Urogynecology and Pelvic Surgery

If you’re dealing with stress incontinence, vaginal prolapse or another pelvic condition that’s affecting your quality of life, you deserve the highest quality care so you can get back to feeling your best.

The specialists at Atrium Health Women's Care Urogynecology and Pelvic Surgery are pioneers in their specialized fields. They create, study and use the latest technologies and treatments available.

Our female pelvic medicine and reconstructive surgeons, also known as urogynecologists, provide cutting-edge diagnostic and treatment options for complex pelvic floor disorders, like pelvic organ prolapse, urinary incontinence and fecal incontinence. And our minimally invasive gynecologic surgeons offer a wide range of advanced surgical care for gynecologic conditions, like fibroids, endometriosis and ovarian cysts.

No matter what type of pelvic or gynecological issue you’re experiencing, our team is here for you with the specialized treatment you need. 

Patient care – what to expect

Patients choose Atrium Health Women's Care Urogynecology and Pelvic Surgery for care because we provide:

• Advanced treatments. We combine our expertise with the newest technologies to deliver advanced treatments. From being the only program in the Charlotte region to offer 3D laparoscopy, enabling our surgeons to operate with greater precision, to using the most advanced vaginal laser to treat vaginal dryness. 
• Better care through research. We are passionate about research and conduct studies to both improve patient outcomes and contribute to the education of our fellows and residents. One of our recent research projects focused on providing safe gynecologic care via virtual platforms (virtual care), which we found to be a very effective method. 
• Highest level of expertise. Our doctors are innovators in this very specialized field of care and are fellowship trained in female pelvic health reconstructive surgery or minimally invasive gynecologic surgery. 
• Minimally invasive surgery. We are one of the only programs in the Charlotte region to offer minimally invasive options for all our procedures and surgeries – and 98% are performed minimally invasively. We use laparoscopic, robotic and vaginal techniques. This means most of our patients go home the day of surgery and experience fewer complications and less pain. 
• Personalized treatment plans. To figure out the best plan for you, we discuss your symptoms, goals, expectations, and medical history, and run diagnostic tests and screenings if needed. With that information, we work with our larger team to create a surgical or nonsurgical plan. 
• Team approach. To provide the best possible care, we work seamlessly as a team, collaborating on cases and treatments. And we work closely with all types of Atrium Health specialists to provide a full continuum of care. 
• Virtual care. We offer virtual appointments, via video visit or phone, making it easier for you to get the specialized care you need.

Conditions we treat

We treat a variety of pelvic and gynecologic conditions that can negatively impact your quality of life. Patients with the following conditions come to us for care.

Female pelvic medicine & reconstructive surgery – conditions treated

• Conditions related to connective tissue disorders, like Ehlers-Danlos syndrome
• Fecal incontinence (inability to control bowel movements)
• Fecal/rectal fistula (abnormal opening in the skin near the anus)
• Gender dysphoria
• Mixed urinary incontinence (combination of urge and stress incontinence)
• Neurogenic bladder (impaired nerves of the urinary system)
• Neurogenic bowel (impaired nerves of the gastrointestinal system)
• Nocturia (waking up at night to urinate)
• Pelvic floor dysfunction (disorders related to pelvic floor weakness)
• Pelvic mesh complications/erosions
• Pelvic organ prolapse (cystocele, rectocele, uterine prolapse, vaginal prolapse)
• Prior pelvic floor surgery and mesh complications
• Urinary/bladder fistula (abnormal connection between bladder/ureter and vagina)
• Urinary incontinence
  • Stress incontinence (urinary leakage with activity, like coughing)
  • Urgency incontinence (overactive bladder)
• Vaginal atrophy/dryness

Minimally invasive gynecologic surgery – conditions treated

• Adenomyosis (displaced endometrial tissue)
• Endometriosis
• Infertility (in coordination with our fertility specialists)
• Ovarian cysts (like endometrioma and dermoid cysts)
• Painful or heavy periods
• Uterine anomalies
• Uterine fibroids (noncancerous growths of the uterus)

Chronic pelvic pain – conditions treated

• Dyspareunia (sexual pain)
• Endometriosis
• High-tone pelvic-floor muscle dysfunction (chronic muscle strain)
• Myofascial pelvic pain syndrome (localized chronic pain)
• Painful periods
• Pelvic floor tension myalgia (muscle soreness or pain)
• Pudendal neuralgia (chronic nerve pain)
• Vulvodynia (pain around vagina opening)

Treatments and services

We offer the latest in female pelvic medicine & reconstructive surgery and minimally invasive gynecologic surgery. Many treatments do not require surgery and include medications, targeted exercises, dietary changes or other nonsurgical management options. When surgery is necessary, our surgeons specialize in the newest minimally invasive surgery techniques.

