Advanced Urogynecology of Michigan (AUGM)
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Advanced Urogynecology of Michigan (AUGM)
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Frequently Asked Questions – Advanced Urogynecology of Michigan

Pelvic floor symptoms can affect daily comfort, confidence, sleep, work, intimacy, and quality of life. Advanced Urogynecology of Michigan (AUGM) in Dearborn provides specialized care for urine leakage, recurrent bladder infections, pelvic organ prolapse, bowel leakage, constipation, bladder pain, and pelvic pain with Dr. Salil Khandwala. If you don’t find the answer you’re looking for, call (313) 982-0200 or send us a message. 

Main FAQs

Where is Advanced Urogynecology of Michigan located?

Advanced Urogynecology of Michigan is located at 22731 Newman Street, Suite 200, Dearborn, MI 48124. Patients visit AUGM for specialized pelvic floor and urogynecology care in Southeast Michigan. 

AUGM is led by Dr. Salil Khandwala, Medical Director. Their work focuses on urogynecology, pelvic reconstructive surgery, and care for women living with bladder, bowel, prolapse, and pelvic floor conditions. 

AUGM treats urine leakage, frequent bladder infections, vaginal bulge and prolapse, bowel leakage, constipation, bladder pain, and pelvic pain. Care is built around accurate diagnosis, education, and treatment options that help women return to daily life with more control and confidence. 

Many urogynecology evaluations and medically necessary treatments may be covered by insurance, but benefits vary by plan. AUGM accepts many insurance plans, and patients are encouraged to understand their individual coverage, deductible, copay, and authorization requirements. 

Appointment timing depends on availability, your symptoms, and completion of the new-patient registration process. Creating your patient portal account, uploading insurance information, completing forms, and watching assigned educational videos helps the appointment process move more smoothly. 

AUGM combines advanced urogynecology expertise with a thorough evaluation process and patient education before the visit. Dr. Khandwala has developed specialized techniques for stress incontinence and uterine-sparing prolapse surgery, and AUGM focuses on helping women understand their condition before choosing treatment. 

Not always. Many urogynecology evaluations, conservative treatments, office procedures, and minimally invasive options do not require hospitalization, although the right setting depends on your diagnosis and treatment plan. 

You can begin by registering through the patient portal or calling AUGM at (313) 982-0200. New patients are guided through forms, insurance information, educational videos, and appointment preparation before the first visit. 

Your first appointment should include a detailed history, review of symptoms, and a thorough urogynecological evaluation. The goal is to identify the real cause of your symptoms and create a treatment plan that fits your body, priorities, and daily life. 

AUGM serves patients in Dearborn and surrounding Michigan communities. Patients also travel to AUGM for specialized urogynecology and pelvic floor care.

Urine Leakage FAQs

What is urine leakage?

Urine leakage, also called urinary incontinence, means urine escapes when you do not intend for it to happen. Some women leak with coughing, laughing, sneezing, lifting, or exercise, while others leak after a sudden urge to urinate. Many women experience both patterns at the same time. The right treatment depends on whether the leakage is related to pelvic support, bladder urgency, muscle function, or another underlying factor. 

You may be a candidate for urine leakage treatment if leaking affects your exercise, sleep, work, travel, intimacy, or confidence. Treatment can also help if you plan your day around bathrooms, wear pads regularly, avoid activities, or feel anxious about accidents. You do not need to wait until leakage is severe. Evaluation can help determine whether the problem is stress incontinence, urge incontinence, mixed incontinence, or another bladder concern. 

No. Urine leakage treatment may include pelvic floor therapy, bladder training, lifestyle changes, medications, office-based options, or surgery depending on the cause. Stress incontinence and urgency-related leakage are treated differently, so diagnosis matters. Some women improve without surgery, while others need a more advanced procedure for lasting control. The best plan is based on symptoms, exam findings, health history, and how much leakage disrupts daily life.

Recovery depends on the type of treatment. Conservative care may not require downtime, while medications or bladder training may take time to show full improvement. Office-based or surgical treatments may involve activity restrictions, pelvic rest, or temporary changes while the tissues heal. The most important factor is matching recovery expectations to the exact treatment being recommended because urine leakage care can range from simple behavior changes to more involved procedures. 

