Nonsurgical and Surgical Options

Pelvic floor disorders are treatable and controllable and patients have the best results when they are active participants in their care.

The specialists at the Pelvic Floor Center at the George Washington University Hospital can offer several nonsurgical and surgical treatment options for pelvic floor disorders

Nonsurgical Options 

  • Pelvic floor muscle strengthening can often help alleviate the symptoms of urinary incontinence and urinary frequency. A pelvic floor rehabilitation specialist can help you learn to activate these muscles properly, using biofeedback tools such as Real Time Ultrasound.
  • A pessary can be inserted in the vagina. It is similar to a ring and can stay in the body all day to help give support to the pelvic floor organs. This custom device is especially good for women who still want to have children in the future or those who are not good candidates for surgical repair.
  • Electrical impulses can be sent through the rectum or vagina to help control and stimulate the pelvic floor muscles. However, this treatment must be done several times over a few months.
  • A bowel management program and stimulated defecation (enemas, suppositories, medications) can help reduce bowel incontinence or constipation.
  • Bladder training and scheduled urination can help retrain the bladder and put you back in control.
  • Medication can be prescribed for bladder control.

Surgical Options 

For Urinary Incontinence 

  • Overactive bladder or retention of urine can be treated by the placement of electrodes in the spinal region that sends electrical stimulation to the nerves of the bladder.
  • A "sling" can be inserted in the urethra during a minimally invasive procedure to support it into its natural position. This can be performed in patients with urinary incontinence or sphincter dysfunction.
  • The tissue surrounding the urethra can be surgically enhanced or "bulked" to help tighten the area around the urinary sphincter. 
  • Bladder neck suspension surgery can be performed by making an incision into the abdomen and securing the bladder to a ligament near the pubic bone.
  • An artificial urinary sphincter muscle may be inserted to help control the pelvic floor muscles. This doughnut-shaped ring is inserted around the urethra. It stops the flow of urine, and when pressed manually, will release it.

For Fecal Incontinence 

  • Sphincteroplasty is the direct repair of the muscle defect.
  • Artificial bowel sphincter is an implanted inflatable donut placed around the anal muscles.
  • In sacral nerve stimulation, electrodes are used to stimulate spinal nerves.
  • Colostomy (a piece of the colon is directed to an opening in the abdomen to bypass a damaged part of the colon) or ileostomy (a piece of the small intestine is directed to an artificial opening in the abdomen).