Female Pelvic Medicine & Reconstructive Surgery

Age or childbirth causes many women to develop pelvic floor disorders that affect the uterus, bladder, vagina and rectum.

The first symptom may be a pressure or heaviness in the pelvic area or difficulty keeping a tampon in the vagina. Some women may even feel as though something is falling out of the vagina. Others find they have urine loss during everyday activities like coughing, laughing, sneezing or vigorous exercise.

Half of all women experience some of these symptoms, which can limit normal daily activities, but few of them seek treatment. Sometimes women are embarrassed by these symptoms and hesitate to mention them to a physician. But these conditions are not a normal part of aging, and they do not have to be endured. There are a number of ways to correct or manage these problems.

University of Louisville Physicians-Female Pelvic Medicine & Reconstructive Surgery treats women with pelvic floor disorders, such as incontinence (urinary or fecal) and prolapse (bulging or falling) of the vagina, bladder or uterus.

Urinary incontinence means not being able to control the flow of urine. This condition affects about two  in 10 women younger than age 65 and more than half of women age 65 or older.

Prolapse means to fall or slip out of place. Prolapsed organs bulge or sag. Although this can sometimes happen quickly, prolapse usually takes many years. One in 10 women undergoes surgery for this condition.

Women often have both prolapse and incontinence. Each may be caused by damage to the pelvic floor after delivering a baby. Constant heavy lifting, chronic coughing, severe constipation and obesity also may contribute to prolapse and incontinence.

UofL Physicians offers a complete diagnostic evaluation of your condition and a variety of treatment options from drug and physical therapies to surgery, including a vaginal surgical approach using less invasive options, such as advanced laparoscopy/robotic surgical reconstructive procedures.

When your prolapse becomes more pronounced or when urine leakage becomes bothersome, our compassionate, appropriate and effective care offers the latest, most practical solutions. Our services can help you enjoy an active lifestyle.

 

 

Our expert physicians treat stress urinary incontinence (any unintentional loss of urine during physical activities such laughing, coughing, sneezing, or lifting) or urgency (a powerful need to urinate immediately).

  • Overactive bladder (a sudden uncontrollable urge to urinate)
  • Dysuria (painful urination)
  • Nocturia (excessive frequency of nighttime urination)
  • Fecal (stool) incontinence
  • Cystitis (infection that causes an urgency to urinate immediately and frequently)
  • interstitial cystitis (chronic painful bladder inflammation)
  • Pelvic organ disorders or prolapse, such as a cystocele (bulging of the bladder into the vagina), rectocele (weakened tissues that allows the front wall of rectum to bulge into the vagina), enterocele (vaginal hernia caused when the small bowel descends and bulges into the vagina), uterine prolapse (falling of the uterus into the vaginal canal)
  • Pelvic pain

  • Cystoscopy / urethroscopy: an in-office procedure using a small, lighted scope to examine the internal lining of bladder and urethra for the evaluation of incontinence, pelvic pain, overactive bladder and interstitial cystitis.
  • Management of pelvic floor disorders, such as urinary incontinence and pelvic organ prolapse.
  • Urinalysis or urine culture (microscopic and chemical test of the urine).
  • Ultrasound: use of sound waves to study pelvic organs such as the anal sphincter, bladder, urethra, kidneys or ureters.
  • Cystometrogram /urodynamic testing: an in-office procedure that uses a small catheter inserted into the bladder to study how well the bladder and urethra store and empty urine.
  • Sacral nerve modulation (Interstim) for treatment of overactive bladder.
  • Botox injections to bladder for treatment of overactive bladder.
  • Pessary fitting and placement: a treatment for pelvic organ prolapse; pessaries are worn inside the vagina like a diaphragm to provide internal support.
  • Minimally invasive surgical repair (laparoscopic or robotic), also known as bandaid or keyhole surgeries, because instruments and a camera are inserted into the body through small incisions.
  • Anal manometry: use of a small catheter inserted through the rectum to determine how well the anal sphincter works.
  • Bulking injections such as collagen or other materials, inserted next to the opening of the bladder to build up the urethral wall.
  • Dynamic fluoroscopy of the pelvic floor: use of X-ray images and a contrast dye to study the extent of prolapse in the rectum, vagina and bladder during a bowel movement.
  • Electrodiagnostic testing (EMG) of the pelvic floor: use of EMG sensors in adhesive patches to test nerve and muscle response to light electrical impulses.
  • Intravenous pyelography (IVP): use of x-ray images to track a contrast dye as it moves from the kidneys through the ureters into the bladder and out of the body.
  • Suburethral sling: asurgical procedure to support the urethra by means of a sling made of synthetic or natural materials.

Physicians in this practice may not see patients at all locations listed below. For details, please call the appointment line for the location you are interested in visiting.

Offices and Clinics

  • UofL Health Care Outpatient Center
    401 E. Chestnut St.
    Suite 410, 470
    Louisville, 40202
    502-588-4402
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  • Ambulatory Care Building
    550 S. Jackson St.
    Third Floor
    Louisville, 40202
    502-561-8850
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Hospital Affiliations

  • University of Louisville Hospital

Our committed and compassionate physicians are well-trained, experienced and considerate. Each offers comprehensive care to treat patients with dysfunctions of the urinary tract and pelvic floor.  When surgery is needed, our doctors are highly skilled laparoscopic and robotic gynecologic surgeons who perform pelvic organ procedures utilizing minimally invasive techniques. Through counseling, our physicians will keep you involved in the decisions regarding the best available treatment for you. As faculty members of the University of Louisville School of Medicine, we are all inquisitive researchers and dedicated teachers of future doctors. Our team approach guarantees that our patients receive the most thorough diagnosis and treatment for incontinence and prolapse through our supportive network of medical professionals.