Urine leakage treatment is often considered medically necessary when symptoms affect quality of life, but coverage depends on your insurance plan and the recommended treatment. Some plans may require testing, documentation, authorization, or conservative treatment before approving certain procedures. Patients should review benefits carefully and ask about copays, deductibles, and prior authorization requirements before moving forward. 

The two most common patterns are stress urinary incontinence and urge urinary incontinence. Stress leakage happens with pressure on the bladder, such as coughing, laughing, sneezing, or exercising. Urge leakage happens when a sudden need to urinate becomes difficult to control. Some women have mixed incontinence, which means both patterns are present and the treatment plan may need to address more than one cause. 

Diagnosis usually starts with a detailed symptom history, pelvic exam, and discussion of when leakage happens. Some patients may need urine testing, bladder testing, or additional evaluation depending on the pattern and severity of symptoms. The goal is to understand whether leakage is caused by weak support, bladder overactivity, incomplete emptying, infection, prolapse, or another pelvic floor problem. Accurate diagnosis helps avoid treating the wrong issue. 

Preparation helps make the appointment more productive. Helpful steps include: 

  • Noting when leakage happens and what triggers it 
  • Tracking how often you urinate during the day and night 
  • Listing pads, liners, or protective products you use 
  • Writing down bladder medications or prior treatments 
  • Being honest about how leakage affects exercise, sleep, intimacy, and daily life 

Urine leakage is common, but it is not something you have to simply tolerate. A clear symptom history helps identify the most effective path toward better control. 

Frequent Bladder Infections FAQs

What is frequent bladder infection?

Frequent bladder infection usually means repeated urinary tract infections, often involving the bladder and lower urinary tract. Symptoms may include urgency, frequency, burning with urination, bladder discomfort, incomplete emptying, cloudy urine, odor, or blood in the urine. If infection travels toward the kidneys, symptoms like back pain, fever, or chills may occur. Recurrent symptoms deserve careful evaluation, so treatment is not limited to repeated antibiotics without understanding the cause. 

You may be a candidate for recurrent bladder infection evaluation if you get repeated UTIs, symptoms return soon after treatment, infections happen after sex, or antibiotics are not solving the problem long term. Evaluation is also important if symptoms occur with prolapse, diabetes, incomplete emptying, pelvic pain, or bladder irritation. The goal is to confirm whether infections are truly present and identify why they keep happening. 

No. Most frequent bladder infection treatment is not surgical. Care may include urine testing, culture-guided antibiotics when appropriate, prevention strategies, vaginal estrogen when appropriate, hydration guidance, behavioral changes, and evaluation for bladder emptying or pelvic floor problems. Additional testing such as cystoscopy or imaging may be recommended for certain patients. Surgery is only considered when a structural issue is contributing to the infections and conservative care is not enough. 

An uncomplicated bladder infection may improve within a few days after appropriate treatment, but recurrent infection care is more focused on prevention over time. If infections are happening repeatedly, recovery means reducing the frequency of future episodes and identifying any contributing factors. Some patients need ongoing prevention planning, while others improve once the underlying problem is corrected. Kidney infection symptoms or fever require faster medical attention. 

Evaluation and treatment for recurrent urinary tract infections are often covered when medically necessary, but benefits vary by insurance plan. Coverage may depend on testing, diagnosis, medications, procedures, and whether prior authorization is required. Patients should review plan details and ask about out-of-pocket costs for visits, urine cultures, imaging, cystoscopy, and prescribed medications. 

Bladder infections may keep returning because bacteria are repeatedly entering the bladder, the bladder is not emptying well, hormone changes affect tissue health, or another pelvic floor condition is contributing. Some women notice infections after sex because bacteria near the urethra can be pushed into the bladder. Recurrent infections should not be treated casually because unnecessary antibiotics can increase resistance and side effects. 

Yes. Urgency, burning, frequency, and bladder discomfort can happen with conditions other than infection, including bladder pain syndrome, pelvic floor dysfunction, irritation, or inflammation. This is one reason urine culture may be important when symptoms are frequent or confusing. Treating every symptom flare as an infection can lead to unnecessary antibiotics and may delay the right diagnosis. 

