SERVICES:
UROGYNECOLOGY

Urogynecologist

A gynecologist who has special training to deal with problems of the pelvic floor and the organs that are connected with it.

Pelvic floor

the complex of muscles and supporting tissues that closes the space at the bottom of the bony pelvis. Rectum, vagina, neck of the uterus and urethra pass through the fibers of this structure.

Because of their anatomy and because of the changes due to childbearing, women are more prone to hernias of the pelvic floor. These hernias form bulgings from the vagina or the rectum, interfering with daily life and bodily functions. The word "prolapse" from the Latin "prolapsus" means exactly this ( pro = in front, out;  lapsus = fallen).

The traditional operations performed to "repair" prolapses have demonstrated many shortcomings. Since women's life expectancy has increased, it has become more evident that the "repairs" were not everlasting. Moreover, having expanded their area of responsibilities outside the home, and feeling entitled to a more satisfying sexual life, women became more concerned with the pelvic damage produced by labor and delivery as well as aging.  Surgical techniques more respectful of bodily functions have been developed, and they tend to be less invasive but, to this day, there is no surgery for problems of the pelvic floor that can last forever and fix all problems with the guarantee of not creating new ones.

In certain cases, surgery is not indicated and physical therapy can be very effective in correcting incontinence, deterioration in sexual function and pelvic pain.

Even when surgery is appropriate, the long term results are optimized by the work done understanding body functions, improving muscle tone and coordination or acquiring a healthier life style. Read more about our approach to surgery.

Our working approach puts emphasis on understanding the problem in detail and making an individual treatment plan with the patient, to address all contributing factors. We utilize behavioral modification, physical therapy, medications and surgery, as need be, to meet the challenge of each case.

The work-up can be as simple as a detailed history/physical exam, with a few laboratory tests, a voiding diary and the assessment of complete bladder emptying.

For more complex cases, urodynamics, cystoscopy, ultrasonographic exams are performed in the office by the physician. Defecography, intravenous pyelography (IVP), magnetic resonance (MRI) and computed tomography (CT) are referred to specialized facilities. Dr. Sassone reviews all films with the patient. Neurologists and Gastroenterologists are the other specialists most commonly involved in working up a complex case.

If you are unfamiliar with some of the terminology used in this page, please visit our glossary.