Urogynaecology and pelvic reconstructive surgery

Urogynaecology and pelvic reconstructive surgery

The problems with the laxity of pelvic muscles can be very distressing to a woman.  Childbirth, constipation, obesity, respiratory problems and other conditions can weaken the pelvic muscles. In advanced cases, the upper section of the vagina or portions of the pelvic area drop into the vaginal canal. Too often, women don’t seek medical care because they are embarrassed, or don’t realize treatments can help.

The Urogynaecology Department at CIMS offers cutting-edge diagnostic and treatment options for women with complex pelvic floor disorders. Depending on your condition, a variety of effective options are available, ranging from healthy lifestyle changes and medications to nonsurgical techniques. The center offers a wide range of state-of-the-art diagnostic and therapeutic procedures as well as consultation services for the following –

  • Urinary frequency & urgency
  • Recurrent urinary tract infections
  • Overactive bladder syndromes
  • Pelvic organ prolapse (dropped bladder, vagina, uterus or rectum),
  • Vaginal Fistulas, diverticula and vaginal agenesis

If you feel something pushing down from the vagina or if your bladder control is inadequate, we can offer you relief from these distressing problems.  Bladder control is a serious issue for women of all ages. In fact, many women suffer some degree of incontinence and most suffer silently. Our first step is to determine the cause of your incontinence. The initial evaluation will include a complete medical history and physical evaluation, a bladder symptom questionnaire and a bladder diary (a 24-hour record of how much liquid you drink and how much you urinate).  In some cases, we will also do an urodynamic examination. It takes approximately 10 minutes and often helps us understand more precisely the cause of your bladder problem.

If the pelvic floor has weakened to the point that surgery is necessary, our urogynaecologists have expertise in minimally invasive, uterine sparing reconstructive surgery as well as hysterectomy that hasten your recovery, and return you to your normal activities faster. 

Nonsurgical Treatments

  • Pessary: This device is inserted into the vagina to support the pelvic organs. Targeting specific symptoms may be another option.
  • Kegel exercises
  • Weight loss

Uterine sparing surgery for pelvic organ prolapse 

  1. Obliterative Surgery
  • Obliterative surgery narrows or closes off the vagina to provide support for prolapsed organs. Sexual intercourse is not possible after this procedure.
  1. Reconstructive Surgery
  • Reconstructive surgery reconstructs the pelvic floor with the goal of restoring the organs to their original position. Some types of reconstructive surgery are done through an incision in the vagina. Others are done through an incision in the abdomen or with laparoscopy.

The types of reconstructive surgery include the following: 

  • Fixation or suspension using one’s own tissues (uterosacral ligament suspension and sacrospinous fixation)
  • Anterior and posterior colporrhaphy
  • Sacrocolpopexy and sacrohysteropexy
  • Surgery using vaginally placed mesh