Pelvic Floor Dysfunction Treatment

In many cases, we are able to make a diagnosis and provide personalized recommendations in a single visit. We start by performing an assessment that considers your medical history and symptoms. Experts may also perform a pelvic exam if necessary.

Some conditions require advanced testing, which is easily accessible within UMass Memorial. Your care may include:

• Cystoscopy: An in-office procedure to evaluate the inside of the bladder 
• Urodynamic studies: We can observe how the bladder and urethra function when you try to eliminate urine from your body
• Imaging studies: Scans such as CT and MRI help us assess the fine details of pelvic organs
• Defecography and other studies: Enables us to evaluate anal and rectum functioning in the anorectal physiology lab, the only resource in the region for these tests 

Medical Therapies for Pelvic Floor Dysfunction

• Botox injections: Botox relieves urge incontinence (strong, sudden urge to urinate) by slowing contractions of the muscles near your bladder.
• Lifestyle changes: These may include eliminating caffeine, consuming less fluids, losing excess weight or modifying your exercise routine.
• Medications: We prescribe drugs that relax bladder muscles, prevent spasms and increase bladder capacity to improve some incontinence symptoms. 
• Neuromodulation: This therapy uses a small device like a pacemaker to deliver an electrical stimulus that strengthens communication between your brain and the nerves controlling the bladder.
• Pessary: This removable silicone device supports the urethra to stop bladder leaks in some cases. It also can often relieve symptoms of mild, moderate and even severe pelvic organ prolapse.

Minimally Invasive Urogynecology Surgery

If medical therapies are not successful, you may benefit from surgery. We offer every available option and maintain excellent results — even for complex conditions. In most cases, patients go home within 24 hours of their procedure.

You have access to the full range of minimally invasive approaches, which help you avoid large incisions. Instead, we access the treatment area by going through the opening of the vagina or making small incisions in the abdomen.

Urogynecologists carry out procedures using sophisticated techniques, some of which are not widely available in Central Massachusetts. Offerings include: 

• Laparoscopic surgery, which requires small incisions through which we pass tiny instruments and a camera to carry out the procedure. 
• Robotic surgery, which involves a technology that acts as an extension of the urogynecologist’s hands. It enables them to carry out procedures with the highest level of precision.
• Vaginal surgery, which allows for the entire repair to be performed through the vagina and avoid any abdominal incisions.

We perform a high volume of reconstructive procedures to secure pelvic organs back in their natural position. Options include sacrospinous or uterosacral suspension, sacrohysteropexy and sacrocolpopexy. Urogynecologists also use minimally invasive techniques like midurethral slings, sacral neuromodulation and intravesical Botox.