Integrated Clinical Care for Urogynecology and Reconstructive Pelvic Surgery
Loyola Medicine’s Urogynecology & Reconstructive Pelvic Surgery Program was the first of its kind in the greater Chicago area – and is still one of the few programs in the country – to offer single-site location for the multidisciplinary diagnosis and treatment of urogynecological disorders and pelvic-floor dysfunction for women.
Pelvic problems such as urinary incontinence and pelvic-organ prolapse affect about 1 in 4 women in the United States. Most women with these disorders suffer in silence, never mentioning it even to their physicians.
While many women find it difficult to discuss pelvic-floor disorders, such as urinary and fecal incontinence and pelvic-floor prolapse, these conditions can greatly affect your quality of life. We understand that if you have symptoms of a urogynecologic condition, you want an accurate diagnosis as soon as possible – and it’s important to find a healthcare team that has experience in these conditions.
Loyola’s fellowship-trained urogynecology team is highly skilled in treating the following lower urinary tract and pelvic-floor conditions:
- Complications from previous pelvic surgical procedures
- Congenital abnormalities
- Fecal incontinence
- Pelvic-floor problems during/after pregnancy
- Pelvic organ prolapse
- Pelvic pain
- Urinary incontinence
- Urinary or fecal fistulas
- Urinary retention
Loyola’s Female Pelvic Medicine & Reconstructive Surgery Program focuses exclusively on women’s pelvic medicine and reconstructive surgery. Always working at the leading edge of medicine, we were the first in the region to use laparoscopic and robot-assisted surgery for pelvic-organ-prolapse repair.
Our team includes board-certified experts in a variety of fields, including gynecology, urology, and physical medicine and rehabilitation with additional subspecialty certification in Female Pelvic Medicine & Reconstructive Surgery. We review all cases together and perform combined procedures to optimize patient outcomes.
Our dedicated team will determine what is causing your symptoms and develop a comprehensive treatment plan. At Loyola, we believe in treating the whole person, not just your illness, which is why your care team may include surgeons, radiologists, psychologists, physical therapists, rehabilitation specialists, urogynecologists, pathologists and advanced practice nurses.
Our multidisciplinary approach allows a woman’s needs to be met in one visit, in which she can see several providers. Our group is highly collaborative; we review all cases together and even perform multiple procedures concurrently on patients who require surgery.
U.S. News & World Report ranked Loyola urology as high performing in its 2015-16 Best Hospitals list, meaning it was among the top 25 percent of hospitals offering this specialty. We were also one of the first medical centers in the Chicago area to offer minimally invasive pelvic surgery to treat fecal, urinary and vesicovaginal fistulas, incontinence and other urogynecologic conditions.
As part of an academic medical center, Loyola’s expert clinicians perform and teach the latest surgical techniques and medical treatments in numerous locations across the Chicago area. In addition, our nurses have earned Magnet status, which means they have been recognized for delivering the highest level of care.
How are Urogynecology and Pelvic Floor Conditions Diagnosed?
Accurate diagnosis is essential to successful treatment. Loyola’s team has vast experience in treating all urogynecological disorders, which develop for many reasons.
Childbirth, age and other factors can weaken or damage the muscles, ligaments or nerves in the pelvic floor, leading to numerous conditions. Loyola’s urogynecologists and reconstructive pelvic surgeons are experts at diagnosing and treating a variety of disorders and conditions of the pelvic floor.
Your doctor will take a detailed medical and family history and conduct an examination. Depending on your condition, your doctor may request imaging and tests, including:
- Bladder function tests – These tests will measure how well your bladder collects and stores urine.
- Muscle/nerve function tests – These studies will provide information about muscle function and electrical activity of the nerves in the pelvic floor.
- Ultrasounds – High frequency sound waves are used to create images of structures within the pelvis.
- X-rays – Images produced from electromagnetic radiation can provide useful information about the tissues and structures within the pelvis.
What Conservative Treatments are Available for Pelvic Floor Disorders?
Pelvic-floor disorders affect many areas of a patient’s life: physical, social and emotional. Pelvic-floor disorders interfere with intimacy and impede physical activities, including fitness exercises vital to overall health. For women with these life-changing problems, Loyola offers life-changing solutions.