A clear history helps separate true recurrent infection from bladder irritation or pelvic pain. Helpful steps include: 

  • Listing how many infections you have had and when they occurred 
  • Bringing prior urine culture results if available 
  • Noting whether symptoms happen after sex 
  • Writing down antibiotics used and whether they helped 
  • Mentioning fever, back pain, blood in the urine, or incomplete emptying 

Frequent bladder infections can be frustrating and disruptive, but a careful evaluation can change the pattern. The goal is not only to treat the next infection, but to reduce the chance of repeated infections in the future. 

Vaginal Bulge | Prolapse FAQs

What is vaginal bulge or pelvic organ prolapse?

Vaginal bulge or pelvic organ prolapse happens when pelvic organs drop from their normal position and press into the vaginal canal. Women may feel pressure, heaviness, a bulge, or the sensation that something is falling out. Prolapse can involve the bladder, uterus, vaginal walls, rectum, or top of the vagina after hysterectomy. Symptoms vary widely, and the degree of bulge does not always match how much it bothers daily life. 

You may be a candidate for prolapse treatment if you feel vaginal pressure, see or feel a bulge, have trouble emptying your bladder or bowels, or avoid activities because of pelvic heaviness. Treatment may also help if prolapse affects intimacy, exercise, standing, or comfort. Some women need only monitoring or support, while others need a more active plan because symptoms interfere with daily living. 

No. Prolapse treatment may include observation, pelvic floor therapy, pessary support, lifestyle changes, or surgery. The best choice depends on symptoms, prolapse severity, age, health, sexual activity, uterus status, and personal preferences. Some women want to avoid surgery as long as possible, while others want a more durable repair. Uterine-sparing surgical options may be available for women who want prolapse repair without hysterectomy. 

Recovery depends on the treatment. A pessary or pelvic floor therapy usually has little to no downtime, while prolapse surgery may require several weeks of activity restrictions, pelvic rest, and lifting limitations. Patients who have surgery should expect gradual improvement rather than an immediate return to full activity. Recovery planning should include work demands, caregiving, exercise, and the amount of physical strain in daily life. 

Pelvic organ prolapse treatment is often medically necessary when symptoms are bothersome or affect bladder, bowel, or sexual function, but insurance coverage depends on the plan and treatment type. Visits, pessaries, testing, and surgery may have different coverage rules. Patients should confirm benefits, authorization requirements, deductibles, and out-of-pocket costs before scheduling a procedure. 

Yes. Prolapse can make it harder to empty the bladder, create a feeling of incomplete emptying, contribute to urinary symptoms, or make bowel movements more difficult. Some women notice they need to change position or apply pressure to empty more completely. These symptoms can be embarrassing, but they are important to discuss because they help identify which pelvic structures are involved. 

In selected cases, yes. Some prolapse procedures can preserve the uterus while restoring pelvic support. Uterine-sparing surgery may appeal to women who want prolapse correction without hysterectomy, but candidacy depends on anatomy, symptoms, medical history, and the type of prolapse present. A thorough evaluation helps determine whether preservation is safe and appropriate. 

How can I prepare for a vaginal bulge or prolapse appointment? 

Preparation helps clarify how prolapse is affecting your life. Helpful steps include: 

  • Noting when the bulge feels worse, such as standing, lifting, or later in the day 
  • Writing down bladder or bowel emptying problems 
  • Mentioning discomfort with intimacy or exercise 
  • Thinking about whether you prefer non-surgical or surgical options 
  • Asking whether uterine-sparing repair may be appropriate 

Prolapse treatment should reflect both anatomy and quality of life. The right plan is the one that relieves symptoms while respecting your goals, health, and preferred recovery timeline. 

Bowel Leakage FAQs

What is bowel leakage?

Bowel leakage, also called fecal incontinence, means stool or gas leaks when you do not intend for it to happen. It may involve small staining, urgency accidents, trouble controlling gas, or larger stool leakage. Bowel leakage can be caused by pelvic floor weakness, nerve injury, childbirth-related changes, stool consistency, diarrhea, constipation, prolapse, or muscle damage. Many women do not talk about it, but treatment options are available. 

You may be a candidate for treatment if bowel leakage affects your clothing choices, work, travel, exercise, intimacy, or confidence leaving the house. Evaluation can also help if you have urgency, accidents, stool seepage after bowel movements, or trouble distinguishing gas from stool. Even mild leakage is worth discussing if it changes how you live. Earlier evaluation can often prevent the problem from becoming more limiting. 

