Department of Obstetrics, Gynecology and Reproductive Sciences
Pelvic Floor Program
There are a variety of treatment options for urinary incontinence, including exercise, physical therapy, and surgery. If surgery is required, minimally invasive procedures are available that allow a woman to get back to her active life sooner. One of the latest developments is the tension-free suburethral sling, a thin piece of mesh inserted to support the urethra.
For some patients, the problem can be resolved with a simple office procedure in which the urethral sphincter is strengthened with injections of special bulking agents that increase the resistance in the urethra.
Many treatment options are available for all types of bladder and pelvic floor disorders. Our comprehensive services include:
- Bladder repair (anterior colporrhaphy) is the vaginal repair of dropped or prolapsed bladder. In this procedure, the anterior "skin" of the vagina is opened and the weakened support under the bladder is reinforced using sutures and graft.
- Vaginal rectal repair or rectocele/enterocele repair (posterior colporrhaphy) is the vaginal repair of the weakened support that cause a bulge into the posterior lower and upper part of the vagina, using the same technique as the bladder repair, performed with or without graft augmentation. NOTE: Both the anterior bladder and the posterior rectocele repairs can be done to provide a tightening effect of the vagina, as well as resolving the pressure and bulge they cause.
- Vaginal prolapse repair or vaginal vault suspension is a vaginal procedure that uses minimally invasive techniques to reattach and anchor the upper vagina (vault) to firm ligaments deep in pelvis using grafts and permanent sutures. This procedure is usually done in conjunction with an anterior (cystocele) repair and posterior (rectocele) repair as part of pelvic reconstruction. A concomitant anti-incontinence procedure is often incorporated in the reconstruction.
- Perineoplasty is the external repair of the posterior vaginal outlet to restore normal form and function and is often done in conjunction with posterior vaginal repair when the anatomy has been distorted or damaged by childbirth trauma. The result is a more cosmetic and functional vaginal introitus.
- Suspension of prolapsed uterus:
- a) Vaginal technique – This procedure often requires permanent vaginal mesh or graft material as part of a prolapse repair that attaches to the lower uterus and helps support and prevent further prolapse of the uterus. In cases of extreme prolapse, it may be best to remove the uterus vaginally (vaginal hysterectomy) and to support or suspend the upper part of the vagina with permanent sutures and graft material.
- b) DaVinci-assisted Sacropexy – Allows for the use of minimally invasive techniques to suspend the vagina through the abdomen.
- Urinary Incontinence Sling – A vaginal procedure that uses a thin, permanent mesh under the urethra to control urine loss during coughing, sneezing, laughing or any other activity that increases abdominal pressure and causes bladder leaking. Several techniques exist to introduce the mesh, some using small incisions in the groin and, more recently, by small intravaginal (invisible) incision with minimal pain or discomfort. It is usually done as outpatient.
- Urethral Bulking
- InterStim Therapy
Our faculty is available for services at Robert Wood Johnson University Hospital, as well as to assist physicians in area hospitals.