Female pelvic medicine and reconstructive pelvic surgery at MedStar Health
Specialized, comprehensive care for women with pelvic floor disorders
The pelvic floor plays an important role in supporting internal organs, including the uterus, bladder, and bowel. Sometimes pelvic floor muscles become weak after childbirth or due to other medical conditions.
When that happens, you might experience urine leakage (urinary incontinence), stool leakage (fecal incontinence), an overactive bladder, constipation, or other pelvic floor issues. These conditions are common in aging, as one in three women over the age of 45 will experience a pelvic floor disorder in her lifetime. However, you don't have to live with these conditions.
Our fellowship-trained specialists are experts in all kinds of treatment approaches, including behavioral modifications, medications, and medical therapies, as well as minimally invasive and robotic surgery. In addition, we work closely with other specialists, including colorectal surgeons, gynecologists, physical therapists, and others, to ensure our patients receive comprehensive care that addresses the root of their concerns. Our wide range of expertise allows us to offer personalized treatment and find what works best for our patients with pelvic floor disorders.
What is a urogynecologist?
A urogynecologist is a physician who specializes in the care of women with pelvic floor disorders. Urogynecology and reconstructive pelvic surgery is a subspecialty in the field of Obstetrics and Gynecology or Urology. That means a urogynecologist completed medical school and a residency in Urology or Obstetrics and Gynecology and has additional years of fellowship training and certification in Female Pelvic Medicine and Reconstructive Surgery.
When should I see a urogynecologist?
Your primary care doctor may refer you to a urogynecologist if you are experiencing the following symptoms:
- Urinary issues, including urinary incontinence, a strong urge to urinate, or painful urination.
- Pressure in the pelvic region or rectum. Some, especially women facing a pelvic organ prolapse, may experience a heavy feeling in the pelvis or a bulge in the vagina or rectum.
- Pain, including pain in the lower back, pelvic region, genitals, or rectum. Women may also experience pain or discomfort during sexual intercourse.
- Constipation, which involves dry, hard bowel movements or going fewer than three times per week.
- Muscle spasms, typically experienced in the pelvis.
Conditions we treat
Bladder disorders
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Painful bladder syndrome/interstitial cystitis
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Difficulty voiding
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Recurrent bladder infections
Pelvic support disorders
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Relaxed vaginal outlet
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Childbirth injury
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Management of vaginal and pelvic mesh complications
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Painful bladder/interstitial cystitis
Treating pelvic floor disorders
If you’re experiencing pain or discomfort in your pelvic floor, our women’s urology specialists will begin with a thorough consultation to understand your symptoms and their impact on your life. We may use advanced diagnostic tools to further evaluate any underlying conditions. Your treatment options consider your lifestyle, goals, and preferences, and may include one or more of the following:
Nonsurgical treatment options
Injections for incontinence and bladder control problems
- "Bulking agents" (polyacrylamide gel) can be injected into the urethra to treat stress incontinence
- Botulinum toxin (Botox®) can be injected into the bladder muscle to treat overactive bladder and urge incontinence
- Doctors can do both procedures with a local anesthetic, and the procedure is performed on an outpatient basis or in the office
Medications
Medicine can be prescribed for certain incontinence problems and other conditions.
Vaginal pessary for prolapse
These are soft, removable devices that support areas affected by a prolapse. These can be placed during an office visit.
Pelvic floor muscle training
Pelvic floor therapy can help improve symptoms of prolapse and other pelvic floor disorders. Exercises, such as kegels, involve squeezing and relaxing the pelvic floor muscles. They can improve symptoms but cannot correct more severe prolapses.
Nerve stimulation
Nerve stimulation similar to acupuncture can be used to treat overactive bladder.
Surgical treatments
Incontinence surgeries
Surgery can effectively treat incontinence that occurs because of pressure on the bladder. Our surgeons are experts in various procedures using minimally invasive techniques. Most commonly, surgical options for urinary incontinence may include:
- Sling procedures: The surgeon uses your own tissue or places a "hammock" to support the urethra
- Bladder pacemaker: A device is implanted to treat overactive bladder and difficulty urinating
Learn More About Urinary Incontinence Surgery
Prolapse surgeries
These surgeries repair the prolapse and build pelvic floor support. The options vary depending on which organs are prolapsed. Some options include:
- Repairing the vaginal wall
- Supporting the rectum or small bowel
- Supporting the bladder
- Removal of the uterus
- Surgery for bladder control
Pelvic floor reconstruction
Some patients need pelvic reconstruction surgery after a previous surgery to correct a urogynecologic condition or restore normal female anatomy and function.
If you are experiencing symptoms such as persistent prolapse, urinary incontinence, or pelvic pain, you may be a candidate for further evaluation. Our urogynecologists have vast experience performing pelvic reconstructive procedures using minimally invasive approaches such as transvaginal, laparoscopic, and robotic techniques.
Robotic surgery
Robotic-assisted surgery has created a world of possibilities for surgeons—and for you. During robotic surgery, a surgeon uses a computer to control and guide robotic “arms” with small instruments.
With the use of a small camera and special surgical tools, surgeries are being done with a higher degree of precision than ever before.
Robotic surgery allows for a wider range of motion than the human hand offers and, combined with our highly trained surgeons’ knowledge and experience, often makes minimally invasive surgery possible.
Benefits of robotic surgey
- Smaller incisions
- Less scarring
- Less pain/discomfort
- Quicker recovery
- Protection of surrounding tissue in the area of operation
- The ability for surgeons to reach otherwise hard-to-reach areas
Our providers
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Elizabeth Timbrook Brown, MD, MPH
Urogynecology, Female Urology & Urology
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Rachael Dana Sussman, MD
Urogynecology, Urology, Minimally Invasive Urology & Female Urology
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Our locations
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MedStar Health: Urology at Chevy Chase
5530 Wisconsin Ave. Ste. 950 Chevy Chase, MD 20815
MedStar Health: Urology at MedStar Georgetown University Hospital
3800 Reservoir Road, NW Pasquerilla Healthcare Center 3rd Floor Washington, DC 20007
MedStar Health: Urogynecology at Rockville
5410 Edson Lane Ste. 306 Rockville, MD 20852
MedStar Health: Urogynecology at MedStar Washington Hospital Center
106 Irving Street, NW Physicians Office Building South Tower Ste. 405 Washington, DC 20010