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About Female Pelvic Medicine & Reconstructive Surgery – also known as Urogynecology

Our goal is to improve the quality of life for all women. Our primary purpose is to deliver the most current treatment and therapies related to female urinary incontinence and pelvic floor disorders. We offer our patients the highest standards of treatment our specialty - female pelvic health. We offer comprehensive evaluation and treatment in: 

  • Urinary incontinence - stress and urge
  • Pelvic organ prolapse with non-surgical and surgical options. We have a number of new therapeutic options available that have a very high success rate, even with recurrent pelvic organ prolapse.
  • Overactive bladder
  • Interstitial Cystitis
  • Chronic pelvic pain
  • Vulvodynia and Vulvar dermatological disease
  • Providing the most up-to-date medical and surgical treatments available in a patient-oriented care system.

We have developed a multi-modal therapeutic approach including:

  1. We provide comprehensive consultation & evaluation for obtaining the correct diagnosis
  2. We provide comprehensive treatment plans that include surgical but also non-surgical options such as the following:
    • Pelvic floor therapy & rehabilitation
    • Pain injection including Botox for muscle spasm & persistent pain
    • Bladder instillations
    • Interstim Therapy

Surgical approaches include:

  1. Office based procedures for urinary incontinence
  2. Pelvic pain
  3. Heavy menstrual periods - ablations (in office procedure)
  4. permanent contraception - (in office procedure)
  5. We also can provide the most comprehensive approach to treating incontinence and prolapse available including the following 
    • Inpatient & outpatient surgery
    • minimally invasive vaginal surgery
    • minimally invasive laparoscopic surgery
    • minimally invasive robotic surgery

We treat other conditions such as:

  • Recurrent urinary tract infections
  • Recurrent endometriosis & pain in spite of prior laparoscopic treatment
  • Persistent pelvic pain post hysterectomy
  • Overactive bladder with incontinence
  • Heavy menstrual bleeding
  • Sexual dysfunction
  •  

If you suffer from urinary incontinence or pelvic organ prolapse, you are not alone. This problem occurs in many women & often they think it is part of normal aging. Most women are not aware that new treatment modalities are available to successfully manage their problems and help them live a normal life.

Gaining urinary control is obtainable, by comprehensive evaluation to help make an accurate diagnosis and then using necessary treatment modalities to treat it including:

  • Comprehensive testing including Urodynamic testing (evaluation of bladder function)
  • Office based Percutaneous Nerve Evaluation for Interstim
  • Use of suburethral slings to treat genuine stress urinary incontinence
  • Treating irritative bladder conditions such as interstitial cystitis .
  • Pelvic floor therapy to improve both stress control & urge control.
  • Dietary consultation regarding bladder irritants.

We employ tried and tested as well as the newest techniques for correction of both prolapse & urinary incontinence.

Dr. Vikas Merchia, MD, FACOG, FPMRS is Board Certified in the subspecialty of Female Pelvic Medicine and Reconstructive Surgery. He has been practicing for nearly 20 years with a wealth of knowledge and experience in using all the modalities mentioned previously. He is a compassionate and emphatic patient advocate, with the single goal of working to help improve the quality of life of his patients.

What is a Urogynecologist?

A urogynecologist is an obstetrician/gynecologist who has specialized in the care of women with pelvic floor disorder. The pelvic floor is the muscles, ligaments, connective tissue and nerves that help support and control the rectum, uterus, vagina and bladder. The pelvic floor can be damaged by childbirth, repeated heavy lifting, chronic disease or surgery.
Some problems due to pelvic floor disorder and their symptoms are:

  1. Incontinence: loss of bladder or bowel control, leakage of urine or feces.
  2. Prolapse: descent of pelvic organs; a bulge and/or pressure; ‘dropped uterus, bladder, vagina or rectum.’
  3. Emptying Disorders: difficulty urinating or moving bowels.
  4. Pelvic (or Bladder) Pain: discomfort, burning or other uncomfortable pelvic symptoms, including bladder or urethral pain.
  5. Overactive Bladder: frequent need to void, bladder pressure, urgency, urgency incontinence or difficulty holding back a full bladder.
  6.  

What Kind of Training Does a Urogynecologist Have?

Urogynecologists have completed medical school and a four-year residency in Obstetrics and Gynecology. These doctors become specialists

with additional training and experience in the evaluation and treatment of conditions that affect the female pelvic organs, and the muscles and connective tissue that support the organs. The additional training focuses on the surgical and non-surgical treatment of non- cancerous gynecologic problems.

When Should I See a Urogynecologist?

Although your primary care physician or OB/GYN may have knowledge about these problems, a urogynecologist can offer additional expertise.

You should see (or be referred to) a urogynecologist when you have problems of prolapse, and/or troublesome incontinence or when your primary doctor recommends consultation. Other problems for which you or your doctor might think about consulting a urogynecologist include: problems with emptying the bladder or rectum, pelvic pain and the need for special expertise in vaginal surgery.

What Treatment Options are Available from a Urogynecologist?

A urogynecologist can recommend a variety of therapies to cure or relieve symptoms of prolapse, urinary or fecal incontinence, or other pelvic floor dysfunction symptoms. He or she may advise conservative (non-surgical) or surgical therapy depending on your wishes, the severity of your condition and your general health. Conservative options include medications, pelvic exercises, behavioral and/or dietary modifications and vaginal devices (also called pessaries). Biofeedback and physical therapy are additional modalities that your urogynecologist may recommend. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse. He or she will discuss all of the options that are available to treat your specific problem(s) before you are asked to make a treatment decision.

Diagnosis and Treatment of Urinary Incontinence

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Diagnosis and Treatment of Pelvic Organ Prolapse

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