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Surgical Treatments
Tension-free Vaginal Tape (TVT) / Mid-urethral Sling - A special type of sub-urethral sling that has become the standard of care for most types of urinary stress incontinence. A ribbon-like piece of permanent mesh is placed underneath the urethra to provide support to the urethra and prevent urinary stress incontinence. It is minimally invasive with excellent long-term outcomes.
Burch Retropubic Urethropexy – A procedure performed through a small abdominal incision designed to support the urethra by placing sutures in the vagina and attaching them to a ligament under the pubic bone. This procedure was the gold standard for treating stress incontinence for many years and is still used widely today.
Pubovaginal Sling - A procedure performed by placing a “ribbon” of material underneath the urethra where the urethra meets the bladder, to support the urethra and treat stress incontinence. The sling material is natural and is usually taken from the abdomen or leg. This procedure is used in special cases where other procedures to treat stress incontinence have failed.
Periurethral Injections - This procedure involves an injection of material next to the opening of the bladder designed to prevent stress incontinence. This procedure is performed in the office or operating room.
Cystocele repair - This is a vaginal procedure designed to reestablish the support between the bladder and vagina and reduce a cystocele. For the repair to be successful, it requires attachment at the highest point of the cystocele to strong supporting structures within the pelvis. This is where differences in old procedures contrast with newer techniques that have better long-term outcomes.
Paravaginal Repair - This is an extension of a cystocele repair with specific attachment of the vaginal wall to the pelvic sidewall. The procedure is designed to establish support between the bladder and vagina.
Rectocele Repair - This is a vaginal procedure designed to reestablish the support between the vagina and rectum. This repair often requires attachment of the strong tissue between the rectum and vagina to supporting structures within the pelvis. This is where differences in old procedures contrast with newer techniques that have better long-term outcomes.
Enterocele Repair - This procedure is designed to close the space at the top of the vagina to prevent the small intestine from pushing the vagina out. There are only two scientifically supported surgical treatments for an enterocele that have successful durability: sacral colpopexy and vaginal uterosacral/ iliococcgyeal/ or sacrospinous suspension.
 Sacral Colpopexy - A procedure (performed abdominally or laparoscopically) that attaches the prolapsed vagina to the sacrum using synthetic mesh material.
Uterosacral Vaginal Vault Suspension - A vaginal or laparoscopic procedure that attaches the prolapsed vagina to ligaments deep within the pelvis previously used to hold up the uterus.
Iliococcygeal/ Sacrospinous Vaginal Vault Suspension - A vaginal procedure that attaches the prolapsed vagina to strong connective tissue around the iliococcygeal muscle within the pelvis or the sacrospinous ligament.
Total Colpectomy & Colpocleisis - This procedure involves the complete closure of the vagina to correct prolapse. This procedure is only performed when the patient is ABSOLUTELY sure that she will never want to have vaginal intercourse again.
Anal Sphincteroplasty - This procedure is designed to re-attach torn muscle edges around the anus to correct fecal incontinence.
Advanced Hysterectomy Options – The Woman’s Center for Advanced Pelvic Surgery offers a variety of hysterectomy options to accommodate your special needs and lifestyle. Below are several common types of hysterectomy procedures we perform:
- Total Abdominal Hysterectomy - This procedure involves the removal of the uterus (including the cervix) and possibly the tubes and ovaries through an abdominal incision.
- Total Laparoscopic Hysterectomy - This procedure involves the removal of the uterus (including the cervix) and possibly the tubes and ovaries through a laparoscopic approach.
- Total Vaginal Hysterectomy - This procedure involves the removal of the uterus (including the cervix) and possibly the tubes and ovaries through a vaginal incision.
- Supracervical Hysterectomy - This procedure involves the removal of most of the uterus - leaving the cervix behind. This approach can be done abdominally or laparoscopically.
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