As surgeons subspecialized in Female Pelvic Medicine and Reconstructive Surgery (FPMRS), we are trained to manage more complex conditions involving the lower urinary tract.

Fortunately conditions like pelvic anatomy including fistula, urethral diverticulum, and urethral stricture are rare. When help is needed, our team is dedicated to a patient-focused approach and equipped to provide an efficient diagnosis and effective surgical plan.

Symptoms of Lower Urinary Tract Conditions

  • Continuous, silent leakage of urine or stool 
  • Urinary control problems following hysterectomy, other pelvic surgery, or, pelvic radiation treatments
  • Bowel control problems after childbirth, or after pelvic surgery or radiation treatments
  • Bulge or protruding tissue arising from underneath the urethra
  • Slowed urinary stream, incomplete emptying of urine

Lower Urinary Tract Surgeries

Fistula surgery

Fistulas are abnormal connections or holes that can develop between the bladder or urethra and the vagina or bowel, sometimes leading to severe or constant leakage of urine or stool. They can be caused by childbirth trauma, previous hysterectomy or other gynecologic or pelvic treatments, and/or other inflammatory conditions. The patient-specific method for fistula surgery is recommended based on the type of fistula and its location, size, and the amount of time it has been present. We commonly perform vaginal fistula repairs and in other cases may recommend robotic assisted laparoscopy. Nearly all of these surgeries are performed on an outpatient basis.  

Urethral Diverticulum Repair

Diverticulum in the urinary tract refers to an outpouching of the urethral or bladder wall that can cause infection, irritating symptoms during or after urination, and/or a small bulge of skin protruding from the vagina. Surgery for a urethral diverticulum is performed on an outpatient basis, typically using a small vaginal incision with no external incision required.

Urethral Stricture Repair

Urethral strictures refer to narrowing of the urethral tube, creating a slow urinary stream and sense of incomplete voiding. This can occur as a minor congenital issue (from birth), or due to chronic inflammation, previous surgery or radiation, or lack of estrogen in post-menopausal women. We provide diagnostic evaluation and non-surgical treatments for urethral strictures. We facilitate referral to our colleagues in the Department of Urology for cases requiring surgery. 

3-D Ultrasound Imaging: Diagnosing your condition in the office

While MRI imaging may be needed in select cases, we can utilize in-office 3D pelvic ultrasound imaging to determine the nature of the problem and outline a treatment plan for many women with complex conditions. Our 3D pelvic ultrasound imaging provides vivid mapping of pelvic floor anatomy. This can clearly delineate abnormalities and lesions such as a urethral diverticulum.

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