Diagnosis & Treatment

Patients who come to UChicago Medicine's Center for Pelvic Health benefit from one of the most experienced imaging teams in the country. Physicians and hospitals from around the region send their pelvic floor patients here for advanced radiologic testing.

Some of our services include:

• Computed tomography of the pelvis, which uses X-rays to create cross-sections of the body

• Cystoscopy, a procedure to look inside the bladder using a tiny camera

• Urodynamics, a series of tests to provide information about the function of bladder and urinary muscles

• Ultrasound, which uses sound waves to view the anatomy in the pelvis or anus

• Pelvic magnetic resonance imaging, which uses magnets to create detailed pictures of the body.

• Anoscopy, in which a small instrument is inserted into the anus to check the anal canal

• Anorectal manometry, which checks the muscles that keep stool inside the body

• Defecography, which shows how much stool the rectum can hold, how well it can hold it and how well it can empty it

Many pelvic floor disorders can be treated successfully without surgery. For this reason, strategies such as behavior changes, physical therapy and medication are often the first approach for many patients.

Some of the nonsurgical treatments available include:

• Instruction with Kegel exercises, which strengthen pelvic floor muscles

• Physical therapy and biofeedback, which can help patients learn how to strengthen or coordinate their pelvic floor muscles

• Medication, which can help treat urinary and fecal incontinence

• Pessaries, which are small, removable silicone or plastic devices inserted through the vagina to comfortably help hold pelvic organs in place, treating stress incontinence or pelvic organ prolapse

• Guidance on changing behaviors, including diet and fluid intake, that can contribute to symptoms

• Botox injections, which block muscle contractions that can cause an overactive bladder

• Neuromodulation procedures such as posterior tibial nerve stimulation for overactive bladder or sacral nerve stimulation for overactive bladder, urinary retention and fecal incontinence

Our Center for Pelvic Health offers convenient access to physical therapy and biofeedback at the UChicago Medicine campus in Hyde Park and at seven other sites around the Chicago area and in Northwest Indiana.

Our treatment team includes experienced surgeons who routinely perform minimally invasive procedures that spare patients large incisions, unnecessary pain and longer recovery times. Many of the procedures used to treat pelvic floor disorders can be performed using these sophisticated approaches, including transvaginal procedures and laparoscopic techniques. During delicate surgeries such as pelvic floor repairs, our surgical team uses a robotic system that allows them to see the patients’ anatomy more easily. More importantly, patients who have robotic surgery have less blood loss, fewer complications and a quicker recovery.

At the Center for Pelvic Health, our surgeons can perform the most complex prolapse surgeries, even on patients who have had previous surgery. We routinely treat patients with recurrent prolapse or incontinence who have not found solutions elsewhere.

Our high-volume center also draws expertise from one of the top urology practices in the country. In addition to treating women, our urology team can help men who may suffer from incontinence related to treatment for prostate, bladder or kidney cancer.

Our team draws from a nationally recognized gynecology team that was one of the first in Chicago to perform minimally invasive robotic surgery for the treatment of pelvic organ prolapse and genitourinary fistula. This team is also the first in the region to utilize single-site robotic surgery for hysterectomy and sacrocolpopexy, minimizing the number of incisions needed during surgery.

Our nationally recognized gastroenterology and colorectal surgery team, has a longstanding reputation for their treatment of inflammatory bowel disease (IBD). Some IBD patients require pelvic floor testing to determine the best treatment approach. In addition, these colorectal surgeons have performed more than 1,000 surgeries on patients with a range of digestive and pelvic floor conditions.

For women who require complex reconstructive procedures to the pelvis, our team includes plastic and reconstructive surgeons who are skilled at rebuilding tissues using advanced surgical techniques that promote wound healing. This can help patients who have congenital abnormalities of the genitourinary tract or who have significant scarring because of previous surgery or radiation treatment. Our plastic and reconstructive team is also on hand to help women who are interested in pursuing a cosmetic treatment, such as a tummy tuck, at the time of their surgery.

When symptoms fail to improve with nonsurgical treatment, our experienced surgeons can often improve symptoms with surgery. Some of these procedures can be performed using minimally invasive techniques. For instance, during delicate surgeries like pelvic floor repairs, our surgical team can use vaginal approaches or a robotic laparoscopic system that allows them to see the patients’ anatomy more easily and operate with more precision. The benefits of minimally invasive surgery include:

• Less pain

• Less injury to tissue

• Minimal scarring

• Less blood loss

• Faster return to normal activities

In fact, many patients who have these less invasive procedures can go home the same day.

• Some of the surgical treatments available include:

• Urethral bulking, which involves injections to reduce urine leakage

• Anal bulking, which uses injections to reduce fecal leakage

• Robotic, laparoscopic and transvaginal pelvic floor repair, which restores the anatomy in people with pelvic organ prolapse

• Midurethral slings, which are small mesh slings placed under the urethra to help prevent stress incontinence in women and men

• An artificial sphincter, an implanted device that keeps the urethra closed until men are able to urinate