Female Pelvic Medicine and Reconstructive Surgery

New Patient Appointment or 214-645-8300

Pelvic floor dysfunctions, including pelvic organ prolapse, urinary incontinence, fecal incontinence, sexual dysfunction, and chronic pelvic pain, affect about half of all women and can lead to decreased quality of life.

One of the Nation’s Leading Female Pelvic Medicine Divisions

UT Southwestern Medical Center has one of the largest Female Pelvic Medicine and Reconstructive Surgery divisions in the country. Our providers are some of the nation’s leading researchers, educators, and providers.

We offer a full range of treatments for urinary and pelvic floor conditions as well as provide comprehensive pelvic floor evaluation, including urodynamic testing, office cystoscopy, and endoanal sonography evaluation.

To meet the needs of our patients, we take a multidisciplinary approach to care and collaborate with colorectal, physical therapy, pain management, and other specialists.

Conditions We Treat

Common disorders we treat include:

Constipation
Defecatory disorders
Genitourinary anomalies
Fecal incontinence
Female sexual dysfunction

Interstitial cystitis
Pelvic organ prolapse
Pelvic pain
Sexual dysfunction

Urinary incontinence
Urinary tract infection
Voiding dysfunction
Vulvar diseases

Diagnosing Female Pelvic Medicine and Reconstructive Surgery Conditions

Patient care begins with a comprehensive diagnostic evaluation that includes a history, a physical examination, and a thorough discussion of symptoms.

Our urodynamics laboratory provides a comprehensive array of diagnostic studies to determine the cause of urinary and fecal incontinence and other pelvic floor disorders.

Treating Female Pelvic Medicine and Reconstructive Surgery Conditions

Once a diagnosis has been made, we offer the latest surgical and nonsurgical treatment options.

Nonsurgical Treatments

Our nonsurgical therapies include:

Pelvic floor biofeedback: Muscle retraining to help patients learn to strengthen or relax pelvic floor muscles
Pelvic floor therapy: Manual therapy to help strengthen or modify the pelvic floor
Botox bladder injections: A muscle relaxant that can be helpful for urinary incontinence
Urethral bulking agents: Injections that can help treat urinary incontinence in women
Pelvic floor electrical stimulation: Electrical stimulations to rehabilitate weak pelvic floor muscles
Percutaneous tibial nerve stimulation: Minimally invasive form of neuromodulation used to treat overactive bladder
Bladder instillation: A combination drug therapy to help painful bladder or cystitis symptoms
Pessary fitting and maintenance: A removable device that can support areas of pelvic organ prolapse
Pelvic floor trigger point injections: Medication injections into trigger points that help treat chronic pelvic pain syndrome

Surgical Treatments

Our surgical interventions include:

Abdominal sacrocolpopexy: A surgery to correct the supporting muscles, ligaments, and tissues of the vagina
Uterosacral ligament suspension: An operation that restores support to the uterus or vagina
Sacrospinous fixation: An additional operation that restores support to the uterus or vagina
DaVinci robot-assisted prolapse procedures: A minimally invasive way to surgically treat prolapse
Midurethral sling: Provides support under the urethra to prevent it from dropping during physical activity
Burch urothropexy: A surgical procedure in which support is provided to the urethra
Pubovaginal sling: A procedure used to manage urinary incontinence
Anterior and/or posterior repairs: Including repairs to both the vagina and the bladder
Fistula repairs: Repairs to vaginal fistulas
Congenital anomaly repairs: Including repairs to many congenital pelvic floor anomalies
Ureteral stents: A thin tube inserted into the ureter to help obstruction of urine flow
Mesh removal: Removal of vaginal mesh that was previously placed to treat pelvic organ prolapse or urinary incontinence
Sacral neuromodulation: An implanted neurostimulator electrically stimulates the sacral nerve to help treat urinary and fecal incontinence

Clinical Trials

Research being performed at UT Southwestern is comparing available treatments for bothersome mixed urinary incontinence, which is the presence of leakage both from physical stress (for example, cough, laugh, or sneeze) and when there is too little warning time and a sudden, strong desire to pass urine results in leakage (so-called urgency urinary incontinence). An ongoing clinical trial, led by UT Southwestern’s David Rahn, M.D., is comparing two different methods for treatment: mid-urethral sling surgery for treating stress urinary incontinence, and Botox injections in the bladder for treating urgency urinary incontinence. Both procedures are standard treatments and are not experimental, but the study team wants to see which one will help most for women with both types of incontinence.