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Surgery for Female Urologic Conditions

Surgery for Female Urologic Conditions

Urogynecologic Surgeries

The emerging specialty of Female Pelvic Medicine (urogynecology) deals with the diagnosis and treatment of pelvic floor disorders. A urogynecologist is an OB/GYN with a three-year specialty fellowship in female pelvic medicine and reconstructive surgery. In women, the pelvic floor includes the muscles, ligaments, and connective tissue supporting the vagina, uterus, bowel, bladder, and rectum. Our urogynecologic surgeons (specialists in Female Pelvic Medicine) have a broad range of expertise in open surgery and minimally invasive procedures, and, where appropriate, robotic surgeries utilizing the da Vinci Xi ® surgical system.

Pelvic Organ Prolapse (POP) Surgery

The type of surgery our urologists recommend depends on the site of the prolapse, the presence of urinary or fecal continence, the patient’s age and general health, her desire to remain sexually active, and her personal preferences. Pelvic floor surgery can be reconstructive, which aims to correct the prolapse and restore normal anatomy, or obliterative, which corrects prolapse by removing or closing off a portion of the vaginal canal. Obliterative surgery is an option for women who can’t tolerate more extensive surgery and/or don’t plan to be sexually active.

Most women with POP have reconstructive surgery. This can be performed abdominally or vaginally, depending on the type of repair needed. Some reconstructive surgery may include the implantation of surgical mesh, a woven fabric made of biologic or synthetic materials. The surgeon uses the woven material to create a hammock-like support for the prolapsed organs and surgically anchors the mesh to muscles or ligaments. Over time, the patient’s tissues grow over the mesh, which stabilizes it in its supportive position.

Abdominal Procedures

  • Sacral colpopexy/cervicopexy/colpoperineopexy
  • Sacral hysteropexy
  • Uterosacral ligament suspension
  • Paravaginal defect repair
  • Hysterectomy with or without salpingo-oophorectomy

Vaginal Procedures

  • Sacrospinous ligament fixation
  • Uterosacral ligament suspension
  • Anterior and posterior colporrhaphy
  • Perineorrhaphy
  • Levator myorrhaphy
  • Transverse defect repair
  • McCall’s culdoplasty
  • Paravaginal defect repair
  • Total colpocleisis
  • Le Fort colpocleisis
  • Robotic and laparoscopic procedures
  • Sacrocolpopexy/sacrocervicopexy
  • Hysterectomy with or without salpingo-oophorectomy
  • Hysterectomy with or without salpingo-oophorectomy

Other Pelvic Surgeries

As experts in female pelvic surgery, our surgeons are experienced in a broad range of less common procedures, including:

  • Fistula repair (A fistula is an abnormal opening between two organs, such as the bladder or urethra and the vagina, or the rectum and the vagina.)
  • Reconstructive surgery of the anal sphincter
  • Repair of vaginal and perineal lacerations

Gynecologic Oncology

The diagnosis and treatment of cancers of the female reproductive system, including the ovaries, fallopian tubes, uterus, cervix, vagina, and vulva falls under a subspecialty known as gynecological surgery. Learn more.