No. Bowel leakage treatment may include diet changes, fiber or stool-consistency management, medications, pelvic floor therapy, bowel retraining, nerve stimulation, or surgery in selected cases. The first step is identifying why leakage is happening. Loose stool, constipation with overflow, pelvic floor weakness, nerve problems, and sphincter injury require different treatment strategies. Many women improve with non-surgical care. 

Recovery depends on the cause and treatment. Dietary changes and stool-management strategies may help within days or weeks, while pelvic floor therapy and nerve-based treatments often require more time and consistency. Surgical recovery depends on the procedure performed and may involve activity limits. The goal is steady improvement in control, urgency, stool consistency, and confidence. 

Bowel leakage evaluation and medically necessary treatment are often covered by insurance, but coverage depends on the plan and treatment recommended. Testing, therapy, medications, nerve stimulation, and procedures may have different benefit rules. Patients should ask about authorization, copays, deductibles, and coverage for ongoing therapy if that becomes part of the treatment plan. 

Childbirth can stretch or injure pelvic floor muscles, nerves, and the anal sphincter, even when symptoms do not appear right away. Aging, menopause, constipation, diarrhea, prior surgery, and pelvic organ prolapse can also affect bowel control. Some women develop symptoms years after the original injury because support and muscle function change over time. A careful evaluation helps connect symptoms to the real cause. 

Yes. Constipation can contribute to bowel leakage when stool builds up, causes pressure, or allows looser stool to seep around harder stool. Straining can also weaken pelvic support and worsen bowel control over time. Treating constipation may be an important part of improving leakage. This is one reason bowel habits, stool consistency, and emptying patterns should all be discussed during evaluation. 

Bowel leakage care works best when symptoms are described clearly. Helpful steps include: 

  • Tracking how often leakage happens and whether it is stool, gas, or staining 
  • Noting urgency, diarrhea, constipation, or incomplete emptying 
  • Listing childbirth injuries, pelvic surgeries, or prior rectal problems 
  • Writing down medications, supplements, and bowel products you use 
  • Being honest about how symptoms affect travel, work, intimacy, and confidence 

Bowel leakage can feel isolating, but it is a medical condition that deserves direct care. A detailed history helps build a treatment plan that improves control and reduces fear of accidents. 

Constipation FAQs

What is constipation?

Constipation means bowel movements are difficult, infrequent, incomplete, or require excessive straining. Some women have hard stools, while others feel blocked even when stool is present. Constipation can be related to diet, hydration, medications, pelvic floor dysfunction, rectocele, prolapse, nerve issues, or bowel motility changes. The right treatment depends on whether the problem is stool consistency, bowel movement coordination, pelvic support, or a combination. 

You may be a candidate for constipation treatment if bowel movements require straining, take a long time, feel incomplete, or require positional changes or vaginal pressure to empty. Evaluation is also helpful if constipation contributes to pelvic pressure, bladder symptoms, bowel leakage, pain, or prolapse. Chronic constipation should not be dismissed when it affects daily comfort or pelvic floor health. 

No. Most constipation treatment begins without surgery. Care may include fiber adjustment, hydration, bowel habit retraining, medication review, pelvic floor therapy, stool-softening strategies, and treatment of underlying pelvic floor dysfunction. Surgery may be considered only when a structural issue such as significant prolapse or rectocele is a major contributor and conservative care is not enough. 

Constipation improvement depends on the cause. Some patients improve within days or weeks with stool consistency changes, while pelvic floor retraining may take longer. If constipation is related to prolapse, rectocele, or obstructed defecation, recovery depends on the treatment chosen. Long-term success often requires consistent habits rather than a one-time fix. 

Constipation evaluation and medically necessary treatment may be covered by insurance, especially when symptoms are chronic or associated with pelvic floor dysfunction. Coverage depends on the plan, testing, therapy, medications, and procedures involved. Patients should confirm benefits and ask whether pelvic floor therapy, diagnostic testing, or surgical correction requires prior authorization. 

Yes. Chronic straining places repeated pressure on the pelvic floor, which can worsen prolapse, rectocele, urinary symptoms, and bowel leakage over time. Constipation can also make pelvic pressure feel heavier and more persistent. Treating constipation is often an important part of protecting pelvic support. A bowel plan may be recommended even when the main complaint seems to be bladder or prolapse related. 

