The Center for Female Pelvic Medicine and Reconstructive Surgery is one of the largest centers for female pelvic medicine in the country. Our staff members continually strive to recognize the unique and often broad urological needs of women. We provide individualized treatment with the latest procedures for disorders such as urinary incontinence, pelvic organ prolapse and genitourinary reconstruction. We also offer treatment for women with recurrent infections, interstitial cystitis, overactive bladder and neurogenic bladder.
Additionally, we also offer services to men who suffer from incontinence and voiding dysfunction.
Incontinence Treatment
Non-surgical treatments for incontinence, such as physical therapy and exercise with use of biofeedback, behavioral therapy and medications, are often successful. Yet, many of our patients have stress or urge incontinence or a combination of the two and their cases are often too severe for simpler therapies. We offer specialized bladder control devices, injectable bulking agents, sling procedures and a multitude of innovative minimally invasive procedures.
Cleveland Clinic urologists developed urethral injection therapy for some types of incontinence. We perform more than 300 urethral injection procedures each year.
Recently, we published sling care pathways which optimize throughput for patients undergoing vaginal sling procedures. The result of this practice decreases the average length of stay to less than three hours and patients are able to go home without a foley catheter. To read more about this, read the latest edition of Urology & Kidney Disease News.
Outcomes
A large number of female patients are referred for management of urinary incontinence. Most patients have stress or urge incontinence or a combination of the two. Modern video-urodynamic testing is performed for these patients, and various urethral sling procedures are performed according to the clinical indication. Tension-free vaginal-tape (TVT) is currently performed in the outpatient setting. In a study population of 85 patients, mean discharge time was 2.4 hours after surgery, with only one patient returning to the emergency room for urethral catheterization.
Pelvic Organ Prolapse
Surgery for pelvic organ prolapse is performed by urologic surgeons with specialized training in the field of female and vaginal surgery. The mean length of stay for vaginal repair of pelvic organ prolapse in 2007 was 28 hours, with 85 percent of 110 patients discharged on the first postoperative day.
Cleveland Clinic is home to some of the most experienced female urology experts in the world. The Female Pelvic Medicine Team is capable of handling the most complex vaginal mesh removal cases.
Robotic Surgery for Pelvic Organ Prolapse
Cleveland Clinic urologists were among the first to offer robotic sacrocolpopexy for repair of pelvic organ prolapse. We have the most experience in single-port sacrocolpopexy in the country.
Transvaginal Procedures
Representing some of the most problematic reconstructions for most pelvic surgeons, we are among the most experienced in the country in recurrent vesico-vaginal fistula (VVF) repairs managed vaginally. The vaginal approach offers minimal pain and shorter recovery compared to the open transabdominal approach that is traditionally used. With the vaginal approach, 90 percent of our patients spend less than 24 hours in the hospital postoperatively.