Pelvic Floor Disorders: Treatment Options

Some pelvic floor disorders may be successfully treated via medications or physical therapy. For those cases that call for surgical intervention, the Center for Pelvic Floor Disorders at Virginia Hospital Center has expertise in techniques ranging from simple minimally-invasive procedures to major vaginal, rectal and bladder reconstructive surgeries.

Pelvic Organ Prolapse

Non-surgical treatment options

include lifestyle changes or the use of a vaginal pessary, a plastic or rubber ring inserted into the vagina to provide surgical support.

Surgical options

vary depending on the severity and type of prolapse, and may include:

• Anterior, Posterior or Total Repair of the Vagina with or without Mesh Augmentation
• da Vinci® Robotic Surgical System-assisted Sacrocolpopexy: a procedure that uses mesh to repair vaginal prolapse

Urinary or Fecal Incontinence

With early intervention, up to 80 percent of urinary or fecal incontinence patients may be successfully treated with

Physical therapy

It is administered and supervised by a licensed, specialized physical therapist and may include:

• Patient education: behavior changes, adjustments to food and fluid intake (decreasing amounts; avoiding irritants), self-management of symptoms, and exercises such as Kegels or rectal sphincter exercises
• Therapeutic Exercises of the pelvic floor, lower abdomen and extremities and lower back
• Muscular and Neuromuscular Re-education via Biofeedback

Surgical treatments for urinary incontinence may include:

• Suburethral Slings, such as the "TOT" (Transobdurator Tape) Procedure: a hammock-like strip of synthetic mesh is inserted underneath the urethra to provide support and prevent leakage from coughing or sneezing.

Surgical treatments for both urinary and fecal incontinence may include:

• Sacral Nerve Stimulators (InterStim® Therapy): a small electrode similar to a pacemaker is implanted near the sacral nerves and improves symptoms in up to 70% of cases.