Treatments we offer

Today’s treatments aren’t your grandmother’s medicine. The Michigan Medicine Urogynecology Program offers newer, more successful options to get you back to the life you want to lead!

Each patient’s treatment is individualized based on her own personal needs, underlying causes of her condition, and lifestyle goals. We offer a coordinated team approach to improve symptom control and improve quality of life. Your providers will work with you to find the treatment that is right for you. 

Treatment can include:

  • Physical therapy
  • Outpatient, office-based treatments
  • Surgical treatment

Occasionally in the health care field, the treatment options offered to a woman with pelvic organ dysfunction depend on the training and experience of the surgeon. The benefit to choosing a comprehensive treatment program like U-M’s Urogynecology Program is that every available treatment option is offered, when appropriate. Our board-certified Female Pelvic Medicine and Reconstructive Surgery (FPMRS) subspecialists have deep experience with the full range of treatment options for women with pelvic floor disorders and will work together with you to find the right option.

Physical therapy

Physical therapy can help women with pelvic floor disorders improve the strength and function of their pelvic floor muscles. PT techniques that are often used for women with pelvic floor disorders include:

  • Pelvic-floor relaxation/strength training
  • Bladder/bowel retraining
  • Exercises designed to stretch/strengthen different muscles, including the diaphragm
  • Manual therapy
  • Improvement/restoration of joint movement
  • Biofeedback/electrical stimulation/pressure therapy

Our team includes specialists from the University of Michigan Physical Medicine & Rehabilitation program with cutting-edge expertise in designing exercise and rehab regimens to treat pelvic disorders. Your program will be tailored to you.

Don’t live in Ann Arbor? No problem. We work with a network of PT providers with special expertise in working with women with pelvic disorders throughout the state of Michigan so that you are able to receive therapy conveniently close to home.

Outpatient, office-based treatments

We offer several non-surgical therapies that can be performed during a standard office visit.  These often serve as a temporary measure before surgery, or can resolve the problem without surgery.

  • Pessaries are devices that are inserted into the vagina to support the pelvic organs. After some brief training with your physician, a woman can usually take the pessary out and reinsert it herself. Pessaries are used to treat prolapse, incontinence or both. When fit properly, they are comfortable and don’t cause infections.
  • Muscle Injections can be helpful when pelvic muscles are in deep spasm and unresponsive to traditional therapy. These can include neurotoxins, such as Botox, to relax the pelvic muscles, or trigger point injections to increase effectiveness of physical therapy.
  • Urethral bulking agents are injected at the intersection of the bladder and urethra to reduce urine leakage with exercise (i.e. stress urinary incontinence). You’ll leave the office leaking less and ready to get right back into life’s activities.
  • Nerve stimulation sends small electrical pulses from a nerve near the tibial nerve in the ankle to the sacral nerve to help control urination urgency, frequency, and incontinence.

Surgical treatments for pelvic floor disorders

For patients for whom non-surgical therapies don’t provide desired relief, we offer a full spectrum of short-stay surgical procedures, including laparoscopic and robotic-assisted surgery.

We will work with you to determine what procedure is right for your individual needs, factoring in your lifestyle and health history. Please ask questions of your surgeon and be upfront with your concerns so that we can factor everything into the decision.

Three different types of surgical approaches are available.

  • Vaginal surgery has a faster recovery time, no incisions, and causes less pain and blood loss than an abdominal surgery. Some types of vaginal surgery can be done without mesh, using dissolvable sutures to attach the top part of the vagina to a ligament deep in the buttocks. Women typically are able to go home the following morning from surgery with little pain.
  • Robotic-assisted laparoscopic surgery, performed through small incisions with the use of a telescope camera, allows for faster healing and shorter hospital stays in place of larger incisions that were previously used. Our experience with robotic surgery has shown that patients experience less pain and scarring, lose less blood, are at less risk of wound infections and return to normal activities more quickly compared to traditional open surgeries.
  • Abdominal surgery is performed through an abdominal incision, has a longer recovery time and generally causes more discomfort than vaginal surgeries, but may be your only option due to anatomy or other existing conditions. We can still use the smallest incision possible.

Procedures offered can include:

  • Incontinence surgeries done via the vaginal approach
  • Repair of bladder or bowel vaginal prolapse done through the vaginal opening without the use of mesh
  • Vaginal hysterectomy and support of the vaginal canal
  • Surgeries to repair prolapse but keep the uterus intact
  • Repair of fistula connections between the vagina and other organs
  • Robotic-assisted sacrocolpopexy to repair vaginal prolapse

We also offer special expertise in complex pelvic reconstruction procedures and surgeries to fix complications from prior procedures. 

Take the next step

To schedule an appointment or learn more about the Michigan Medicine Urogynecology Program, call one of our four clinics in Ann Arbor, Northville and Midland.