Female Pelvic Medicine and Reconstructive Surgery

From Cvillepedia
Jump to navigation Jump to search

Female Pelvic Medicine and Reconstructive Surgery (FPMRS)—sometimes referred to as Urogynecology—is a certified subspecialty of both Urology and Obstetrics/Gynecology. A specialist in Female Pelvic Medicine and Reconstructive Surgery is a doctor who focuses on the care of women who have disorders of the pelvic floor. The pelvic floor is defined as the set of muscles and ligaments/connective tissue in the lower area of the pelvis that support the internal female organs—notably, the uterus, vagina, bowel, bladder, and rectum.

Disorders of the pelvic floor can arise due to weakened, strained, or torn muscles and connective tissue in the lower pelvis. This damage, which is frequently painful and disruptive, can be caused by childbirth, strenuous exercise or activity, prior surgery, menopause, and chronic disease or genetic factors. In addition, FPMRS doctors also treat common urinary and genital problems including urinary tract infection.

Common Disorders of the Pelvic Floor

Common disorders that arise from damage to the pelvic floor include:

  • Urinary Incontinence: the leakage of urine, which can occur due to several underlying problems. Stress incontinence causes urine loss during activities such as coughing, exercise, and general physical activity. Urge incontinence is associated with a sudden urge to urinate and inability to get to the toilet in time.
  • Pelvic Organ Prolapse: the bulging or falling of pelvic organs (bladder, uterus, rectum) into the vagina. Symptoms often include the sensation of something protruding from the vagina or a heavy sensation in the vagina.
  • Overactive Bladder: the bothersome sensation of significant urgency with urination. Overactive bladder can often include other symptoms, including getting up at night to urinate (nocturia), and urge incontinence.
  • Fecal Incontinence: the unwanted loss or leakage of stool or gas.
  • Pelvic and Sexual Pain: general pain in the pelvis or pain with sexual activity.
  • Fistulas: the abnormal development of connections, or holes, between unrelated organs--for example, between the vagina and the rectum, or between the vagina and the bladder.

Treatment Options

Both non-surgical and surgical options are available for treating pelvic floor disorders. Depending on the health circumstances and desires of the patient, the doctor may initially try a conservative, non-surgical approach. Choices in this category include prescription medications, pelvic exercises (such as Kegel exercises), modification to diet or toileting behaviors, and vaginal devices.

Though surgery may be required to achieve a complete solution, recently-developed methods allow these surgical solutions to be implemented in a variety of minimally-invasive ways. For example, pelvic organ prolapse is often repaired using the da Vinci laparoscopic robot. A progressive method for solving the overactive bladder issue employs the injection of botox into the bladder. And disorders like stress incontinence can be treated quickly and effectively with suburethral slings or urethral injections.

The modern surgical techniques which are available in this area of medicine allow for quick and minimally-invasive procedures, shorter recovery times for patients, and better long-term outcomes than in the past.

Urologic Specialist in Charlottesville

The University of Virginia Health System in Charlottesville, VA, offers a urologic specialist in Female Pelvic Medicine and Reconstructive Surgery. David E. Rapp, MD, joined the UVa Urology Department in 2017 as an Associate Professor of Urology, bringing with him over 10 years of clinical experience and an extensive background as an author, researcher, and innovator in his field.

As a board-certified urologist who is fellowship-trained in Female Pelvic Medicine and Reconstructive Surgery, Dr. Rapp focuses on the surgical and non-surgical treatment of pelvic floor disorders, and is skilled in all the aforementioned techniques and surgeries for treating pelvic organ prolapse, urinary incontinence, overactive bladder, and pelvic pain.

Please refer to the profile/bio page of David E. Rapp, MD, on the Cvillepedia.



References

(to be added shortly)