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Services & Specialties

  • Urogynecology


Women in exercise class

Do you suffer from urinary incontinence and prolapse? You are not alone. Up to one-third of all women have this condition, and half of all women over the age of 50 experience some degree of pelvic floor disorder.

Fortunately, Billings Clinic has the only urogynecologists in Montana, Wyoming and North Dakota who are specially trained to treat pelvic floor disorders. Schedule an appointment with either Dr. Mayr or Dr. Hokenstad to better understand your diagnosis and treatment options.

Conditions Treated by a Urogynecologist

Types of Treatment

  • Botox injections
  • Cystoscopy
  • Non-invasive treatment
  • Minimally invasive surgery
  • Sacral Neuromodulation or InterStim

Questions and Answers

Q: What is a urogynecologist?

A urogynecologist is a physician who went to medical school and completed a four year residency in obstetrics and gynecology and continued on with a three year fellowship training in urogynecology—the evaluation and treatment of female pelvic organ conditions. This specialty focuses on the surgical and non-surgical treatment of non-cancerous gynecologic problems. Some common problems treated by a urogynecologist include urinary incontinence or leakage, pelvic organ prolapse (bulging of the vaginal walls and/or uterus), and overactive bladder.

Q: What can I expect during my visit?

Prior to your visit you will receive a questionnaire that you will fill out and bring with you to your appointment. This questionnaire provides a wealth of information regarding your complaints, how they bother you, and how they impact your life. This helps to streamline the initial interview with the physician so that more time can be spent evaluating the issues and spending the time necessary to carefully explain the surgical and non-surgical options that might be available to you based upon a thorough physical exam.

When you arrive at the office you will be asked to leave a urine specimen. A urine sample will help us determine if there is a urinary tract infection prior to a bladder function test—this test may be performed whether you suffer from incontinence or even prolapse, which may cause your bladder to malfunction. The physical exam is very similar to a general gynecological exam with special attention paid to the support of the bladder, uterus, vagina, and rectum. The muscles of the pelvic floor will also be evaluated for strength and any pain that might exist. The evaluation is typically performed lying on an exam table but may be performed in a standing position to help determine the severity of prolapse or incontinence in an upright position. Upon completion of the exam you will get dressed and the physician will return to thoroughly explain all of your options and answer any questions that you may have.

Additional Resources

National Association for Continence

American Urogynecologic Society

Association for Pelvic Organ Prolapse Support

Schedule an Appointment

For an appointment with Dr. Mayr or Dr. Hokenstad, Urogynecologists, call:

406-238-2500 or 800-332-7156

Do you have health questions?

The registered nurses at HealthLine are available 24/7.

406-255-8400 or 800-252-1246