Conditions

After a vaginal delivery, the pelvic floor and vaginal anatomy may be different. Prolapse, incontinence, and changes in sensation, as well as new pain and discomfort, can occur. There are different options to resolve and manage these progressive issues.

A cystocele (herniation of the bladder against the vagina), rectocele (herniation of the rectum against the vagina), and enterocele (herniation of the small intestines against the vagina) are all forms of vaginal prolapse. This type of prolapse can be corrected with a vaginal surgical procedure that restores the vagina and surrounding structures to their original position.

Uterine prolapse is a common benign problem due to aging and vaginal childbirth. Depending on the severity, a vaginal hysterectomy may be needed. It has repeatedly been shown to have the lowest complication rate with the quickest return to normal activities.

Involuntary leakage of urine is a common problem affecting many women. It can be caused by an overactive bladder, and with laughing, coughing, sneezing, or exercise. While leakage with urgency is treated with medication, and other non-surgical options, leakage with exertion can often be resolved with a surgical procedure to support the urethra.

Unfortunately, some pelvic mesh products are associated with pain and infection. These issues can be debilitating, but a thorough history and exam can identify these complications, and there are solutions to these chronic problems.

Discomfort during intercourse occurs for many reasons anywhere in the vagina. Symptoms may include stabbing pains, dryness, burning, feelings of tissue pulling or tearing, or generalized vaginal irritation. Depending on the cause for the pain, there are some surgical and non-surgical procedures that may alleviate pain during intercourse.

A rectovaginal fistula is a defect from the rectum to the vagina. A vesicovaginal fistula is a defect from the bladder to the vagina. These fistulae are very troubling and cause numerous infections, and negatively impact quality of life. There are surgical procedures to close the defects and resolve the issue.

A urethral diverticulum is a pocket that forms along the urethra that often causes pain, repeated urinary tract infections, and blood in the urine. The diverticulum can be excised completely through the vagina once imaging confirms the diagnosis.

Some women are troubled with leakage of stool. This concern can sometimes be partially or completely resolved with surgery to repair the external anal sphincter. The external anal sphincter is surgically integrated with the muscles of the perineum to help provide support to maintain continence.