Urogynecology & Reconstructive Pelvic Surgery Program

Integrated Clinical Care for Urogynecology & 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 a single site for the diagnosis and treatment of common pelvic floor disorders. 

Pelvic problems include, but are not limited to, pelvic pain, leakage of urine or feces and vaginal bulge symptoms. These problems affect about one in four 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, these conditions can greatly affect your quality of life. We understand that you want an accurate diagnosis as soon as possible. It’s important to find a healthcare team that is experienced in treating these conditions.

Loyola’s fellowship-trained urogynecology team is highly skilled in treating the following lower conditions:

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.

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.

Our team includes board-certified experts in a variety of fields, including gynecology, urology, and physical medicine and rehabilitation. We review cases together and perform combined procedures to optimize patient outcomes. Our multidisciplinary approach allows a woman’s needs to be met in one visit, in which she can see several providers.

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, physical therapists, rehabilitation specialists, urogynecologists and advanced practice nurses.

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.

Childbirth, age and other factors can weaken or damage the muscles, ligaments or nerves in the pelvic floor, leading to many of the pelvic floor conditions, such as leakage of urine and symptoms of a vaginal bluge.

Your doctor will take a detailed medical, surgical and family history and conduct an examination. Depending on your condition, your doctor may request imaging and tests, including:

• Blood test
• Bladder function tests (urodynamic)
• CT scan
• Cystoscopy
• Laboratory tests
• MRI (magnetic resonance imaging) scan
• Ultrasounds
• Urine analysis and cultures

What Nonsurgical Treatments Are Available for Pelvic Floor Disorders?

Pelvic floor disorders can affect many aspects of everyday life. It can affect you physically, socially and emotionally. Most importantly, pelvic floor disorders interfere with intimacy and impede physical activities, both of which are vital to overall health and well-being. For women with these life-changing problems, Loyola offers life-changing solutions.

We take the time to listen to our patients and find out what is important to them. We assess how pelvic floor problems are affecting our patient's daily life and discuss their preferences and goals for treatment. Our physicians will explain the available treatments, both surgical and nonsurgical, and what to expect from each approach.

Together we devise a treatment plan that will provide a better quality of life and share that plan with our patient's medical team, including gynecologists and primary care physicians.

Whenever possible, we recommend conservative or nonsurgical interventions. Some of the treatments we offer include:

• Acupuncture – Loyola offers specialized acupuncture techniques to treat patients with common conditions such as pelvic pain, nausea from pelvic surgery, interstitial cystitis, painful bladder syndrome, post-surgical pain and overactive bladder. 
• Biofeedback – Biofeedback is used to treat conditions such as chronic pain and urinary incontinence. Biofeedback therapy teaches patients how to improve their health by controlling bodily processes that normally happen involuntarily, such as heart rate, blood pressure, muscle tension and skin temperature. Our licensed and registered occupational therapists are certified by the American Association for Applied Psychophysiology and Biofeedback. 
• 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 symptoms. 
• Pelvic floor physical therapy – Pelvic floor problems sometimes require specialized physical therapy. The pelvic floor muscles play an important role in supporting abdominal organs, such as the bladder, bowel and uterus. They also are important in sexual health and childbirth. Pelvic floor physical therapy treatments can help strengthen pelvic muscles, which may reduce pelvic and bladder pain, bladder spasms, leakage and the sudden urge to urinate. 
• Medications – Medications can provide symptomatic relief for conditions such as pelvic pain, frequent trips to the bathroom or urine leakage. 
• Nerve stimulation – With this advanced therapy, neurostimulators are used to send electric signals to your nerves, easing or eliminating bladder symptoms. This therapy can be done through weekly visits or by implanting a neurostimulator. 
• 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.

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 surgery.

