While pelvic floor disorders are common, affecting up to 50% of all women, they should not be considered normal or simply part of getting old. At Overland Park Regional Medical Center, our board-certified specialists in female pelvic medicine and reconstructive surgery will provide individualized plan of management for the correction of:

  • Urinary Incontinence
  • Fecal Incontinence
  • Pelvic Organ Prolapse
  • Recurrent Urinary Tract Infections
  • Painful Bladder Syndrome
  • Chronic Pelvic Pain
  • Endometriosis
  • Sexual Dysfunction

Our team of experts has:

  • Dedicated focus on complex women’s issues with compassion and understanding to develop personalized treatment plans based on individual patient needs. Our goal is to help women get back to living a life free of pain.
  • Specialized expertise - With over a decade of experience treating women with pelvic issues and performing over 6,000 reconstructive procedures for correction of prolapse, 3,000 slings for stress incontinence and 3,000 complex surgeries for prolapsed bladder
  • Pioneers in the latest treatments - Surgical approaches that might include behavior modification, bladder retraining, pelvic floor rehabilitation, pharmacologic support, intravesical therapy (medicine placed directly into the bladder to correct bladder problems without side effects) as well as various techniques of neuro modulation.

If surgery is needed, you can trust the expertise of our team with over 30 years of experience treating women with pelvic disorders. We emphasize minimally invasive approaches including transvaginal as well as laparoscopic/robotic techniques. This provides the fastest recovery with the least amount of pain and complications.

Comprehensive, specialized urogyn care in Johnson County

Overland Park Regional Medical Center provides diagnostic testing onsite, including:

  • Ultrasound, CT scan or MRI - Imaging used to visualize the physical organs of the bladder, pelvic, urethra or rectum
  • Urodynamic Testing - A test used to identify abnormal bladder function.
    • Urodynamic testing usually takes 30 to 45 minutes. Small pressure catheters are inserted into the urethra and vagina. The bladder is slowly filled with saline. At various points during bladder filling, you will be asked to cough and strain to determine your ability to hold urine without leaking. At the end of the test, you will be asked to urinate with the catheters in place to assess how your bladder is emptied.
  • Cystourethroscopy (Cystoscopy) - A diagnostic procedures used to visualize and detect any anatomical defects, tumors or inflammation in the urethra or bladder.
    • Cystoscopy is usually completed in less than five minutes. A small catheter-like instrument with a camera will be inserted through your urethra into your bladder. The image will be projected onto a monitor in the room. Rarely, a bladder biopsy may be needed.
  • Electrodiagnostic testing (EMG) of the pelvic floor – This testing evaluates nerve function of the pelvic floor. EMG determines the pelvic floor's muscle response to a series of small electrical impulses.
  • Anal Manometry - Frequently used to diagnose bowel control conditions (fecal incontinence) and other problems related to eliminating waste from the body, anal manometry involves the use of a balloon catheter to test the function of the rectum.

Therapeutic or non-surgical treatments

Your doctor will work with you to help you generate a safer lifestyle that promotes better control over your bowel or urinary movements. With other forms of pelvic floor therapy, such as behavioral modification can help alleviate the symptoms of fecal incontinence or urinary incontinence.
Involves biofeedback and exercises to encourage relaxation and strengthening of the muscles of the pelvis. Pelvic floor physical therapy can help improve chronic vaginal or pelvic pain, urinary incontinence and other problems with sexual function.
A procedure that involves injecting a material, called a bulking agent, around the walls of the urethra to narrow its width. This can treat stress urinary incontinence.
Helps you to begin to train your bladder to hold more urine for longer periods of time. This works by gradually increasing the time between each visit to the toilet. This method sounds simple, however bladder retraining takes time and determination and will not work overnight.
 
This treatment regime traditionally involves weekly instillation of 50 mL of 50% DMSO solution into the bladder for 6–8 weeks. Each instillation requires the solution to be retained in the bladder for 10-20 minutes. This method has been shown to be a highly effective treatment regimen for bladder pressure/pain.
Various devices inserted into the vagina that can be used to treat stress incontinence in women by supporting the bladder.
Vaginal rejuvenation that uses a non-surgical technique with lasers to improve vaginal laxity, vaginal dryness and atrophy (often experienced with menopause), and mild urinary incontinence.
A treatment for pain or pelvic floor myofascial spasms with tender trigger points who are unable to tolerate physical therapy. Injections typically consist of local anesthetics and steroids.
Injections used for treating chronic pelvic pain and bowel movement issues. It is highly effective but usually takes 1-2 weeks to start experiencing results.
Bioidentical hormones are man-made hormones meant to mimic natural hormones normally produced by the body. Common hormones that are matched are estrogen, progesterone and testosterone. These are then used as treatment for women whose own hormones are low or out of balance.

