This book provides the most up-to-date and comprehensive aspects of evaluation and therapy of female pelvic floor dysfunction. It is edited by well-known international surgeons with clinical practices within one tertiary referral institution, the Pelvic Floor Center at Cleveland Clinic Florida in Weston (Fort Lauderdale), Florida which serves as a National and International referral center for women with symptomatic pelvic floor problems. Recognized worldwide for its excellence, Cleveland Clinic departments of Gynecology, Urology, and Colorectal Surgery have combined their expertise in producing this text. Focused on urinary incontinence & other voiding dysfunctions, fecal incontinence & other distal gastroenterologic problems, genital and rectal prolapse, & other recognized pelvic floor problems, the book should be of great interest to the practicing Gynecologist/Urogynecologist, Urologist, and Colorectal Surgeon as well as Sexual Dysfunction specialist, Gastroenterologist and Physical Therapist.
I. Concept of the Pelvic Floor as a Unit.- II Epidemiology and Prevalence: Non-neurogenic Urinary Dysfunction.- Bowel dysfunction.- Genital prolapse, Urogenital Atrophy and Sexual Dysfunction.- III Evaluation: Primary Evaluation of the Pelvic Floor.- Urodynamics.- Imaging of the Genitourinary Tract in Females.- Anorectal Physiology.- Anorectal Ultrasound Evaluation.- Neurologic Evaluation of the Pelvic Floor.- Upper GI Evaluation Related to the Pelvic Floor.- IV Anatomic Correlates: Genital Anatomic Correlates.- Colorectal Anatomic Correlates.- V Sexual Function.- VI Incontinence therapy: Device Therapy for Stress Incontinence.- Medications for Stress Urinary Incontinence.- Sling/ TVT.- Bulking Agents.- Retropubic Therapy for Stress Incontinence.- Laparoscopic Surgery for Urodynamic Stress Incontinence.- Other Therapies for Stress Urinary Incontinence.- Anal Sphincter Repair.- Fecal Diversion.- ACYST, SECCA, Sacral Nerve Stimulation, Artificial Bowel Sphincter and Stimulated Graciloplasty.- Case Presentation: SUI/FI.- VII Urgency/Frequency Syndromes Therapy: Overactive Bladder.- Sacral Nerve Stimulation.- Surgical Management of the Overactive Bladder: Evacuation Disorders.- Irritable Bowel Syndrome.- Irritable Bowel-Anismus.- VIII Prolapse Syndromes Therapy: Vaginal Pessaries.- Vaginal - Vault Surgery.- Anterior Vaginal Prolapse.- Vaginal enterocele Repair.- Vaginal Rectocele Repairs.- Rectoanal Intussusception, Solitary Rectal Ulcer and Sigmoidoceles.- Case Presentation: Prolapse (FE).- IX Pain and Irritative Syndromes Therapy: Interstitial Cystitis-Painful Bladder Syndrome.- Painful Conditions of the Urogenital Sinus.- Anal Pain.- Pain Localization and Control.- Acupuncture for Pelvic Floor Dysfunction.- X Evacuation Disorders: Conservative Management of Urinary Retention in Women.-Surgical Management of Urinary Retention.- Bladder Outlet Obstruction After Anti-Incontinence Surgery/ Urethrolysis.- Conservative Management of Constipation.- Surgical Management of Constipation.- XI Hormonal Influences on the Pelvic Floor.- XII Physiotherapeutic Approaches: Kegels and Biofeedback.- Timed Voiding and Fluid Management.- Bowel Retraining for Functional Disorders of the Colon Rectum and Anus.- XIII Surgical Therapy: Mututal and Combined Aspects:Vesico-vaginal Fistula.- Rectovaginal Fistula.- Enterourinary Fistula.- Management of Urinary Tract Injuries.- Combined vs. Sequential Reconstructive Surgeries.- XIV Severity Assessment:Voiding Diary.- Scoring Systems.- Quality of Life Assessment Tools.