Illinois Urogynecology, LTD.




Glossary of Surgical Procedures

This list involves some of the more common procedures performed commonly by the physicians of IULTD. The list is by no means comprehensive.

Abdominal sacrocolpopexy:

surgery performed through an abdominal incision to treat vaginal vault prolapse. In this procedure, mesh is placed below the front and back layers of the vagina (between the vagina and bladder in front, and between the vaginal and rectum in back). The upper portion of the mesh is attached to the ligamentum flavum, a very strong ligament on the front surface of the sacral bone.

Abdominal hysterectomy:

Removal of the uterus through an abdominal incision.

Botox injection:

Botox, yes the same compound that is used to reduce wrinkles, can be very helpful in treating urge incontinence that does not respond to other therapies, and in some cases to treat voiding dysfunction or certain types of pelvic pain.

Burch urethropexy:

surgery used to treat stress incontinence, in which stitches, are placed in the vaginal support tissue on either side of the urethra and attached to a ligament on the pelvic side wall to provide urethral support.

Colpectomy:

A procedure used to treat advanced pelvic organ prolapse in an older woman, who is no longer sexually active. The procedure is commonly referred to as “closing the vagina”. The surgery can be done using regional (spinal) anesthesia, or under local anesthetic, if the patient has many co-existing medical problems. The result is normal appearing female anatomy.

Cystocele repair:

Surgical reconstruction of the supportive structures of the bladder. May be accomplished abdominally, vaginally, or laparoscopically.

Endometrial ablation:

Outpatient procedure performed under local anesthesia to treat the condition of menorrhagia or excessive menstrual bleeding and cramping. Women choosing this procedure must have completed child-bearing. A number of different types of ablation are available. Your physician will discuss with you which option is best. This procedure can be performed in the outpatient ambulatory setting or in the office.

Enterocele repair:

reconstruction of the space at the upper vagina or between the vagina and rectum which has weakened or torn and now allows the small bowel to prolapse. This can be accomplished abdominally, vaginally, or laparoscopically.

Hysteroscopic tubal occlusion:

also known as the Essure procedure, or incision-less tubal ligation. This procedure provides permanent birth control by using a hysteroscope to place an occlusive device into each fallopian tube. The hysteroscope is a very thin telescope is placed via the opening in the cervix (opening of the uterus), allowing the surgeon to visualize the inside of the uterus, and the openings of the fallopian tubes. This procedure can be performed under sedation in a surgicenter, or under local anesthetic in the office. No recovery time is required.

LAVH:

Laparoscopically-Assisted Vaginal Hysterectomy. The uterus is removed through a combination of laparoscopic approach and vaginal incision.

LSC or LSCH:

Laparoscopic Supracervical Hysterectomy: The body of the uterus is removed through minimal (1/2 inch – 1 inch) incisions in the abdomen. The cervix is left in place. Pap smears are still indicated after this procedure.

Laparoscopy:

Minimally invasive abdominal surgery, performed under general anesthesia, which allows access to the abdominal cavity through multiple small (1 inch or less) incisions through which long thin instruments are placed.

Mesh or graft augmentation:

refers in particular to prolapse repair surgery. Because prolapse is necessarily associated with weakened supportive structures, a graft may be placed to strengthen the repair. Graft may be made of natural tissue; such as human donor skin or fascia; or porcine (pig) intestine. Alternatively, graft may be comprised of synthetic mesh, which is non-absorbable. Many factors must be considered in balancing the benefit and risk of using or not using graft for prolapse repairs. Your physician will discuss how these relate to your condition. This decision may be made intraoperatively.

Mid-urethral sling:

a minimally invasive procedure in which a thin tape is placed as a hammock under the urethra to provide support as a treatment for stress urinary incontinence.

Obturator sling:

a version of mid-urethral sling in which 2 small (about ˝ inch) incisions are made at the inner, upper thigh. The outer portions of the sling pass through the obturator membrane, a strong muscular layer near where the thigh meets the pelvis.

Perineorrhaphy:

A repair of the introitus or perineum, which is the tissue at the vaginal opening, and commonly refers to the area between the vaginal and rectal openings. Muscles and support tissue frequently tears away from this area during childbirth allowing a lax vaginal opening and contributing to prolapse and/or sexual dysfunction.

Peri-urethral collagen injection:

a procedure used to treat certain forms of stress urinary incontinence

Rectocele Repair:

Reconstruction of the supportive layer between the rectum and the vagina to correct rectocele. This procedure is most commonly performed through a vaginal incision, and may or may not involve mesh augmentation.

Renessa procedure:

A radio-frequency collagen remodeling procedure used to treat stress incontinence. This procedure is performed in the office using local anesthesia. During the procedure, a catheter is placed into the urethra. Very thin needles protrude into the layers just under the urethra and thermal (heat) energy is used to heat the collagen. The tissue heals over the next several weeks to become less elastic and more able to resist urine loss.

Uterosacral suspension:

surgical procedure used to correct vaginal vault prolapse or uterine prolapse if uterine preservation is desired. The upper vagina is reattached to the uterosacral ligaments which have usually been shorn from the upper vagina in cases of prolapse. This may be performed abdominally, vaginally, or laparoscopically.

Vaginal hysterectomy:

Removal of the uterus through a vaginal incision.

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