Female Pelvic Medicine and Reconstructive Surgery (Urogynecology): Services
Evaluation and Diagnosis
A patient's first visit to UF Health Female Pelvic Medicine and Reconstructive Surgery
– Jacksonville is often preceded by completion of a voiding (emptying the
bladder of urine) diary and questionnaire that documents symptoms, activities, fluid
intake, voiding patterns and leakage. A consultation and a physical exam are performed.
Urine is collected for analysis, a pelvic exam is performed and a small tube inserted
into the bladder during a procedure called catheterization to measure post-void
residual (sometimes referred to as PVR) urine volume. The PVR is the amount of urine
left in the bladder after normal urination. Based upon initial findings, additional
testing may be required to complete the workup. This may include:
Bladder instillation - A solution of local anesthetics is put into
the bladder through a catheter to evaluate and treat interstitial cystitis.
Complex urodynamic studies - This involves a variety of voiding
and filling tests that require a small catheter be inserted into the bladder to
evaluate the bladder and urethra.
Cystoscopy/urethroscopy - A small, lighted scope is inserted into
the urethra and bladder to look for inflammation, stones or tumors.
Ultrasound/CT scan - Radiologic imaging studies are sometimes required
to further evaluate the bladder, ureters and kidneys for stones, tumors or other
Treatment options are dictated by patient preference, nature and severity of the
urogynecologic problem, and the medical and physical condition of the patient. Since
a wide variety of conditions are treated, many surgical and non-surgical therapies
Pelvic muscle rehabilitation - Some types of pelvic pain, pelvic
organ prolapse and urinary incontinence respond to physical therapy. Kegel exercises
can be instructed by the physician and easily performed by many patients. Other
patients might be referred to therapists with expertise in diagnosing and treating
conditions of the pelvic floor.
Bladder retraining and behavior modification - Certain types of
bladder conditions can be managed by establishing urinary voiding schedules, fluid
intake changes and dietary modification.
Medications and Devices
Medications are available to treat a range of urogynecologic problems, including
urgency/frequency, urge incontinence, mixed incontinence and interstitial cystitis.
Pessaries are devices designed for insertion into the vagina to correct prolapse
and sometimes improve voiding or defecation. Once fitted for such a device, patients
can remove and insert them on their own or follow up with routine visits for pessary
maintenance with a physician.
The gynecologic surgeons offer a variety of surgical treatment options ranging from
minimally invasive to vaginal and abdominal surgery.
Minimally invasive surgery for urinary incontinence - Suburethral
slings (TVT) and periurethral collagen injections can often be performed on an outpatient
basis unless combined with more invasive procedures.
Minimally invasive surgery for urge incontinence - Sacral nerve
Laparoscopic surgery - Performed using a laparoscope and surgical
instruments placed through small holes in the abdomen, this technique can be used
to treat pelvic organ prolapse and aid in the diagnosis and treatment of certain
types of pelvic pain.
Vaginal surgery - In many patients, pelvic reconstructive surgery
can be performed through the vagina, leaving virtually no visible scars. Some conditions
or patient factors lend themselves to abdominal surgery.