Female Pelvic Medicine and Reconstructive Surgery (Urogynecology)

Finding help for pelvic floor disorders

If you are suffering from a pelvic floor disorder, you are not alone. Almost one out of every four women suffers from at least one type of pelvic floor disorder whether it be urinary incontinence, anal incontinence or pelvic organ prolapse. Pelvic floor disorders are a major health concern for all women, especially as you grow older.

Choosing a physician to treat your pelvic floor disorder

The growing prevalence of female pelvic floor disorders has given way to female pelvic medicine and reconstructive surgery being recognized and accredited as its own subspecialty within gynecology and urology. When choosing a physician it is important to make sure your physician is board certified specifically in female pelvic medicine and reconstructive surgery so you can trust they are an expert in the evaluation, diagnosis and treatment of your condition.

Experience and expertise in treating female pelvic floor disorders

At Main Line Health, our female pelvic medicine and reconstructive surgery physicians are amongst the few board-certified subspecialists in the Philadelphia region, as well as some of the most experienced clinicians in the United States. They offer both surgical and non-surgical treatments that can help you regain control and get back to living your life more fully.

Understanding pelvic floor disorders

The female pelvic floor is a set of muscles, ligaments and connective tissue that occupy the lowest part of the pelvis and provide support and function for a woman’s internal organs, including the bowel, bladder, uterus, vagina, and rectum. A pelvic floor disorder occurs when this supportive structure becomes weakened or damaged, as the result of pregnancy, childbirth, repeated strenuous activity, menopause and aging, certain neurologic conditions or pelvic surgery. Women suffering from pelvic floor disorders may develop problems with bladder or bowel control or experience protrusion of parts of the vagina or uterus through the vaginal opening.

Female pelvic floor disorders can result in embarrassing symptoms, resulting in significant impairment to a woman’s quality of life.

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

• Incontinence – loss of bladder or bowel control, leakage of urine or feces
• Pelvic organ prolapse – descent of the pelvic organs, including the vaginal walls, uterus, bladder or rectum into or beyond the vaginal canal resulting in bulge and/or pressure symptoms
• Emptying disorders – difficulty urinating or moving bowels
• Fistulas – abnormal opening or communication between the vagina and rectum, vagina and urethra, or vaginal and bladder
• Urethral diverticulum – painful cystic out-pouching of the urethra that can trap and leak urine
• Complications of prior pelvic surgeries including hysterectomy, bladder repairs, incontinence procedures, pelvic floor mesh procedures that can result in pelvic pain, incontinence or emptying disorders
• Damage to the anal sphincter muscles, as a result of vaginal delivery or pelvic floor surgery

Diagnosing female pelvic floor disorders

When it comes to pelvic floor conditions, we have experienced female pelvic medicine and reconstructive surgery specialists and one of the largest and most comprehensive diagnosis and treatment programs in the Philadelphia area. We offer of team of board certified physicians, continence nurse specialists and physical therapists. We also offer dedicated programs to help women regain pelvic floor strength and function following pregnancy and delivery.

Diagnostic procedures offered:

• Complex urodynamic studies
• Cystoscopy
• Pelvic floor ultrasonography including endoanal ultrasound
• Pelvic floor muscle and nerve testing

Strength and support through surgical and non-surgical therapy

Main Line Health offers the oldest and most experienced pelvic floor muscle therapy in the Philadelphia region. Our continence nurse specialists and physical therapists work closely with our physicians to offer:

• Bladder retraining – to manage urinary frequency, urgency and urge leakage
• Behavior modification training, including fluid and dietary management
• Biofeedback training for the treatment of both urinary and fecal incontinence as well as detailed assessment and treatment of pelvic muscle weakness
• Electrical stimulation therapy – to recondition bladder and anal sphincter muscles
• Pelvic Floor muscle rehabilitation, including exercises to strengthen the pelvic floor
• Botox injections for urinary incontinence and overactive bladder

Minimally invasive surgical options

Many, but not all pelvic floor disorders, can be treated by surgery—performed both vaginally and abdominally. Minimally invasive surgical options exist for urinary and fecal incontinence and pelvic organ prolapse. Most can be performed as either ambulatory surgery where you go home on the same day or with a one night hospital stay.

Our board-certified surgeons offer surgical treatment including:

• Minimally invasive mid urethral slings for stress incontinence
• Sacral neuromodulation therapy including Interstim® and percutaneous tibial nerve stimulation for urgency urinary incontinence
• Surgical correction of pelvic organ prolapse
• Surgical repair of anal sphincter injuries
• Surgical repair of bladder and rectal fistulas and urethral diverticula
• Prolapsed bladder surgery
• Surgical correction for failed prolapse surgery
• Surgical correction of pelvic floor mesh complications
• Periurethral bulking procedures to treat severe stress urinary incontinence

For women dealing with chronic pelvic pain and complex, noncancerous gynecological conditions, we offer evaluation and treatment by specialty-trained minimally invasive gynecologic surgeons (MIGS).