Non-Surgical Therapy

We believe it is important for patients to make informed choices about their treatment, and we encourage our patients to try non-surgical therapies whenever possible.  Common non-surgical alternatives include:

Pelvic Floor Exercises

Pelvic floor exercises (‘Kegel’ exercises) are the basic workout for the pelvic floor, and can reduce incontinence symptoms in many cases.  They are designed to increase your awareness of the muscles around the vagina, bladder and rectum, then strengthen and tone them. Understanding the right way to do these exercises is essential, as you need to learn which muscles to contract, and which others to relax.  Several techniques can be used to identify the Kegel muscles on your own.

Dietary & Behavior Modification

Dietary and behavioral approaches can play an important role in restoring urinary comfort and control.  Patients at the Center are provided with the necessary tools to implement these strategies.

Biofeedback

Women who have difficulty performing pelvic floor muscle exercises on their own may find that biofeedback therapy with the help of a nurse specialist or physical therapist enables them to witness significant improvement in pelvic floor strength.  Biofeedback provides patients with information about the activity of their bladder, urethra, and pelvic floor muscles that may enable them to improve their control over bladder and/or bowels. Techniques suitable for both home and office situations are available.

Medications

Incontinence medications are available in the form of pills, skin patches, and even vaginal creams and tablets.  For patients failing to respond to first-line medications, the Center offers frequent opportunities to enroll in research trials of new medications.

Pelvic Floor Stimulation

Painless electrical stimulation of the muscles of the urethra and bladder is an effective way to treat both genuine stress incontinence and detrusor instability.

Urethral Injections

Urinary stress incontinence can be treated with ‘bulking’ injections around the urethra, providing a very useful alternative to surgery for some women.  These procedures are performed in the office using local anesthesia, and can result in an immediate reduction in stress incontinence symptoms.  Several different bulking materials are used at the Center.

Interstim ‘Pacemaker’

This innovative procedure involves placement of a small permanent electrode beside the key ‘sacral nerves’ that exit the spine, and help to maintain normal function of the bladder and pelvic floor.  It is used for cases of ‘overactive bladder’ and/or urinary retention, which fail to respond to more conservative treatments.  Interstim is now performed under local anesthesia as an outpatient procedure.  Recent studies have reported 61% ‘excellent response’ and 22% ‘good response’ for treatment of overactive bladder.  According to another published series, 94% considered it a success. 

Magnetic Innervation

Painless magnetic waves are transmitted to the pelvic muscles and nerves while sitting fully clothed in a chair, to treat both stress incontinence and overactive bladder symptoms.

Pessary Devices

Pessaries provide the major non-surgical approach to supporting prolapse, and relieving symptoms of pressure and discomfort.  They are made of silicone and latex, in various shapes and sizes – such as Rings, Donuts, Cubes, and Bridges.  When fitting properly, they can hold back bulging pelvic tissues and provide an invisible, effective, ‘low tech’ treatment alternative.  The Center is equipped with every type and size, for patients interested in this approach. 

Management of Vulvodynia & Vestibulitis

Comprehensive approach to the evaluation and treatment of vulvar pain syndromes, including topical and oral medications, trigger point therapy, and surgical repair.

Surgical Procedures

As a major referral center for gynecologic, female urologic and pelvic surgery, we offer the most advanced minimally invasive solutions whenever possible.  Many major gynecologic operations – including hysterectomy – can be performed without any abdominal incision.  Although we have the privilege of performing nearly 300 major surgical procedures each year, we are dedicated to individualizing each patient’s surgical plan – according to her age, reproductive plans and 

Advanced Gynecologic & Pelvic Surgery

We offer vaginal, laparoscopic and abdominal techniques to achieve the goals of long-term success, high patient satisfaction, and improved quality of life.  Surgical techniques developed at The Evanston Continence Center, involving the use of graft & mesh materials, have resulted in dramatically improved surgical outcomes.

  • Vaginal & Laparoscopic Hysterectomy
  • Repair of Pelvic Prolapse
  • Incontinence & Urinary Disorders
  • Conservative Surgery for Fibroids and Pelvic Pain

“Tension Free” Incontinence Procedures

New minimally invasive procedures for Stress Incontinence can be performed in less than 20-minutes, on an outpatient basis, resulting in complete cures for up to 96% of patients.   These procedures typically require no overnight hospital stay.

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