Minimally invasive and robotic assisted surgical techniques

Sphincteroplasty or “Sphincter Repair” When more conservative treatments do not work, a sphincteroplasty may be an option for you. First areas of weakness with be identified and the damaged ends will be stitched together to create a new complete, tightened ring of muscle.
For women with vaginal prolapse, including cystocele and rectocele, this surgical technique provides relief by returning the vagina to its normal position in the pelvis and typically involves using the patient’s own tissue. This can be done vaginally or laparoscopically.
For women who experience chronic discomfort from pelvic organ prolapse and are in poor health, this procedure can provide significant relief. This procedure is not intended for women who are currently sexually active or will engage in future sexual activity.
Native tissue or augmented implant.
Laparoscopic/robotic treatment of all stages.
Bladder, urethra and rectal.
Transvaginal and laparoscopic treatment.
Native tissues or augmented implant.
Sacral neuromodulation, also known as sacral nerve stimulation, is an advanced electrical stimulation procedure performed to treat urinary incontinence and other bladder control problems in patients who have not responded to more conservative treatment options. A neurotransmitter device placed under the skin of the upper buttocks will send electrical impulses to the sacral nerve, which controls the bladder, sphincter and pelvic floor muscles.
Sacrocolpopexy and sacrohysteropexy are abdominal procedures used to treat vaginal prolapse. Both procedures are typically done in a minimally invasive manner through the abdomen using laparoscopy or physician-guided robotic surgery.
To prevent urinary leaks and stress incontinence, your doctor may place a sling to provide support for the bladder neck and urethra. There are a variety of approaches both open and laparoscopic and various types of mesh materials.
Repairs to the fistula may be needed between the bladder, vagina and rectum. Surgeons will often use a laparoscopic techniques through the vagina or abdomen.
Your doctor may recommend sacral nerve stimulation for the treatment of urinary incontinence, overactive bladder, fecal incontinence or other pelvic floor disorders. This technique is used to stimulate the nerves that control bladder function and bowel movements through the use of a small device that is implanted under the skin.
When there is a congenital anomaly, disease or trauma to the ureter (tube connecting the kidney to the bladder) resulting in obstruction or fistula, this procedure reimplants the ureter into the bladder.
This minimally invasive surgical option is used to treat urine leakage during activity (ie. running, jumping, etc.) by adding support to the urethra.
Usually done laparoscopically, this procedure is used for women with vaginal or uterine prolapse, your surgeon can restore support to the internal organs by stitching the uterosacral ligaments to the top of the vagina. Laparoscopic/robotic reconstructive procedures.
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Here are some common questions patients ask:

Why do I pee when I sneeze, laugh or cough?

You are describing a common form of urinary leakage called stress incontinence. It is caused by a combination of poor support to the urethra as well as weakness involving the sphincter (this represents the muscles that form the “door” to the bladder. There are many simple therapies for this particular problem including simply controlling your bladder volume by making sure that she drank a normal amount of fluid each day and urinate on a regular basis. Your Kegel muscles help provide support but often your muscles need some help so that they can support the urethra as well as help you hold that urine. A simple office laser can help improve the support with nearly a 75% success rate. This approach involves no down time yet will get you back to the gym without leakage. If necessary there is a simple outpatient surgery we can do with local anesthesia that is typically called a mid-urethral sling. This has nearly a 90-95% success rate.

What are types of incontinence?

There are 3 different types of urinary incontinence. Stress incontinence as we discussed above is very common. Urge incontinence is especially common as all of us get older. It can however affect even women in their 20s and is typically very easily controlled with behavior modification combined with medications. More advanced therapies such as Botox or neuromodulation (the use of a small surgically implanted battery-like a pacemaker-that corrects your bladder function) or sometimes required. The most common type of leakage is mixed incontinence which is a mixture of both stress incontinence and urge incontinence and requires the combination of problems to be treated at the same time.

What causes the “gotta go” feeling?

There are many different reasons for having the constant feeling that you must urinate more often than your friends. It can be simply the problem of drinking excessively. It could be a sign of over active bladder and this responds commonly to simple therapies such as medications and behavior modification. Often it is a problem caused by over active pelvic floor muscles where the muscles are too tight and it triggers the feeling that you need to urinate even though you just voided. A very simple evaluation in the office will quickly determine the cause for your symptoms and therapy is very successful. This symptom is not caused by you having a small bladder even though many people will tell you that but that is not true.