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What is Urogynecology?
Urogynecology is a sub-specialty of Obstetric & Gynecology. An Urogynecologist, is a specialist that has completed their training in OB/GYN and then further specialized in the field of Urogynecology, preferably from an Accreditated American Board of Obstetrics & Gynecology fellowship program. An Urogynecologist has expertise in the diagnosis and treatment of pelvic floor disorders, more specifically pelvic organ prolapse and urinary incontinence.
What causes prolapse?
Due to weakness of the connective tissues of the vagina, the uterus, bladder, or rectum can drop into the vaginal canal and even into the vaginal opening. This is termed prolapse. This is analogous to a hernia which can occur along the lower abdomen due to weakness of the tissue of the lower abdominal wall. Prolapse can result in problems affecting the organ which has prolapsed: urinary incontinence if the bladder has prolapsed, problems with bowel movements if the rectum has prolapsed.
What causes urinary incontience?
Commonly known as lack of bladder control, urinary incontinence is a common problem in adult women. There are various types of urinary incontinence. Your urogynecologist will evaluate your bladder function in order to precisely determine what is causing your bladder problem. This will allow him/her to recommend treatments specifically designed for your care. In order to evaluate your bladder function, you may be asked to complete a bladder diary, undergo a full pelvic exam, undergo bladder function testing (urodynamics), or undergo cystoscopy to examine the inside of your bladder.
Are there non-surgical therapies for prolapse?
Based on your complete evaluation, your urogynecologist will recommend treatment specifically designed for your case. There are a few non-surgical options to choose from. These include pelvic floor exercises, intra-vaginal medications, and devices (pessaries) to help elevate vaginal prolapse. At our center, we provide treatment that is tailored for each woman’s needs and long-term goals.
Will the surgery work for the rest of my life?
We hope that our surgical correction will prevent a prolapse for reoccuring within someone’s lifetime. The reality is however, that one out of three women undergoing surgical correction have had previous surgeries. Prolapse is a hernia that occurs in the vagina and reoccur form due to a varity of risk factors. However, at our center we strive on providing the latest and most prgressive surgical treatments, including the use of synthetic graft materials to correct vaginal prolapse. Also, we offer treatments that are evidence-based and provide the greatest durability based on log-term clinical investigations.
Do I need a hysterectomy to have my prolapse corrected?
The answer in NO. New minimally invasive techiniques allow for the correction of pelvic organ prolapse without the need for a hysterectomy. At our center, we believe in the minimalist approach to surgery where each surgical candidate is offered a surgical plan that maximizes clinical efficacy and benefit and minimizes operative risks.
Are there any restrictions after surgery?
Pelvic Reconstructive Surgery is an art. It has more similarities to cosmetic plastic surgery than to routine gynecologic or general surgery. As such, multiple factors affect the success and healing from a surgical procedure. The main restrictionn is that you will be asked to not lift anything more than 10 lbs for a minimun of 6 weeks. Healing continues beyond six weeks and is not completed until at least 3 or more months after surgery. New mimally invasive techniques for the correction of vaginal prolaspe have greatly reduced post-operative pain, hospital stay and recovery time form many women.
Are there non-surgical therapies for urinary incontinence?
Non surgical therapies include pelvic floor rehabilitation, the use of medications and pessaries. Many times peri-uretral bulking agents can be used that may be an alternative to a surgical procedure. At our center, we strive to provide the best treatment that is suited to for each patient’s needs. Please refer to Non Surgical Therapies for a more detailed description of these medical treatments.