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Female Pelvic Medicine and Reconstructive Surgery (FPMRS)

What is Female Pelvic Medicine and Reconstructive Surgery (FPMRS)?

FPMRS addresses treatment of pelvic floor disorders which include urinary incontinence, vaginal prolapse, and pelvic pain. Specialists in this area help women in various stages of life.

Childbirth can weaken the pelvic floor muscles and cause urinary incontinence, but other causes of pelvic floor problems include:

  • Aging
  • Injury
  • Menopause
  • Nervous system disorders

Many women leak urine when they sneeze, cough, or laugh. They often believe it's a normal part of aging.

But, urinary incontinence and other pelvic-floor disorders are not always age-related or unavoidable.

Loss of bladder control can sometimes lead to other problems, including depression. As a result, you may not want to go out in public or be intimate due to embarrassment.

Why Choose UPMC Female Urology for Pelvic Health Problems? 

FPMRS urologists in the Magee-Womens Hospital Female Urology clinic:

  • Are experts in pelvic-floor conditions. Their training includes both urology and gynecology.
  • Treat all types of bladder, urethra, and pelvic health issues, like vaginal prolapse and urethral diverticulum.
  • Improve women's lives through behavioral, medical, and surgical treatment options.

Pelvic Floor Conditions We Treat

Urologists treat the following pelvic floor conditions at UPMC facilities:

  • Stress urinary incontinence. The muscles that support the urethra can weaken over time. Childbirth is one cause, but there are others. You may leak urine when you laugh, lift something heavy, cough, or sneeze.
  • Overactive bladder. Nearly 40% of American women suffer from an overactive bladder. Symptoms include a sudden and uncontrollable urge to urinate which may result in urine leakage. You may also need to pass urine many times throughout the day and night.  If medications fail, bladder botox in the office, pelvic nerve stimulation, or ankle nerve stimulation in the office help many.
  • Pelvic organ prolapse. In this common disorder, one or more pelvic organs shifts to result in a vaginal bulge. The bladder, vaginal top, or uterus drop from their normal position, causing discomfort and problems with bladder or rectal emptying.
  • Urethral diverticulum.  Some women with recurrent UTIs and dribbling after urination have a weakness in the urethra that leads to a collection of urine around the urethra – and this is called a urethral diverticulum.
  • Pelvic pain. Some women experience steady or sharp pain in the pelvic area. That is sometimes a sign there's something wrong with the pelvic muscles.

How to Prepare for Pelvic Reconstruction Surgery 

To help you prep for surgery, your doctors will ask about:

  • Your overall health.
  • Prescription drugs you take.
  • Any prior surgeries you've had.

You also may need to have:

  • Bladder tests
  • Blood work
  • EKG
  • X-rays

Questions to ask your doctor

Ask your doctor about the risks of bladder, urethral, or vaginal reconstruction surgery.

Risks may include:

  • Bleeding
  • Potential injury to internal organs
  • Reaction to anesthesia

Find out if you need to stop eating or drinking fluids at a certain time before the surgery. If you smoke, try to quit (or at least decrease the amount you smoke).

What to Expect Before, During, and After Surgery for Urinary Incontinence and Pelvic Floor Disorders

Before your pelvic surgery or treatment, make sure to ask your doctor any questions you have.

Find out what time you should get to the surgical center. Most treatments allow you to go home the same day.

On the day of the surgery, a nurse will insert an IV tube. After you move into the operating room, doctors will give you anesthesia

After the procedure, you'll be in a recovery room for a few hours. You'll have a urethral catheter, a tube that empties urine from your bladder.  The catheter is removed in most patients before you go home.

Recovery from Urinary Incontinence and Pelvic Reconstructive Surgery

You'll be up and walking soon after the procedure. It will take about eight weeks to fully heal from surgery.

Your doctor may prescribe medicine to ease your pain. He or she will schedule a post-op visit in about eight weeks to check on your progress.

Post-op healing at home

  • Eat light meals at first. If constipation becomes a problem, ask your doctor for a stool softener.
  • Showers are fine as you recover, but baths are not allowable after vaginal surgery. You may have some vaginal bleeding or spotting, but do not to use tampons or douche.
  • Slowly increase your activity but don't overdo it. Walking is fine, but hold off from strenuous exercise and avoid lifting heavy objects.

Call the doctor's office if you have questions or concerns.

At your follow-up visit, ask your doctor when it's ok to resume exercise and sexual activity.

Contact the Female Urology Clinic at Magee-Womens Hospital

To make an appointment or learn more about FPMRS, call 412-641-1818.