Female pelvic medicine & reconstructive surgery

Our urogynecologists diagnose and treat conditions related to your pelvic floor so you can get back to your active life. Our treatments and services include:

• Physical exam and diagnosis. We perform a physical exam, which may include a variety of other exams, such as a pelvic exam or rectal exam, to determine the cause of your symptoms. We may also run various diagnostic tests and procedures to help pinpoint the cause. Here are a few examples:
  • Cystourethroscopy evaluation. This is a procedure that allows us to examine the inside of your bladder and urethra in detail and treat urinary problems.
  • Endoanal ultrasound. We use this ultrasound to evaluate the integrity of the sphincter, typically for women who have an anal sphincter tear from vaginal delivery, to see if they’re a candidate for surgical repair.
  • Urodynamics. This is a bladder function test that allows us to better understand the capacity of your bladder and the mechanisms that trigger leakage. It also helps us plan for surgery.
• Medication therapy. We may prescribe medication as part of your treatment plan. For example, some medications can help control your bladder or bowel movements.
• Pelvic floor physical therapy. A specialized physical therapist takes you through focused exercises to strengthen your pelvic muscles and treat incontinence and pelvic pain linked to a variety of conditions. 
• Pelvic support devices (pessaries). These rubber or plastic devices are round in shape and are inserted through your vagina to help support and/or hold certain pelvic organs in place, like your uterus. We’ll help you decide what type of device is right for you.
• Pelvic floor reconstruction. If other treatment options aren’t working, you may need surgery to repair prolapse and incontinence conditions. We will either perform the procedure through an incision in the wall of your vagina or through tiny incisions in your abdomen (a laparoscopic or robotic surgery). Sometimes we use mesh, or other grafts, to help support the tissue and ensure the repair is durable. Occasionally a hysterectomy, or removal of the uterus, is recommended during surgery. 
• Gender affirming surgery. Tailored to each patient’s unique needs, this type of surgery changes a person’s sexual characteristics to better reflect their gender identity. For some trans and gender diverse people, these surgeries are needed for their well-being and to treat a condition called gender dysphoria. (We follow the Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People outlined by World Professional Association for Transgender Health.)
• Labiaplasty. Sometimes the labia (skin folds of the vulva) can hypertrophy or cause discomfort. This procedure can help to minimize the size of the labia minora (inner skin folds) and/or the labia majora (outer skin folds).
• Vaginal laser therapy. This procedure helps blood flow return to the vagina, promoting healthy tissue growth to treat vaginal dryness. Some people call this vaginal rejuvenation.
• Vaginal mesh removal. If you’re experiencing pelvic mesh complications, we may need to perform a surgical procedure to carefully remove as much of the mesh as possible.

Minimally invasive gynecologic surgery

Our minimally invasive gynecologic surgeons are specially trained to surgically treat a wide range of gynecologic conditions. Minimally invasive surgery, such as laparoscopy, is an alternative to open surgery and results in less pain and a faster recovery. Minimally invasive techniques require no or only a few small incisions, rather than one large incision.

Our minimally invasive gynecologic surgeries include:

• Anterior and posterior repair (colporrhaphy) to restore the look and function of your pelvic organs that have dropped out of their normal positions
• Colpocleisis (vaginal closure) to reduce vaginal prolapse by shortening the vaginal canal and reducing the size of the opening of the vagina
• Laparoscopic excision of endometriosis and endometriomas to remove lesions without harming the uterus or other parts of the body endometrial tissue can grow on, like the bowel, diaphragm and nerves
• Laparoscopic myomectomy to remove uterine fibroids
• Laparoscopic salpingectomy-oophorectomy to remove one or both of your fallopian tubes and ovaries
• Laparoscopic ovarian cystectomy to remove ovarian cysts while preserving your ovaries
• Perineorrhaphy (perineoplasty) to repair a tear of the perineum, usually from childbirth
• Robotic-assisted laparoscopic sacral colpopexy to repair pelvic organ prolapse by inserting a transvaginal mesh into the vagina
• Total laparoscopic hysterectomy to remove the uterus
• Sacrospinous fixation and uterosacral ligament suspension to improve support of the uterus or vaginal vault by using your own tissue or a vaginal mesh to fix (secure) sagging pelvic organs

Chronic pelvic pain

There are many different issues that can cause chronic pelvic pain. Our expert team works together to figure out the right treatment approach to relieve your painful symptoms.

Here are some of the treatments we offer:

• Oral and topical medications. There are variety of medications we may prescribe to alleviate your pain, such as antidepressants, vaginal suppositories and creams, and nonsteroidal anti-inflammatory drugs (NSAIDS).
• Botulinum toxin (BOTOX®) injections. We inject this neurotoxin into your pelvic floor muscles to treat muscle spasms and chronic pain.
• Trigger point injections. We inject a local anesthetic into your abdomen to temporarily interrupt pain signals related to trigger points that contribute to pelvic pain.
• Pudendal nerve blocks. Using X-ray guidance, we carefully inject a local anesthetic and a steroid near your pudendal nerve to block pains signals from reaching the brain.

Your expanded care team

Our specialists work together to create the right treatment plan for you. Your care team may include:

• Advanced practice providers (specially trained nurse practitioners or physician assistants) who work closely with our surgeons to diagnose and treat patients with various pelvic conditions
• Fellows (doctors in advanced fellowship training) who observe and help treat patients (under the supervision of the attending surgeon) as they complete their training to become female pelvic medicine and reconstructive surgeons
• Female pelvic medicine and reconstructive surgeons (urogynecologists) who diagnose and treat conditions affecting the female pelvic organs, such as incontinence and prolapse, both medically and surgically
• Minimally invasive gynecologic surgeons who perform complex laparoscopic or robotic surgeries to manage various gynecologic conditions, such as excision of endometriosis and fibroids
• Pelvic floor physical therapists who help patients with pelvic floor disorders through targeted exercises and massage work
• Urodynamic nurses who perform bladder testing to help identify the cause of urinary incontinence