Urogynecology

The Urogynecology Service is a combined service consisting of Female Pelvic Medicine and Reconstructive Surgery, and Pelvic Floor Physical Therapy. All healthcare treatment plans are individualized using a patient-physician shared decision making process.

FEMALE PELVIC MEDICINE & RECONSTRUCTIVE SURGERY (FPMRS)

The FPMRS surgeons provide comprehensive, cutting-edge surgical and non-surgical care for women with pelvic floor disorders. Your FPMRS team may consist of a fellowship-trained surgeon, FPMRS fellow, Ob/Gyn resident(s), and/or medical student(s).   

Common Diagnoses:

Pelvic organ prolapse:

• Cystocele
• Rectocele
• Uterine prolapse

Urinary disorders:

• Stress Incontinence
• Urgency incontinence
• Urinary retention
• Bladder pain syndrome
• Recurrent urinary tract infections

Bowel disorders:

• Accidental bowel leakage
• Constipation

Other:

• Urethral diverticulum
• Vulvar/vaginal/urethral cysts
• Genitourinary/rectovaginal fistulas
• Pelvic pain disorders
• Female sexual dysfunction

Capabilities

All of our surgeons are trained in all office-based procedures and all minimally invasive surgical techniques. Nearly all of our procedures are performed in minimally invasive fashion, to include laparoscopic, vaginal, and robotic surgical approaches.
 

Office-based Services

• Urodynamic testing
• Cystoscopy (Botox and bulking procedures)
• Bladder instillations
• Pessary and bowel control device fittings
• Posterior tibial nerve stimulation
• Trigger point injections
• Pelvic floor Botox injections

Common Surgical Procedures:  

• Stress incontinence:

• Midurethral sling (synthetic mesh)
• Pubovaginal sling (non-mesh)
• Urethral bulking injection

• Urge incontinence:

• Sacral nerve stimulation

• Prolapse surgery – laparoscopic, vaginal, or robotic approaches, with optional:

• Removal of the uterus (hysterectomy)
• Mesh/graft augmentation
• Removal of the tubes and/or ovaries

 

PELVIC FLOOR PHYSICAL THERAPY (PFPT)

The Pelvic Floor Physical Therapy clinic provides examination and treatment of pelvic floor muscle dysfunction related to urinary and bowel leakage, pelvic organ prolapse, constipation, and pelvic pain symptoms. We examine and treat symptoms from a neuromusculoskeletal perspective, working closely with physicians from various specialties to provide comprehensive treatment. Our pelvic floor physical therapists have advanced training in pelvic floor dysfunction at the doctorate level.
 
Please note: Pelvic Floor Physical Therapy services are available to both female and male patients.
 

Common Diagnoses:

• Stress urinary incontinence
• Urgency urinary incontinence
• Urinary retention (of muscular cause)
• Constipation (of muscular cause)
• Fecal incontinence
• Pelvic organ prolapse
• Pelvic pain
• Pain with sexual activity and/or sexual dysfunction
• Pregnancy and post-partum related pelvic girdle pain: pubic symphysis and sacroiliac joint dysfunction
• Diastasis rectus abdominis
• Post-surgical/oncology rehabilitation of the genitourinary system, including but not exclusive to pelvic reconstructive surgeries and pelvic radiation

 

Treatments offered:

• Instruction in correct form and frequency of pelvic floor exercises (Kegels)
• Biofeedback training
• Education on bowel and bladder irritants
• Bladder training to help regain normal function and habits
• Therapeutic exercise for improved core and pelvic girdle stability
• Body mechanics training
• Manual techniques to improve tissue and joint mobility
• Scar massage / mobilization
• Relaxation training of the pelvic floor
• Electrical stimulation: transcutaneous nerve stimulation (TENS) and neuromuscular e-stim (NMES)
• Pain modalities: ultrasound, cold, and heat