Urogynecology

 

What is a Urogynecologist?


A urogynecologist is a surgeon who has specialized in the care of women with pelvic floor disorders.

The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that provides support for a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum.

A pelvic floor disorder occurs when women have weakened pelvic muscles or tears in the connective tissue due to excessive strain on the pelvis due to childbirth, repeated strenuous activity, menopause, chronic disease, or pelvic surgery. Other factors that can weaken the  pelvic floor include repetitive heavy lifting, tobacco use, and genetics.

 

The following are some problems that arise from damage to the pelvic floor:

  1. Incontinence: loss of bladder or bowel control, leakage of urine or feces.
  2. Prolapse: descent of pelvic organs; a bulge and/or pressure; ‘dropped uterus, bladder, vagina or rectum.’
  3. Emptying Disorders: difficulty urinating or moving bowels.
  4. Pain: discomfort to the lower back, pelvis or bladder and/or urethra.
  5. Overactive Bladder: frequent need to void, bladder pressure, urgency, urge incontinence (difficulty holding back urine when having the urge to urinate)
  6. Fistulas: abnormal hole between the vagina and rectum (rectovaginal), vagina and urethra (urethrovaginal), or vagina and the bladder (vesicovaginal)
Conditions treated:
  • Pelvic organ prolapse
  • Fecal incontinence
  • Overactive bladder syndrome
  • Urgency urinary incontinence
  • Stress urinary incontinence
  • Vesicovaginal and rectovaginal fistulas
  • Congenital anomalies of the lower reproductive tract (for example, imperforate hymen, vaginal septum, uterine anomalies)
Tests and procedures:

 Diagnostic tests include:

  • Bladder instillation

  • Complex urodynamic testing

  • Cystourethroscopy

  • Urodynamic testing

Innovative treatment options:

  Surgical approaches to pelvic floor disorders include:

  • Minimally invasive hysterectomy
  • Vaginal reconstructive surgery
  • da Vinci® robotic sacrocolpopexy
  • Minimally invasive bladder suspension surgery

Nonsurgical approaches to pelvic floor disorders include:

  • Medications
  • Pessaries
  • Pelvic floor physical therapy
  • Biofeedback
  • Electrical stimulation (“e-stim”)
  • Urge suppression
  • Pelvic floor re-education
  • Behavioral and medical management of urinary incontinence

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© 2018 All Rights Reserved. SD Women's Health.

The center for Womens health, wellness, and minimally invasive surgery

9850 Genesee Avenue - Suite 640
La Jolla, CA 92037

Phone:  858-677-0777
Fax:      858-677-0666

©2018.  All Rights Reserved.  San Diego Women's Health.