Our team is nationally recognized for its expertise in vaginal, laparoscopic and robotic-assisted surgery through years of work in clinical trials. 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:

• Bulking agent therapy – For patients experiencing urinary incontinence, this procedure may provide relief by reducing urinary leakage from coughing, laughing and exercise. This therapy works best for women who do not lead a physically active lifestyle. 
• Colpocleisis – For women who experience chronic discomfort from pelvic organ prolapse and are in poor health, this procedure can provide significant relief. This procedure is not intended for women who are currently sexually active or will engage in future sexual activity. 
• Colporrhaphy – For women with vaginal prolapse, including cystocele and rectocele, this surgical technique provides relief by returning the vagina to its normal position in the pelvis. This can be done vaginally or by using a laparoscopy and typically involves using a woman's own tissues. 
• Cystoscopy – For women who have blood in their urine, their doctor may require this procedure to look inside the bladder and urethra. 
• Fistula repair – Fistulas are connections that may arise between the bladder and the vagina or the rectum and the vagina. There are many other types of fistula that may also develop. These can be repaired through your vagina or through your abdomen using laparoscopy. 
• 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 skin. 
• Sacrocolpopexy or Sacrohysteropexy – Sacrocolpopexy and sacrohysteropexy are abdominal procedures used to treat prolapse. Both procedures are typically done in a minimally invasive manner through the abdomen using laparoscopy or physician-guided robotic surgery. 
• 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. 
• Ureteral reimplantation – In patients with a congenital anomaly, disease or trauma to the ureter (tube connecting the kidney to the bladder) resulting in obstruction or fistula, this procedure reimplants the ureter into the bladder. 
• Urethral slings – This minimally invasive surgical option is used to treat urine leakage during activity (ie. running, jumping, etc.) by adding support to the urethra. 
• 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 & Reconstructive Pelvic Surgery Program offer 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 – Loyola offers specialized acupuncture techniques to treat patients with common conditions such as pelvic pain, nausea from pelvic surgery, interstitial cystitis, painful bladder syndrome, post-surgical pain, and overactive bladder. 
• 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. 
• Colon and Rectal Surgery – The colorectal surgical team specialize in the surgical treatment of colorectal cancer, inflammatory bowel disease, motility disorders, benign anorectal conditions and pelvic floor problems. Learn more about colon and rectal surgery. 
• 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. 
• 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. 
• Multidisciplinary Clinic for Pelvic Floor Disorders – Urinary and fecal incontinence are socially disabling problems as well as frequent reasons for institutionalizing elderly patients. Although both genders are affected, women greatly outnumber men not only with respect to incontinence but also for other pelvic floor problems such as prolapse (rectum, bladder, vagina and uterus), inability to defecate and chronic pain. Specialists from Loyola's Urogynecology & Reconstructive Pelvic Surgery Program have partnered with colorectal surgeons, gastroenterologists, and specialists in physical medicine, rehabilitation and physical therapy in forming a clinic for women with urinary and fecal incontinence, pelvic organ prolapse, dysfunctional defecation and chronic pain. Representatives of all of these disciplines attend each clinic session so that patients meet their team of doctors at a single clinic visit. 
• 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. 
• Women's Sports & Pelvic Medicine Program – The goal of the Women’s Sports & Pelvic Medicine Program is to help women and girls become active, stay active, stay healthy, reduce pain and prevent injuries. The program treats women's sports medicine injuries as well as pelvic floor dysfunction and pelvic pain conditions.

Ongoing Research to Advance Urogynecology & 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 Loyola University Chicago Stritch School of Medicine.

Our current research studies include:

• Defining the role of bacteria maintaining in urinary health
• Enhancing care through surgical quality improvement projects
• Improving surgical treatments for vaginal prolapse and incontinence
• Treating and preventing recurrent or repeating urinary tract infections
• Understanding how aging affects pelvic floor function
• Understanding the impact of pelvic floor dysfunction on relationships
• Understanding the link between birth trauma and 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.

The Loyola Urinary Education & Research Collaborative (LUEREC) is a transdisciplinary translational research team composed of physicians and researchers interested in understanding how the urinary microbiome affects urinary symptoms and health. Read more about the LUEREC.