Gynecology and pelvic health

Neuromodulation, or nerve stimulation, gently modifies the nerve signals that stimulate the bladder through the use of a minimally invasive needle electrode temporarily placed near the ankle. During a series office visits, a device attached to the needle delivers mild electrical impulses that travel up the leg nerves to the nerves that control the bladder. Patients typically have 12 weekly sessions, with most seeing improvement in symptoms after 5 to 7 weeks.

At Sharp, we offer minimally invasive treatments, including robotic surgery, which can safely treat endometriosis with fewer complications and a shorter recovery time.

If you need a hysterectomy, there are several surgical options available to you, depending on your diagnosis. At Sharp we offer traditional "open" hysterectomies, vaginal hysterectomies, laparoscopic hysterectomies and robotic-assisted hysterectomies.

Injections such as Botox® can be used to treat incontinence by targeting muscles in the bladder's back wall to "calm" the bladder and help reduce symptoms. These injections are performed through a scope that is inserted into the bladder. Most patients see results within 5 to 7 days that last for 6 to 10 months. Additionally, estrogen may help limit further weakness of the pelvic floor muscles.

• Hysterectomy
  The surgical removal of the uterus is used to treat uterine prolapse, among other conditions. This type of surgery can be performed through the vagina or the abdomen, and minimally invasive, robotic techniques may be used.

• Sacrocolpopexy
  This procedure, for uterine or vaginal prolapse, involves removing the uterus, leaving the cervix in place and correcting the supportive structures of the vagina. Pelvic mesh or a "sling" of tissue may be used to support the pelvic structures. The procedure can be done laparoscopically, robotically or as a traditional open abdominal procedure.

• Vaginal vault suspension
  A vaginal vault suspension may be used to correct vaginal vault prolapse. During the procedure, the vagina is attached to strong tissue in the pelvis or to the sacrum (a bone at the base of the spine).

• Colpectomy and colpocleisis
  For women who are no longer sexually active, this procedure removes the vaginal lining (colpectomy) and closes off the vaginal canal (colpocleisis) to prevent further prolapse.

Sharp Rehabilitation Services offers a specialized physical therapy program designed to treat pelvic pain and dysfunction.

• Urodynamics testing
  The program's certified rehabilitation registered nurses use a state-of-the-art urodynamics lab to assess bladder function (relationship of pressure to volume), activity of the bladder sphincter muscle, urine flow and other measurements to better diagnose bladder conditions and determine the best treatment.

• Pelvic pain and incontinence program
  Physical therapy has been shown to be effective for a range of pelvic health conditions, including irritable bowel syndrome; pelvic, vaginal or rectal pain; urinary urge incontinence or stress incontinence (leaking when you sneeze or cough); bladder urgency or bladder frequency; pain after childbirth or during intercourse; endometriosis; and sacroiliac or tailbone pain.

To learn more about our pelvic rehabilitation program at Sharp Memorial Hospital, call 858-939-6947. For Sharp Coronado Hospital, call 619-522-3729.

Using fine instruments that provide greater precision and control, surgeons perform robotic gynecologic procedures without incisions or with a few very small ones. The result can be less pain and scarring, a shorter hospital stay and a quicker return to normal activities.

Urine leakage can be treated during pelvic organ prolapse surgery. This can be done through the abdomen, the vagina or both. In some cases, sutures are used to attach the vagina to strong tissue in the pelvis. A "sling" of tissue may be used to help support the bladder and urethra.