I'm Megan Dillman. I'm a women's health nurse practitioner at Pelvic Medicine and Reconstructive Surgery here at the University of Virginia. Typically, we are dealing with 
issues of urinary incontinence, pelvic organ prolapse, and fecal incontinence. If someone is having urinary leakage, or feeling uncomfortable bulge symptoms in their pelvic area, or having bowel leakage, that would be an indication that they should come and see us. The troubling thing is many patients aren't aware that this is an actual medical concern, more so than a natural process of aging. Patients that I've talked to have sort of not even realized that a clinic like pelvic medicine exists, where this can be addressed specifically. We'd really try to prioritize what their personal goals are for coming. Whether that be using less pads a day or eliminate leakage altogether, we really try to have a patient-focused set of goals that we sort of work towards together. If a patient does not achieve the results they're hoping for. If we don't meet their goals with conservative management, there are other second and third line therapies that we offer. Botox injections in the bladder wall for overactive bladder. There's also sacral nerve modulation for overactive bladder and fecal incontinence as well. We frequently have patients that are from Tennessee or areas where they've driven five or six hours to come get an opinion from us. And I feel like that just speaks really highly of this institution, but also the providers in the practice.