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Vesicovaginal Fistula

May 15, 2012

A vesicovaginal fistula is an abnormal connection between the bladder and vagina that results in urine leakage into the vagina. Diagnosis is made by history and physical exam. Some patients with vesicovaginal fistula complain of large amounts of urine leakage through the vagina. In these patients, diagnosis could be made by physical exam alone. However, with small fistulas, diagnosis could […]

Community Support for Women with Pelvic Floor Disorders

May 10, 2012

While pelvic floor disorders (PFD) such as pelvic organ prolapse, bladder control and bowel control problems are not commonly talked about, many women experience these conditions. The American Urogynecologic Society (AUGS) is a physician-based organization founded in 1979 which offers an online community for women with PFD. You can join the conversation, ask physician experts questions and read about other […]

The Role of Genetics in Pelvic Organ Prolapse

May 7, 2012

The most well known cause of Pelvic Organ Prolapse in Women is prior vaginal deliveries. There is increasing evidence that genetic factors contribute to pelvic organ prolapse. There was a study led by Dr. Peggy Norton where researchers examined the chromosomes of 115 women who were treated for Pelvic Organ Prolapse and all 115 women also had a family history […]

Is the Midurethral Sling Surgery for Stress Urinary Incontinence Cost Effective?

May 3, 2012

Is the mid-urethral sling operation done to repair urinary incontinence cost effective? It seems like everyone is talking about containing medical costs these days. So how about the mid-urethral sling we know it improves patients’ Quality of Life Index but is it cost effective? The answer is yes. Dr. Leslee Subaks clinical trial of 491 women who underwent either Burch […]

Urethral Caruncle

March 27, 2012

A urethral caruncle is a benign outgrowth at the urethral meatus (urethral opening). They occur most commonly in postmenopausal women. Urethral caruncles occur when the outermost part of the urethra everts or turns out. When the mucosa is circumferentially everted, meaning the growth encompasses the entire diameter of the urethra, rather than just a segment of the urethra, the lesion […]

Urethral Diverticulectomy

February 8, 2012

A urethral diverticulum is a saclike protrusion between the tissue surrounding the urethra and the anterior vaginal wall.

Most women diagnosed with urethral diverticulum are between the ages of 30 and 50. Causes of urethral diverticula include an obstructed gland that lies next to the urethra and urethral injury. Symptoms include painful urination, painful intercourse, dribbling after urination, recurrent urinary tract infections and urinary incontinence. Symptoms may also include bulging in the vagina. Evaluation consists of a physical […]

Pessary for Prolapse

February 8, 2012

Pessaries are the most commonly used non-surgical device for management of pelvic organ prolapse. A Pessary is a silicone vaginal insert that holds prolapse in place. There are many types of pessaries available, varying in size and shape. The size and shape of pessary chosen is based on your symptoms and your exam. The pessary is typically inserted and removed […]


February 8, 2012

The implantable InterStim II® sacral nerve stimulation uses mild electrical stimulation of the sacral nerves to control the muscles of the pelvic floor, lower urinary tract, urinary and anal sphincters, and colon. These sacral nerves are located just above the tail bone.

In properly selected patients, the InterStim neurostimulator can dramatically reduce or eliminate symptoms of overactive bladder (OAB), urinary retention, and fecal incontinence. Sacral Nerve Stimulation therapy is delivered in two procedures. The first is the test to see if the therapy will work for you. A test [temporarily test stimulation] is used before implantation of the InterStim Neurostimulator to see […]

Bowel / Fecal Incontinence

January 28, 2012

Bowel (fecal) Incontinence is the impaired ability to delay the release of gas or stool. Its severity ranges from mild difficulty with gas control to severe loss of control over liquid and formed stools. Causes: Pelvic floor muscle damage: If the muscles that control bowel continence are damaged, fecal/bowel incontinence may result. These muscles include the anal sphincter and the […]

TVT sling complications and vesicovaginal fistulas managed robotically

September 28, 2011

Dr. Shashoua and Dr. Shaw of Austin Urology Institute have been working collaboratively on developing minimally invasive techniques with the daVinci robot to manage patients with mid-urethral sling complications (tvt sling complications) and vesicovaginal fistulas. They have treated several patients robotically who were referred with mid-urethral sling erosion into the bladder as well as patients referred for vesicovaginal fistula repair.

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