Female Pelvic Medicine & Reconstructive Surgery

Ochsner's physicians are specially trained in the evaluation and treatment of conditions that affect the female pelvic organs. From prolapse to incontinence, our physicians can offer the most advanced symptom relief and treatments available to women today.

What is Female Pelvic Medicine?

The "Pelvic Floor" refers to the group of muscles that form a hammock-like sling across the opening of a women's pelvis. This musles and tissues keep the pelvic organs - the bladder, uterus, vagina, rectum - in place so the organs can function properly.

Female pelvic medicine is a sub-speciality of both Urology and Gynecology. It treats acquired or congenital problems related to the female pelvic floor, pelvic organ anatomy or urinary tract function specifically for women. This includes urinary and fecel incontinence, voiding dysfunction, pelvic organ prolapse, urogenital fistulas and congenital female genital anomalies.

Female Urologist vs. Urogynecologist

Essentially, the Female Urologist and the Urogynecologist practice the same sub-speciality of Female Pelvic Floor Medicine. The Female Urologist has completed a five year residency in Urology, while the Urogynecologist has completed a four year residency in Obsetrics and Gynecology. Following residency, both would have further completed a Fellowship in the field of Female Pelvic Floor Medicine.

What are pelvic floor disorders?

Urinary Incontinence

Some women may have trouble leaking urine with common activities such as sneezing, laughing and coughing. This is known as stress incontinence. Another type of incontinence is known as urge incontinence. This occurs when a woman feels the sudden urge to urinate. Often, she is not able to make it to the bathroom before getting wet. These are the two most common types of incontinence. A urogynecologist can address these issues and discuss your treatment options.

Pelvic organ prolapse

Pelvic organ prolapse is the descent or "drooping" of the pelvic organs. A woman may feel like everything is "falling out". This could be the uterus, front or back vaginal walls or top the vagina after a hysterectomy. This is a very common problem that usually occurs as a woman ages. It can be treated in several different ways, including surgical and nonsurgical options.

Other Conditions treated:

Over-active bladder - Urinary frequency & urgency.

Fistulas -"passageway" or connection between pelvic organs which are abnormal

  • Vesicovaginal (bladder/vagina)
  • Vesicouterine (bladder/uterus)
  • Vesicocutaneous (bladder/abdominal wall)
  • Rectovaginal (rectum/vagina)
  • Urethral reconstruction (fistula/diverticulum)

Congenital anomalies

  • Vaginal agenesis (absence)
  • Imperforate hymen
  • Vaginal septum

To schedule an appointment, call the Female Pelvic Floor and Reconstructive Surgery services at 504-842-4155 and 504-842-4083

We offer a range of treatment options for patients, including conservative non-surgical, medication and surgical options for each condition as appropriate.

Conservative treatments

  • Pelvic floor re-education
  • Biofeedback
  • Placement of pessary (internal brace)

Medical treatment for

  • Overactive bladder syndrome
  • Stress urinary incontinence

Surgical treatments

  • Vaginal reconstructive surgery
  • Abdominal reconstructive surgery
  • Laparoscopic (minimally invasive) reconstructive surgery
  • Pubovaginal slings
  • Sacral nerve stimulation
  • Robotic-assisted laparoscopic surgery

Urodynamic Testing

Urodynamics measures the interaction between the bladder and the urethra, the organs that compose the lower urinary system. The bladder is a hollow organ with a smooth muscular wall that expands and contracts. The urine is received from your kidneys and stored in the bladder. The bladder expands without abnormal rises in pressure. During urination, the bladder contracts causing urine to leave the bladder and exit the body through the urethra. A sphincter muscle is in the upper portion of the urethra, right below the bladder. The sphincter muscle remains tightened as long as the bladder is not ready to empty. Thus, when you cough, sneeze or jump, the tightened sphincter will not allow the flow of urine out of the bladder. When you are ready to urinate, the sphincter relaxes during the contraction of the bladder to allow the unobstructed flow of urine from the bladder through the urethra and out of the body. Urinary difficulty or incontinence results from a functional disorder in the lower urinary tract. As a result, doctors will often order an urodynamics test to assess the function of a patient's lower urinary tract. The test usually takes about one hour and is conducted in the doctor's office or hospital without anesthesia. Normally, there is no restriction in diet before the test, and patients will often be asked to arrive with a full bladder.

Pelvic Surgery

The Department of Urogynecology provides surgical correction of the pelvic floor to treat issues of pelvic prolapse. Pelvic prolapse can manifest in the form of a “bulge” from the vagina. This “bulge” may be a cystocele, rectocele, enterocele or prolapse of the uterus. In most cases, this can be repaired vaginally through a variety of procedures to restore the normal anatomy. Often a laparoscopic approach can be performed to achieve restoration of the normal anatomy. This involves the suspension of the pelvic organs and various pelvic ligaments.