Textbook of Robotic
Urologic Surgery.
Release Date: January, 2007
Michael Esposito, Vincent Lanteri & Jeffrey Stock
Urologic Surgery for Women
If you are one of the approximately 17 million American women who are coping with urinary incontinence and chronic bladder control issues, we understand that you are urgently seeking solutions. Likewise, up to one third of women experience pelvic prolapse, also known as vaginal prolapse, after pregnancy or after menopause. Furthermore, if you are experiencing extreme discomfort or sexual dysfunction, you may require specialized care. When lifestyle changes and medication fail to deliver the answers you are looking for, NJCPC&U offers minimally-invasive, urologic surgery to restore your quality of life. The surgeons of NJCPC&U have special expertise using the state-of-the-art da Vinci Robotic Surgical System to resolve female urologic disorders.
Learn about treatments for:
Incontinence
Urinary incontinence – the inability to control urination normally - is so common that it’s estimated up to 13 million people a year suffer the discomfort to one degree or another. You may be experiencing one of these several types of incontinence:
- Urge incontinence (when you feel the urge to go and the urine comes out before you're able to get to the bathroom)
- Stress incontinence (loss of urine during commonplace activities like sneezing, coughing or laughing)
- Mixed incontinence (combination of both stress and urge incontinence)
- Total incontinence (leaking urine all the time)
- Overflow incontinence (when your bladder malfunctions, retaining urine until it is full and the urine leaks out)
If medications and lifestyle changes have not provided adequate relief and your symptoms have become intolerable, NJCPC&U offers several, minimally invasive procedures as treatment:
- Retropubic Suspensions - These surgical options treat hypermobility and often are referred to as the Burch procedure. They elevate and restore the urethra and bladder neck to a higher anatomical position.
- Slings - A sling procedure is used to treat both hypermobility and intrinsic sphincter deficiency. The sling serves as support for the urethra during increased abdominal pressure.
- Bone fixated slings treat incontinence by supporting the urethra with a graft material that is secured to the pubic bone, such as the AMS In-Fast Ultra.
- Self-fixating slings treat incontinence by supporting the urethra. The sling is secured in place by friction and natural tissue ingrowth, rather than by sutures or screws. The AMS SPARC™, AMS Monarc™, AMS BioArc™ SP and AMS BioArc™ TO all are examples of self-fixating slings. The new AMS MiniArc™ features small, self-fixating tips that anchor the sling and provide short-term fixation. Mesh characteristics allow tissue fixation without suturing.
To ascertain which procedure could provide the best solution for your Incontinence condition, please schedule a consultation with NJCPC&U.
Overactive Bladder
If you have been frequently urinating (more than eight times during the day), you may be diagnosed with an Overactive Bladder. This condition occurs when the nerves that control your bladder malfunction, prompting the bladder muscles to spasm suddenly. Sadly, the bladder may not even be full. You find yourself running to the bathroom and then not being able to urinate much at all. Even though Overactive Bladder is often associated with aging, the condition is common and occurs in patients of all ages.
Your symptoms likely include some or all of the following:
- urinary urgency - the need to urinate immediately – without warning
- urinary frequency - urination eight or more times a day
- urge incontinence - the strong, sudden urge to go, followed by leakage or uncontrolled rush of urine
- nocturia - sleep interrupted at night due to urgent need to urinate
If medications and lifestyle changes have not provided adequate relief and your symptoms have become intolerable, NJCPC&U offers several, minimally invasive procedures as treatment:
- Cystoscopy with BOTOX - Botox is injected into areas of the bladder. The botox serves to "relax" the bladder muscles thereby decreasing the urge to urinate. This is an outpatient procedure with results lasting as long as 9 months.
- Interstim - device that allows manipulation of the nerves responsible for bladder sensation and control. This offers a more permanent solution.
To ascertain which procedure could provide the best solution for your Overactive Bladder condition, please schedule a consultation with NJCPC&U.
Reconstructive Surgery
If you are one of the 14 million women in the US who have been diagnosed with pelvic organ prolapse, also known as vaginal prolapse, you may be experiencing significant pain, the uncomfortable sensation of bulging in the vagina, difficulty walking or standing and perhaps, pain during sexual intercourse. As with other urologic conditions, you may also have difficulty emptying your bowels or bladder. Vaginal Prolapse occurs when the bladder or rectum protrude into the vaginal wall like a hernia. Bladder prolapse is sometimes referred to as cystocele. rectal prolapse is referred to rectocele. Finally, in the most serious cases, the entire uterus and cervix may protrude from the vagina, a condition commonly known as total pelvic prolapse.
NJCPC&U offers several minimally invasive, reconstructive surgeries to restore your pelvic health:
- Prolapse Repair System - NJCPC&U use three revolutionary prolapse repair systems from AMS that take graft augmented vaginal surgery to a new level by standardizing minimally invasive approaches to restore function.
- Apogee™ is a vaginal vault suspension procedure. When combined with IntePro or InteXen, apical and posterior wall repair can be performed.
- Perigee™ is a surgical solution for bladder prolapse (cystocele) that is performed vaginally using InteXen or IntePro.
- Elevate™ is a total transvaginal approach to prolapse repair requiring just a single incision. Prolapse repair systems return prolapsed organs to a more normal anatomical position and support structures around the vagina.
- Sacral Colpopexy - A surgical procedure for severe and total prolapse that attaches one end of mesh to top of the vagina and other end to the upper part of the tailbone or lower part of the spine. This procedure can be performed with our without a hysterectomy.
- Straight-In™ from AMS is a repair system designed to treat vaginal vault prolapse in an open, laparoscopic, or robotic procedure.
To ascertain which of these minimally invasive procedures may provide relief for your specific condition, please make an appointment for a consultation with NJCPC&U. We welcome your inquiry and look forward to answering all of your questions.