Obstructed defecation means stool is difficult to pass even when you feel the urge to go. Some women feel stool gets trapped, need to strain excessively, change positions, or press on the vagina or perineum to empty. This can be related to pelvic floor muscle coordination, rectocele, prolapse, or other structural concerns. Evaluation helps determine whether the problem is functional, structural, or both. 

Preparation helps identify whether constipation is bowel-related, pelvic floor-related, or both. Helpful steps include: 

  • Tracking bowel movement frequency and stool consistency 
  • Noting straining, incomplete emptying, or the need to press for support 
  • Listing laxatives, stool softeners, fiber, or supplements you use 
  • Writing down bladder, prolapse, or bowel leakage symptoms 
  • Mentioning pain, bleeding, weight loss, or major bowel habit changes 

Constipation can affect far more than bathroom comfort. A careful evaluation can help reduce straining, improve emptying, and protect the pelvic floor over time. 

Bladder / Pelvic Pain FAQs

What is bladder and pelvic pain?

Bladder and pelvic pain can include pressure, burning, aching, urgency, frequency, pain with a full bladder, pain after urination, or discomfort with intimacy. Some women feel symptoms in the bladder, urethra, vagina, pelvis, lower abdomen, or pelvic floor muscles. Pain may be related to bladder pain syndrome, pelvic floor dysfunction, recurrent infection, nerve sensitivity, inflammation, or overlapping conditions. Diagnosis often requires looking beyond one possible cause. 

You may be a candidate for treatment if pelvic discomfort, bladder pressure, urinary urgency, painful urination, painful intimacy, or recurrent “UTI-like” symptoms affect daily life. Evaluation is especially important when urine cultures are negative, antibiotics do not help, or pain keeps returning. Many women live with symptoms for years before getting a focused pelvic floor and urogynecology evaluation. 

No. Bladder and pelvic pain treatment is usually not surgical at first. Care may include bladder retraining, pelvic floor therapy, medications, diet changes, pain-modulating strategies, trigger management, bladder treatments, or other targeted therapies depending on the diagnosis. Surgery is not the default answer and is usually reserved for specific structural problems or carefully selected cases. 

Recovery varies because bladder and pelvic pain often involve more than one factor. Some patients improve after infections, irritants, or muscle spasms are addressed, while others need a longer treatment plan to calm bladder sensitivity and pelvic floor tension. Progress may happen gradually, especially when pain has been present for months or years. A realistic plan should focus on fewer flares, better function, and improved daily comfort. 

Bladder and pelvic pain evaluation is often covered when medically necessary, but coverage depends on the plan and services recommended. Visits, urine testing, cystoscopy, pelvic floor therapy, medications, and procedures may have different benefit rules. Patients should ask about authorization requirements, therapy coverage, copays, and deductibles before starting a longer treatment plan. 

A bladder infection usually involves bacteria and may cause burning, urgency, frequency, cloudy urine, odor, or blood. Bladder pain can feel similar but may persist even when cultures are negative or antibiotics do not help. Some women are repeatedly treated for UTIs when the real issue is bladder sensitivity, pelvic floor dysfunction, or another pain condition. Testing helps separate infection from non-infectious pain. 

Yes. Tight, irritated, or poorly coordinated pelvic floor muscles can contribute to bladder pressure, pelvic aching, painful intimacy, urinary urgency, and incomplete emptying sensations. Muscle-related pain can mimic bladder problems, which is why a pelvic floor evaluation is important. Treating only the bladder may not fully help if pelvic floor tension is part of the cause. 

A detailed symptom history helps identify triggers and patterns. Helpful steps include: 

  • Tracking pain location, timing, and intensity 
  • Noting whether symptoms worsen with urination, sex, foods, stress, or activity 
  • Bringing prior urine culture or infection results if available 
  • Listing antibiotics, bladder medications, or pain treatments you have tried 
  • Mentioning pelvic floor symptoms, bowel issues, and intimacy concerns 

Bladder and pelvic pain can be complex, but symptoms are real and treatable. A careful evaluation helps move the focus from repeated frustration to a more targeted plan. 

Schedule an Appointment with Advanced Urogynecology of Michigan

Pelvic floor symptoms are common, but they should not control your life. Call (313) 982-0200 or send us a message to schedule an appointment with AUGM or begin the new-patient process through the patient portal.