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Female Pelvic Reconstructive Surgery
Urogynecology and Reconstructive Pelvic Surgery
Prolapse and incontinence can be uncomfortable, embarrassing and cause women to avoid everyday tasks and social activities. And many women are surprised to hear that the most common reason for a hysterectomy after menopause is pelvic organ prolapse.
Urogynecology and reconstructive surgery combines the specialties of obstetrics and gynecology with additional training in neuro-urologic testing and reconstructive pelvic surgery. These specialists have the expertise to combine treatment for prolapse and incontinence in a single operation. Specialists in urogynecology and reconstructive pelvic surgery have typically completed additional medical and surgical training after residency.
What is reconstructive pelvic surgery?
Surgery to correct prolapse and incontinence may be performed either through a vaginal incision only, a small abdominal incision or a combination of both. Other options include a robotic or laparoscopic approach. A urogynecologist will typically discuss several options with you and help you make a decision that best meets your needs and expectations.
Some types of reconstructive surgery may involve hysterectomy (removal of the uterus) while other options can help avoid a hysterectomy.
Types of reconstructive pelvic surgery
- Vaginal repair — to correct cystocele, rectocele and/or uterine prolapse
- Vaginal hysterectomy — the least invasive method to remove the uterus
- Anal sphincter repair — may correct fecal incontinence
- Fistula surgery — can repair bladder, rectal or urethral fistulas
- Sling procedure— to correct stress urinary leakage
- Urethral bulking procedures — another treatment for stress incontinence
- Sacral nerve stimulation— uses technology similar to a pacemaker to help improve bladder control related to urge incontinence
Who needs reconstructive pelvic surgery?
Reconstruction pelvic surgery may be right for people whose incontinence and prolapse symptoms have not been resolved with non-surgical pelvic floor treatments. This type of surgery can help restore normal bladder and bowel control, restore normal support to the pelvic organs and can help restore normal sexual function.
People with the following conditions may be deemed good candidates for reconstructive pelvic surgery:
- Urinary incontinence (stress and urge incontinence)
- Uterine prolapse
- Vaginal prolapse
- Fistulas involving the bladder, urethra or rectum and the vagina
What to expect from a urogynecologic evaluation
At the time of your initial evaluation, you can expect that your provider will take a comprehensive medical history and perform a detailed examination, which will include a vaginal examination. A urine specimen is typically collected and, if necessary, sent to a lab for analysis. It's also common for the provider to evaluate the amount of residual urine left inside the bladder, either through catheterization or by ultrasound, in some cases.
Additional diagnostic testing, such as bladder testing (aka urodynamics) or cystoscopy, may be recommended and are typically performed in the office.
Once your specific symptoms and conditions have been addressed, they'll provide a detailed treatment plan to meet your individual needs.
Benefits of reconstructive vaginal surgery typically include restoration of vaginal and bladder support, improvement in bladder emptying, reduced incontinence and an improvement in sexual function.
Risks of reconstructive pelvic surgery can include:
- Surgical site infection
- Organ injury
- Urinary retention
- Urinary leakage
- Complications related to sling surgery or vaginal exposure of mesh used to re-support the vagina
Reconstructive pelvic surgery team
We offer excellence in gynecological care, including treatment for serious gynecological issues, at locations that are close to home and easy to access.
Physicians at Main Line Health provide a full range of general and specialized gynecologic services for women — from yearly well-woman examinations and cancer screenings to highly specialized procedures including advanced laparoscopic, hysteroscopic and robotic approaches. Our physicians work closely with our subspecialists as well as other physicians at Main Line Health on complex problems at all stages of a woman's life, from adolescence to the specific needs of the aging woman.
Main Line Health's Philadelphia area hospitals — Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital — offer comprehensive women's health services to meet your needs and those of your family. Our healthcare experts are uniquely qualified to address the special concerns of women.
Whether you’re seeing us for common gynecological problems or seeking out advanced therapies and the very best surgical expertise, our physicians, board-certified are here for in gynecology, are here for you every stage of your life from adolescence through the childbearing years into menopause and beyond.