Female Pelvic Medicine and Reconstructive Surgery

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

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

• 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

• 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 shows promising treatments might reduce the recurrence of pelvic floor dysfunction symptoms. An ongoing clinical trial, led by UT Southwestern’s David Rahn, M.D., is examining the effectiveness of vaginal estrogen – a supplemental, nonsurgical therapy – to reduce symptom recurrence and spare more women the risks and financial implications of revisional surgeries. We’re also studying how vaginal estrogen may impact other pelvic floor disorders such as overactive bladder, urinary incontinence, sexual dysfunction and painful intercourse, and postoperative bladder infections.