Outpatient treatment modes have also made a significant progress during the last few years and consist of trigger-point injections for treatment of chronic vulvar and/or vaginal pain, physical therapy for pelvic floor rehabilitation, fitting of pessaries (silicon devices for support of uterine and vaginal prolapse), and urethral dilatations. It is of utmost importance that these treatments be performed by physicians who underwent formal training in the field of urogynecology and reconstructive pelvic surgery. It is your right to assure that the doctor who treats you has undergone such training.
Prof. Yoram Abramov, M.D., Director,
Division of Urogynecology &
Reconstructive Pelvic Surgery,
Carmel Medical Center, Technion
University, Rappaport Faculty of
Medicine, Haifa, Israel
Many women suffer from disorders in the pelvic floor involving the lower urinary and gastrointestinal tracts, the reproductive organs and external genitalia. The field of urogynecology and reconstructive pelvic surgery deals with diagnosis and treatment of urinary incontinence and retention, uterine and vaginal prolapse, aesthetic abnormalities in the vulva and vagina, vaginal and uterine fistulae (abnormal communication between the vagina, recurrent urinary tract infections, urethral diverticulae, and fecal incontinence. A multimodal treatment approach carried out by physicians with adequate training in pelvic floor reconstruction is often mandatory.
The surgical modalities in urogynecology and reconstructive pelvic surgery are evolving rapidly and consist of advanced minimally invasive (i.e. transvaginal or laparoscopic) techniques for uterine and vaginal prolapse repair with or without graft or mesh reinforcement, laparoscopic/vaginal hysterectomy, myomectomy or removal of ovarian cysts, hysteroscopy for excision of uterine polyps and fibroids, sling surgeries for urinary incontinence (TVT), esthetic surgeries of the vulva and vagina (labial plasty), excision of painful foci in the vulva and vagina for chronic vulvovaginal pain, excision of urethral diverticulae, injection of different materials into the bladder and urethra, implantation of sacral neuromodulators (pacemakers) for intractable overactive bladder, and repair of the anal sphincter for fecal incontinence.