Our team won’t initially focus on the illness, but rather on the patient herself. We take time to find out about what is important to her. We assess how her pelvic-floor problems are affecting her daily life and discuss her preference and goals for treatment. Our physicians explain to her the available treatments, both surgical and nonsurgical, and what she can expect from each approach. Together we devise a treatment plan that will give her a better quality of life and we share that plan with her primary gynecologists or primary care physician.
Whenever possible we recommend conservative, nonsurgical interventions. When surgery is needed, we offer minimally invasive procedures as well as traditional approaches. Some of the treatments we offer include:
- Biofeedback – Your therapist will show you how to alter certain body functions, which may help your condition. Learn more about biofeedback.
- Cognitive behavioral therapy – Our psychologists will teach you how to challenge negative thoughts about yourself and your condition to alter unwanted behavior patterns.
- Diet and behavior modification – Bladder retraining for urinary incontinence, and eating more fiber in the case of fecal incontinence, are examples of diet and behavior modification therapies that can lead to notable improvements.
- Injections – Bladder and urethra Injections may be used to relieve urinary incontinence symptoms.
- Pelvic-floor physical therapy – These treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate. Learn more about pelvic-floor physical therapy.
- Medications - Medications can provide symptomatic relief for conditions such as pelvic inflammatory disease, pelvic pain, pelvic-floor dysfunction, endometriosis and others.
- Neurostimulation – With this therapy, neurostimulators are used to send electric signals to your nerves, easing or eliminating pain.
- Pessaries – These devices can help control symptoms of pelvic organ prolapse and urinary incontinence.
If nonsurgical treatments are no longer providing relief or cannot manage your condition, your doctor may recommend surgical treatment. Learn more about urogynecologic and pelvic floor surgeries at Loyola.
What Surgical Treatments are Available for Pelvic Floor Disorders?
If nonsurgical treatments are no longer providing relief or cannot manage your condition, your doctor may recommend surgical treatment. Our urogynecological team is nationally recognized for its expertise in vaginal, laparoscopic and robotic-assisted surgery. These minimally invasive procedures offer a more satisfying experience for our patients, with less pain and blood loss, a shorter recovery time, fewer complications and reduced scarring.
Your healthcare team will develop a surgical treatment plan tailored to your individual needs, with procedures that may include:
- Anal sphincteroplasty — For patients with torn anal sphincter muscles due to a difficult vaginal delivery or a previous anal surgery, Loyola’s surgeons are skilled in anal sphincteroplasty. This procedure restores muscular function to the anal sphincter by using a muscle from the inner thigh.
- Bladder neck suspension — This minimally invasive surgical option is used to treat stress incontinence by adding support to the bladder neck and urethra.
- Bulking agent therapy — For patients experiencing urinary or fecal incontinence, this procedure may provide relief by reinforcing the thickness of the muscles in the anus or urethra to prevent leakage.
- Colpocleisis — For women who experience chronic discomfort from pelvic organ prolapse, will not be engaging in future sexual activity or are in poor health, this procedure closes the vaginal opening and can provide significant relief.
- Colporrhaphy — For women with vaginal prolapse, including cystocele and rectocele, this surgical technique provides relief by pushing the prolapsed organ back into proper position and reinforcing the area with a woman’s own tissues.
- Hemorrhoidectomy — The removal of hemorrhoids can be accomplished through several approaches, including complete surgical removal of extensive or severe hemorrhoids or stapling the hemorrhoid to cut off blood flow. Another option is hemorrhoid banding, which uses a rubber band to cut off blood flow.
- Hysterectomy — The uterus may be surgically removed to treat abnormal bleeding, endometriosis, painful fibroids, pelvic pain, uterine prolapse and cervical or uterine cancers. Your surgeon may suggest laparoscopic or physician-guided robotic surgery for this procedure.
- Oophorectomy — The surgical removal of the ovaries can be performed alone or in conjunction with the removal of the uterus. This often can be performed with minimally invasive surgery. Some women opt for this surgery if they are at high risk for breast cancer or ovarian cancer.
- Rectopexy — For patients with rectal prolapse, your surgeon can stitch the rectum to its proper position. Your doctor may suggest a laparoscopic approach for the procedure.
