Urogynecology and Reconstructive Pelvic Surgery

About This Program

The Female Pelvic Medicine and Reconstructive Surgery program, like the subspecialty nationally, will change its name to Urogynecology and Reconstructive Pelvic Surgery to describe the subspecialty and improve patient care by adopting a name that is more recognizable to the public, patients, and referring health care providers more accurately.

Patients with urinary incontinence or problems related to changes in the pelvic organs often suffer in silence. Many patients are uncomfortable talking about their symptoms or assume these problems can’t be corrected. Too often, rather than seeking medical help, they endure countless inconveniences along with a decline in quality of life.

Our staff in the Urogynecology and Reconstructive Pelvic Surgery Program (URPS) includes obstetricians, gynecologists, clinical fellows, and nurse practitioners who understand a patient’s changing needs throughout their lifetime. We work as a tightly knit team, sharing our expertise to offer you individualized care for your particular symptoms.

You can count on our team to provide compassionate care for group of conditions called pelvic floor disorders that may be difficult to discuss, including:

• Pelvic organ prolapse (when pelvic organs slip out of place and descend towards or through the opening of the vagina, putting pressure on the bladder, urethra or other parts of the pelvis)
• Urinary incontinence (leaking urine), including stress incontinence, urge incontinence and overflow incontinence
• Bladder function problems not related to urinary tract infections
• Bladder or urethral fistulas or diverticuli and rectal fistulas
• Fecal incontinence and constipation

Patient-centered Treatments

We take pride in developing individualized urogynecologic treatment plans for each patient, incorporating the most advanced surgical and nonsurgical options available.

Our treatment philosophy, and the preference of most patients, is to avoid surgery whenever possible. Many symptoms can be address using nonsurgical approaches such as:

• Targeted physical therapy: Our physical therapists specialize in the muscles of the pelvic floor, treating disorders such as pelvic organ prolapse and urinary incontinence
• Pessary use: Placing a removable device such as this into the vagina can provide support to treat prolapse of the uterus or vaginal walls as well as improve urinary incontinence
• Biofeedback: Using biofeedback methods may help patients learn to identify, strengthen and control pelvic floor muscles
• Mind/body medicine: Mind/body techniques such as meditation can empower patients who experience urinary incontinence and other bladder disorders

For patients who do require surgery, we are committed to developing and introducing minimally invasive procedures that involve less pain and a shorter recovery time. Examples include:

• Slings to treat stress urinary incontinence: We insert a thin piece of material under the urethra or bladder neck to provide support and improve continence
• Vaginal surgery to treat pelvic organ prolapse: Vaginal surgery using incisions hidden inside the vagina
• Laparoscopic surgery to treat pelvic organ prolapse: In certain cases, we can use laparoscopic techniques, which require only small incisions in the abdomen
• Robotic surgery: In June 2008 we became the first urogynecology group in Boston to offer robotic surgery to treat pelvic organ prolapse

What to Expect

Patients can access our services in several convenient locations: on the hospital's main campus in Boston, Danvers, and Waltham

Prior to your visit we will ask you to fill out a comprehensive questionnaire to help us understand your symptoms better. This questionnaire can be filled out on paper or online.

During your first visit, you and your doctor will talk about the symptoms you are experiencing. Your doctor will also conduct a comprehensive physical examination. As a next step, you may need to schedule urodynamic testing of your bladder and urethra function.

At your follow-up appointment, you and your doctor will discuss an individualized treatment plan that targets your particular condition. We often recommend patients begin with nonsurgical approaches, such as targeted physical therapy, which can be quite effective for treating mild prolapse, incontinence and other pelvic floor disorders.

If nonsurgical approaches are ineffective — or inappropriate for your condition — only then do we proceed with surgery. Our physicians are highly skilled in performing the full spectrum of surgical procedures, including minimally invasive laparoscopic and robotic-assisted surgeries.