What Does a Surgical Pelvic Floor Specialist Do?

A surgical pelvic floor specialist is a healthcare professional who specialises in surgical treatments for pelvic floor problems. These surgeons are typically urogynecologists or colorectal surgeons who have undergone specialised training to address conditions related to the pelvic floor muscles.

The pelvic floor is a group of muscles that support the bladder, uterus, and rectum, and help control bowel and bladder function. Problems can occur when these muscles become weak or damaged, resulting in conditions such as incontinence, pelvic organ prolapse, and pelvic pain.

Surgical treatments

A surgical pelvic floor specialist who is also a colorectal surgeon may recommend surgical interventions to address severe cases of pelvic floor problems, including:

1. Sacrocolpopexy: This surgical procedure is used to treat pelvic organ prolapse, which occurs when the pelvic organs (such as the uterus, bladder, or rectum) descend from their normal position and bulge into the vagina. During the procedure, the surgeon uses mesh or sutures to support the prolapsed organ and restore it to its normal position.
2. Sling procedures: These surgical procedures are used to treat urinary incontinence. During the procedure, the surgeon inserts a sling made of synthetic mesh or tissue under the urethra to provide support and prevent leakage.
3. Fistula repair: A fistula is an abnormal connection between two organs, which can occur in the pelvic region between the bladder, rectum, or vagina. This surgery is designed to repair the fistula and restore normal function.
4. Colostomy: In some cases of severe bowel dysfunction, a colostomy may be recommended by a colorectal surgeon. This is a surgical procedure that diverts the colon through a hole in the abdominal wall and into a bag.
5. Nerve stimulation: This involves implanting a small device that sends electrical impulses to the pelvic floor muscles to help improve their function.

Non-surgical treatments

Not all pelvic floor problems require surgery – especially if you manage to see your specialist in the early stages. In milder cases, your pelvic floor specialist can offer non-surgical treatments including:

1. Pelvic floor physical therapy: Your specialist will teach you exercises to strengthen or relax the muscles in the pelvic floor, as well as teach you techniques to improve bladder and bowel function.
2. Pessary: This is a small, flexible ring that is inserted into the vagina to help support the pelvic organs by a pelvic floor specialist, such as the bladder or uterus, and prevent them from descending into the vaginal canal. A healthcare professional, such as a pelvic floor specialist, can help determine if a pessary is an appropriate treatment option and help with selecting the right type and size, as well as inserting and maintaining the device.
3. Biofeedback therapy: This involves using electronic sensors to measure muscle activity in the pelvic floor muscles. They will help teach you how to strengthen or relax these muscles, using this biofeedback as a guide.
4. Electrical stimulation: Here, a a low-level electric current is used to stimulate the muscles in the pelvic floor. This can help improve muscle strength and function.
5. Medications: Certain medications can help manage symptoms of pelvic floor problems. For example, anticholinergic medications can help reduce urinary urgency and frequency.
6. Dietary changes: Some people find relief from pelvic floor problems by making changes to their diet. This may include avoiding foods and drinks that irritate the bladder or bowel, such as caffeine and alcohol.

Pelvic floor problems are painful and a disruption to the quality of your daily life – and they can require surgical intervention if left untreated. If you have any symptoms of a pelvic floor problem, it’s important to see a pelvic floor specialist who is a colorectal surgeon as soon as possible.