Pelvic Floor & Urogynecology
Don’t suffer in silence! While it may be uncomfortable to discuss symptoms like incontenience, pelvic floor conditions are common and often easily treatable. Some conditions we treat include urinary incontinence, overactive bladder, and pelvic organ prolapse.
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Not to be confused with plastic surgery, this procedure focuses on repairing and reconstructing problems rather than improving aesthetics. Reconstructive surgery is recommended to help restore your body after injury, or correct abnormalities to improve body function.
Some examples of issues that would require reconstructive surgery include:
- Native Tissue Repair - Used to treat pelvic organ prolapse. The purpose of this procedure is to correct the prolapse, maintain continence and preserve the reproductive functions.
- Colporrhaphy - This minimally invasive procedure known as “vaginal wall repair”, is used to treat defects and strengthen your vaginal wall after a pelvic organ prolapse.
- Sacrocolpopexy - This major surgical procedure is used to treat and correct vaginal vault prolapse in females who have had a previous hysterectomy.
- Sacrohysteropexy - This is another major surgical procedure used to treat and correct uterine prolapse. A strip of synthetic mesh is used to lift the uterus and hold it in place allowing for normal sexual and childbearing functions.
Pelvic Organ Prolapse
Prolapse of the cervix, uterus, bladder, urethra, vaginal walls, or intestines may cause some discomfort, pelvic pressure, and discomfort with activity. Risk factors for prolapse include pregnancy, vaginal delivery, being overweight, having chronic constipation, and activities with repeated lifting. Once the muscles weaken on the pelvic floor, they cannot provide adequate support to pelvic organs, and the organs prolapse into the vagina or beyond.
At Metro, we assess your risks for prolapse, and guide you through conservative treatments like physical therapy or other strengthening exercises and can take you through the whole spectrum of treatment and reconstructive surgery.
Cystocele is when the bladder drops down from the normal supported area into the vagina. It may obstruct some of the vaginal canal, causing pain with sex, urinary loss or leakage, and a persistent pelvic pressure. There may also be symptoms of incomplete urinary emptying, more frequent bladder infections, or pain.
There are several treatments to aid in restoring your normal anatomy. Some treatments are conservative, such as physical therapy, or may involve the use of a pessary, which is a small rubber device to restore the anatomy temporarily, or surgical options like colporrhaphy or mesh insertion. Come see your Metro doctor today to review the risks of bladder prolapse, or anterior vaginal prolapse.
Have you ever had to cross your legs with coughing or sneezing? You might incontinence, or involuntary leakage of urine.
There are various symptoms associated with incontinence, such as the sensation of needing to frequently empty, pain with emptying, incomplete emptying, nighttime urination, or leakage ranging from drops to large amounts of urine. Causes of this problem include parity or prior deliveries, chronic constipation, and loss of muscle strength in the pelvic floor or underneath the urethra.
Treatment for this condition may range from conservative, such as lifestyle changes to avoid drinking close to bedtime, avoidance of bladder irritants such as caffeine and alcohol, and medication adjustments. If conservative therapy does not work, there is a role for physical therapy at home and at a center, fractionated laser to the vagina, urethral Botox injections, and sling placement.
See your Metro doctor today to start the conversation about your bladder symptoms, and we’ll create a customized treatment plan to suit your lifestyle!
Rectocele or Enterocele
This is also known as posterior vaginal prolapse, when the organs behind the back wall of the vagina are bulging through the vaginal muscle. Symptoms of this may include pelvic pressure, discomfort with sex, incomplete emptying of your bowels, and straining with bowel movements.
Typically, when a patient presents with bothersome prolapse, we start with conservative treatment, such as increasing fiber, working on healthier bowel habits, and a course of physical therapy. If conservative treatments fail, we can always repair the muscle weakness with posterior colporrhaphy or add a mesh.
Pelvic Floor Physical Therapy
Physical therapy has evolved quite a bit! There are many options for PFPT to suit your needs. We offer at home devices, such as the vFIT+ and the leva pelvic floor system, which you can use on your own, or referrals to skilled physical therapists who have additional tools at their disposal. PFPT is for anyone who has pelvic pain, prolapse, painful intercourse, or has bladder or bowel dysfunction.
If you think you have any of these symptoms, see your Metro Doc to start the conversation.