotic surgery options.