What's New
Our gynecologic practice strives to offer our patients current and effective diagnostic and therapeutic procedures. Urinary incontinence (loss of urine, especially when coughing, sneezing, laughing, etc.) is common especially after childbearing. Treatment of stress urinary incontinence, once confirmed, has markedly changed and improved in the past five to ten years. Pelvic floor exercises, including Kegel exercises, are recommended but commonly do not improve the problem of incontinence. Outpatient, minimally invasive procedures are now available that will improve or cure the vast majority of patients exhibiting stress urinary incontinence.
Women with moderate or severe stress urinary incontinence need additional support of the bladder and urethra. This can be accomplished with a sling of nylon mesh placed vaginally (TVT, www.controlsuddenurineloss.com). It can be done as an outpatient procedure, but also can be done with other procedures such as hysterectomy.
Relaxation of ligament support to the uterus and/or vagina (uterine prolapse, cystocele, rectocele) occurs commonly, especially after childbirth. Vaginal repair ordinarily includes removal of the uterus, vaginal hysterectomy, to achieve the best possible long-term success of the repair. However, at time preservation of the uterus is important, for example desire for future childbearing. Procedures to correct this condition are done vaginally (sacrospinous fixation) or laparoscopically (Elevest, www.inletmedical.org).
Hysterectomy is an operation that is commonly indicated. Avoidance of abdominal incision is important if at all possible. If cancer, malignancy, is not involved the operation can almost always be accomplished vaginally. It can be done as a less invasive procedure with less anesthesia, pain, complication, hospitalization and recovery time. This is endorsed by the Society of Pelvic Reconstructive Surgeons (www.sprs.org) and the Society of Gynecologic Surgeons (www.sgsonline.org).
