Dr. Eilber performs the latest procedures for the diagnosis and treatment of voiding dysfunction, male and female incontinence, and vaginal reconstruction. For your convenience, we have listed many of these procedures below. If you need more information about how we can help you, please CONTACT US.

 

Vaginal reconstruction
Vaginal reconstruction, also referred to as vaginal rejuvenation, is a general term referring to procedures that are performed for pelvic organ prolapse. Prolapse is a herniation of the pelvic organs into the vaginal canal which occurs mainly because of childbirth. Women with prolapse will often feel a bulge in the vaginal area. The goal of vaginal reconstruction is to restore the normal anatomy and function of the vagina and pelvic organs and this commonly includes cystocele repair, rectocele repair, enterocele repair, colpopexy, perineorrhaphy, and labioplasty.

Cystocele repair
A cystocele is a herniation of the bladder into the vaginal canal and is commonly referred to as a “falling bladder.” Cystocele repair is “lifting” of the bladder back to its normal position. This is typically done through the vagina, and depending on the severity of the cystocele, the repair may be reinforced with some type of graft material. Many women with cystocele also have urinary incontinence, so cystocele repair is often done in conjunction with a urethral sling procedure.

Rectocele repair
Often because of episiotomy or tearing during vaginal delivery, the tissue layer between the back wall of the vagina and rectum becomes weak and the rectum protrudes into the vagina resulting in a rectocele. Many women with rectocele feel a blockage in the vaginal canal with bowel movements. Rectocele repair is done through the vagina and graft material is used to reinforce the repair for recurrent or severe cases.

Enterocele repair
An enterocele is prolapse of the small intestine into the vagina and rarely occurs unless a woman has had a hysterectomy. Most women have no symptoms except for feeling a vaginal bulge. Most enteroceles can be repaired through the vagina, but some require an abdominal surgery. When an enterocele is repaired, a colpopexy is usually performed at the same time.

Colpopexy
Colpopexy is repair of the apex of the vagina back to its normal position. If a woman has not had a hysterectomy, the cervix and uterus are brought back to their normal position. If a woman has had a hysterectomy, colpopexy refers to fixation of the top of the vagina and often includes enterocele repair. Traditionally this surgery has been performed abdominally (abdominal sacral colpopexy) either through an incision or laparoscopically, and the vagina is fixed to the sacrum. Today there are several minimally invasive options that allow this procedure to be done vaginally.

Perineorrhaphy
The perineum is the space between the vagina and rectum and many pelvic muscles converge in this area. These muscles can become separated after childbirth, and consequently many women feel that their vaginal canal is too large. Perineorrhaphy brings the muscles in the perineum back together to restore normal vaginal caliber also commonly referred to as “tightening” of the vagina.

Labioplasty
The labia are the tissues on the sides of the vaginal opening. Many women have excessive tissue that causes discomfort during sexual activity or is cosmetically unacceptable. The excess tissue can be removed to improve sexual function and/or cosmesis.

Female urethral sling
Stress urinary incontinence is involuntary loss of urine with activity such as laughing, coughing, or exercising. The most common procedure performed worldwide for stress incontinence is a urethral sling which restores normal support for the urethra to prevent incontinence during activity. This highly successful procedure is usually done on an outpatient basis through a very small incision in the vagina. Many patients have this procedure performed on a Friday and are back in the office on Monday.

Male urethral sling
Male stress urinary incontinence (involuntary loss of urine with activity such as laughing, coughing, or exercising) usually occurs after prostate surgery. Traditionally the only option men had for treatment of stress incontinence was the artificial urinary sphincter, but today men have the option of choosing a urethral sling. The sling procedure is usually done on an outpatient basis through a small incision in the man’s perineum. For more information please visit www.americanmedicalsystems.com

Urethral bulking agents
For patients with very mild urinary incontinence, injection of a “bulking” substance into the urethra can often cure incontinence. Bulking substances include collagen, calcium hydroxylapatite, and carbon beads. Bulking agents are also useful for patients with a history of severe incontinence who have mild residual incontinence after a urethral sling or other incontinence procedure.

Bladder Botox
Overactive bladder (OAB) is defined by frequent urination greater than eight times a day and often associated with incontinence preceded by a strong urge to void. The most common treatment for OAB is medication, but for patients who do not have success with or cannot tolerate medication then Botox bladder injection or Interstim nerve modulation can be considered. This procedure is usually performed in the office and like cosmetic Botox, the injection is repeated between six and nine months.

Interstim (bladder nerve stimulator)
Overactive bladder (OAB) is defined by frequent urination greater than eight times a day and often associated with incontinence preceded by a strong urge to void. The most common treatment for OAB is medication, but for patients who do not have success with or cannot tolerate medication then Botox bladder injection or Interstim nerve modulation can be considered. Interstim is used to regulate nerve impulses to the bladder and is comparable to a heart pacemaker. An office test is performed prior to considering a patient for an Interstim implant. For more information please visit www.medtronic.com

Artificial urinary sphincter
Male stress urinary incontinence (involuntary loss of urine with activity such as laughing, coughing, or exercising) usually occurs after prostate surgery. A urethral sling is recommended for men with mild to moderate incontinence, but the best alternative for men with severe incontinence is an artificial urinary sphincter. The artificial sphincter is a hydraulic device which has been used since the 1970’s. For more information please visit www.americanmedicalsystems.com

Video-urodynamics
Overactive bladder, incontinence, and other voiding dysfunction conditions often need advanced testing to determine appropriate treatment. Video-urodynamics is a functional test of the bladder and urethra that combines measurements of bladder pressure with radiologic imaging to diagnosis a patient’s condition accurately.

Cystoscopy
Cystoscopy is direct visualization of the inside of the urethra and bladder with a flexible camera. This is necessary for conditions such as difficulty urinating, recurrent infections, and blood in the urine (hematuria). This procedure is performed in the office with local anesthesia and tolerated well by most patients.