What is Female Pelvic Medicine and Reconstructive Surgery?

Female pelvic medicine and reconstructive surgery is a medical specialty that focuses specifically on the treatment of pelvic floor disorders in women. A pelvic floor disorder is any pain or dysfunction that occurs in the area surrounded by the pelvis: the uterus, cervix, vagina, bladder, or rectum. There are many kinds of pelvic floor disorders, but by far the two most commonly treated by female pelvic medicine specialists are incontinence and prolapse.

Urinary incontinence is the unexpected release of small amounts of urine. It can be embarrassing, but it is extremely common. Because of the way women's bodies are shaped, incontinence is much more common in women than in men. It can happen at any age, but is much more common in older women as age and pregnancy relax the muscles that support the bladder. There are two types of incontinence. Stress incontinence happens when sudden movements, such as coughing or laughing, cause slight leakage of urine. It is more likely to be caused by a problem with the muscles around the bladder. Urge incontinence is when a woman has a very sudden need to empty her bladder for no reason, sometimes because of hearing or touching water, and she cannot always make it to the bathroom in time. It is more likely to be caused by a problem with the nerves that signal the bladder to empty.

Prolapse of an organ is a condition that sounds and feels very frightening to most women, but it is also incredibly common and can usually be repaired without problems. One-third of all women will experience a prolapse at some point in their lives. Like incontinence, prolapse is also more common with age because the supporting muscles of the pelvic floor become weaker. A prolapsed organ occurs when the internal organ slips out of its supporting muscle sling and droops or falls into the vagina or rectum. The most common prolapse is when the bladder falls partially into the vagina, but the uterus, urethra, bowels, and even the vagina and rectum themselves can prolapse. Symptoms vary, depending on which organ has shifted, but may include:

  • a heavy feeling or abdominal pressure
  • feeling something in the vagina
  • urinary problems
  • painful intercourse

Treatment varies, depending on the type and severity of the prolapse, and may include strengthening exercises, pushing the organ back into place, or surgery.