Urogynecology and Pelvic Reconstructive Surgery include evaluation and management of pelvic floor disorders. These disorders include urinary incontinence, including stress incontinence (loss of urine when coughing and sneezing), urgency and overflow incontinence (can’t get to the bathroom to urinate fast enough) as well as anal/rectal incontinence. Anatomical abnormalities include utero-vaginal prolapse (uterus and vagina falling out), vaginal prolapse (vagina falling out), cystocele (bladder falling out through the vagina), rectocele (rectum falling out through the vagina), and enterocele (internal vaginal hernia).
Evaluation and management of these disorders include urodynamic testing for urinary complaints with subsequent, surgical as well as non-surgical recommendations for treatment.
Non-surgical treatments would include the use of pessaries, pelvic floor exercises, bladder retraining, as well as pharmacological therapy.
Surgical management would include both in-patient as well as outpatient procedures depending on the complexity of the problem. Various procedures include vaginal hysterectomy, repair of cystocele, rectocele and enterocele, vaginal vault suspension with or without mesh augmentation, incontinence procedures including endo-vaginal sling, repair of anal sphincter, vaginoplasty and labiaplasty.
With the newer methods of surgical treatment, many times the entire surgical procedure can be completed in one day, with the patient going home on the same day as the surgical procedure.