Urogynecology Services

About Us

• We take a total approach to your care, working across teams to help you. We have an on-site pelvic floor physical therapist as well as a strong collaboration with colorectal surgery and urology services.
• We have access to the state-of-the-art da Vinci Surgical System®, which uses smaller incisions and has a faster recovery time than regular surgery.
• Our program is the first in Orange County to offer InsterStim® as a treatment for voiding dysfunction, including overactive bladder and urinary retention.
• We are the only center in Orange County that offers comprehensive evaluation of birth anomalies, such as vaginal agenesis, fistula and Mullerian anomalies.

Conditions & Treatments

Pelvic floor disorders needlessly impact the quality of life of millions of women in the United States. Often, women suffer in silence, too embarrassed to talk to their doctors about these common and treatable problems.

We treat thousands of women experiencing some of the following conditions:

• Urinary incontinence
  There are two main types of incontinence: stress and urgency. Stress loss typically occurs during activities such as coughing, sneezing and laughing, as well as during exercise. It often occurs because the pelvic floor muscles are stretched and the muscles around the urethra fail to tighten properly.
  
  Urgency incontinence typically occurs in association with an urge to urinate that is difficult to put off. The bladder has an involuntary contraction, resulting in urinary incontinence. This type of incontinence can be caused by chronic bladder infections, previous pelvic surgery, as well as conditions such as diabetes, stroke, nerve diseases and multiple sclerosis, though most of the time, we don’t know what causes urge incontinence.
  
  Our urogynecologists perform extensive evaluations to determine the best treatment options for incontinence.
• Fecal incontinence
  The inability to control bowel movements or gas is also known as anal incontinence. It affects 6 percent of women under 40 and 15 percent of older women. The condition can stem from injury sustained at the time of vaginal delivery or surgery, or from conditions such as neuropathy, diabetes and aging.
• Overactive bladder
  Overactive bladder is characterized by a frequent need to urinate (more than seven times a day), having to urinate more than once at night, an inability to postpone the need to urinate or uncontrolled urine leakage associated with a strong urge to urinate.
• Pelvic organ prolapse
  Prolapse occurs when the pelvic muscles and tissues are weakened or damaged, shifting the pelvic organs out of position. This may lead to the bladder, rectum or uterus descending down and outside of the vagina leading to pelvic pressure and pain. Urogynecologists at UC Irvine can help women manage their symptoms with pelvic floor physical therapy, support devices (pessaries) or surgery.
• Fistula
  Fistula, or abnormal connections between the bladder and vagina or the rectum and vagina, can develop after trauma, childbirth or surgery. Women can subsequently suffer from constant and debilitating leakage of urine or stool. Proper repair of these abnormal connections is crucial in their resolution. Urogynecologists at UCI Health have the expertise to diagnose, surgically repair and help women heal from fistula.
• Mullerian anomalies
  Mullerian anomalies affect up to 5 percent of females. The anomaly occurs during fetal development and is present at birth. There are several different forms of anomalies, including the absence of a vagina or uterus, a double utuerus, and a uterus divided by a septum. Our team concentrates on finding the best treatment for each patient affected by these anomalies.

Treatments

There are many treatment options for pelvic floor dysfunction. We work with you to design a treatment plan that is compatible with your lifestyle and personal preferences. Some of the treatments available here include:

• Pelvic floor rehabilitation
  Pelvic floor rehabilitation includes working with our specially trained physical therapists to improve your strength and function.
• Biofeedback
  With biofeedback, you are connected to sensors that help you receive and measure information about your body. Biofeedback teaches you how to make subtle changes in your body to achieve the results you want.
• Pessary
  A pessary is a soft, silicone device—similar to a diaphragm—that is placed in the vagina to reduce prolapse or treat incontinence without surgery. There are many different shapes and sizes to accommodate the individual woman.
• Office-based procedures
  Office-based procedures include the use of bulking agents to treat stress incontinence, as well as:
  • Botox^® injections to treat refractory overactive bladder.
  • Percutaneous tibial nerve stimulation (PTNS), a procedure used to treat overactive bladder and urgency incontinence.
  • The InterStim procedure, which also has an office-based trial period to evaluate the efficacy of the therapy prior to the patient committing to the therapy.
  • Solesta, a gel that can improve the bulk and thickness of the anal wall to reduce anal incontinence.
• InterStim therapy
  InterStim therapy is a minimally invasive treatment for urinary control and bowel control. The system is similar to a "pacemaker" for the pelvic floor and has been successfully used to treat thousands of people for urge incontinence, urgency-frequency syndrome, urinary retention and, more recently, fecal incontinence.
• Surgery
  Surgical options for pelvic organ prolapse include vaginal, laparoscopic and robot-assisted procedures. Robot and laparoscopic-assisted procedures are less invasive than traditional open abdominal procedures as they do not require large incisions. They are ideal for delicate and complex gynecological surgeries. For stress urinary incontinence, midurethral slings can be an effective treatment.

Resources

• American Association of Gynecologic Laparoscopists (AAGL)
• American Board of Obstetrics and Gynecology
• American Congress of Obstetricians and Gynecologists
• American Urogynecology Society
• International Urogynecologic Association (IUGA)
• Society of Gynecologic Surgeons