- Sacral nerve stimulation (neuromodulation) — Your doctor may recommend sacral nerve stimulation for the treatment of urinary incontinence, overactive bladder, fecal incontinence or other pelvic floor disorders. This technique is used to stimulate the nerves that control bladder function and bowel movements through the use of a small device that is implanted under the patient’s skin.
- Sacrocolpopexy — Sacrocolpopexy can be performed in an open surgery or in a minimally invasive fashion; it may be an effective treatment for patients with pelvic organ prolapse. Your surgeon may suggest physician-guided robotic surgery for this procedure.
- Sacrohysteropexy — Uterine prolapse can be repaired by attaching the cervix to the sacrum with a surgical mesh.
- Sacrospinous fixation — For women with vaginal vault prolapse, this procedure can support the vagina by attaching the vaginal vault to a ligament in the pelvic area.
- Sling placement — To prevent urinary leaks and stress incontinence, your doctor may place a sling to provide support for the bladder neck and urethra.
- Supracervical hysterectomy — This surgical option may be used to treat abnormal bleeding, endometriosis, fibroids and other uterine condition. The procedure involves the removal of the uterus; but not the cervix; it may be offered as an alternative to a total hysterectomy, and can be performed with minimally invasive surgery.
- Ureteroneocystostomy — In patients with a congenital anomaly, disease or trauma to the ureter resulting in obstruction or fistula, this procedure reimplants the ureter into the bladder.
- Uterosacral ligament suspension — For women with vaginal or uterine prolapse, your surgeon can restore support to the internal organs by stitching the uterosacral ligaments to the top of the vagina. Your surgeon may suggest a laparoscopic approach for this procedure.
Specialized Care for Urogynecologic and Pelvic Floor Disorders
Loyola’s urogynecology and reconstructive pelvic surgery program offers diagnosis and treatment in outstanding, conveniently located facilities. We offer multidisciplinary facilities at the Loyola University Medical Center campus, in addition to outpatient services at other locations.
Loyola offers the following specialized services to provide you with the most comprehensive care:
- Acupuncture — For the treatment of women with urogynecologic conditions, Loyola offers specialized acupuncture techniques to provide relief from pain and symptoms. This is one of several conservative options considered prior to surgical treatment.
- Chronic pelvic pain program — Loyola’s specialists understand that chronic pelvic pain affects quality of life and are experts in the comprehensive diagnosis, management and treatment of a variety of pelvic floor disorders and conditions. Learn more about chronic pelvic pain.
- Gastroenterology services — Many patients experience digestive conditions in addition to urogynecologic or pelvic conditions. For this reason, our urogynecology and reconstructive pelvic specialists work closely with Loyola’s gastroenterologists to provide truly integrated clinical care for the whole patient. Learn more about our gastroenterology services.
- Mother’s Pelvic Wellness Program – This is the first multidisciplinary program in the Chicago area to help women recover from pelvic-floor disorders related to pregnancy and childbirth. Rehabilitation and urogynecology specialists offer individualized treatment to help women achieve optimal pelvic health during pregnancy and up to one year after childbirth. The focus of the program is education, treatment and planning for future deliveries as well as counseling for long-term pelvic health.
- Pelvic floor physical therapy program — Physical therapy can provide significant relief for symptoms related to pelvic floor dysfunction; it may be recommended as a primary treatment or in conjunction with other treatments. Following surgery, your doctor may recommend physical therapy to retrain and strengthen the muscles of your pelvic floor. Learn more about pelvic floor physical therapy.
Ongoing Research to Advance Urogynecology and Reconstructive Pelvic Surgery
Loyola’s expert Urogynecology & Reconstructive Pelvic Surgery Program is actively pursuing new research with a focus on patient-centered outcomes. Our team is composed of surgeon-scientists who are active in clinical and translational research, with publications in major peer-reviewed journals. Our doctors are faculty members in the Stritch School of Medicine of Loyola University Chicago. Our current research studies include:
- Aging and pelvic-floor function
- Birth trauma and incontinence
- Impact of pelvic-floor dysfunction on relationships
- Pelvic-floor dysfunction
- Role of bacteria in urinary incontinence
- Surgery and urinary incontinence
As an academic medical center, Loyola is dedicated to improving future treatments by conducting research on new diagnostics and treatments. Loyola’s patients benefit from research discoveries made here. Read about Loyola’s current clinical trials.