Complicated and Complex Pelvic Floor Disorders

Complex pelvic floor disorders include functional conditions causing pelvic floor dysfunction associated with urinary incontinence and urogenital prolapse.

Whilst the majority of primary conditions associated with pelvic floor dysfunction will be managed by gynaecologists and urologists with an interest in female urology and urogynaecology more complex cases should be managed by sub-specialist urogynaecologists and female urologists working within a multidisciplinary team.

The core multidisciplinary team should consist of a urogynaecologist, female urologist, colorectal surgeon, nurse specialist and pelvic floor physiotherapist. Additional members may include neurologists, geriatricians, pharmacists and medical physicists.

Urinary Tract Fistulae

  • Vesico-vaginal Fistula
  • Urethro-vaginal Fistula
  • Uretero-vaginal Fistula
  • Utero-vesical Fistula

Colorectal Fistulae

  • Rectovaginal Fistula
  • Enteric Fistula
  • Anorectal Fistula

Urinary Incontinence

  • Recurrent Stress Urinary Incontinence (SUI)
  • Refractory Overactive Bladder (OAB)
  • Occult SUI associated with urogenital prolapse
  • Urinary incontinence following radical cancer surgery
  • Urinary incontinence following radiotherapy
  • Urinary incontinence in neurogenic patients

Urogenital Prolapse

  • Recurrent urogenital prolapse in the same compartment
  • Recurrent urogenital prolapse in a different compartment
  • Recurrent apical prolapse
  • Urogenital prolapse associated with urinary incontinence
  • Urogenital prolapse associated with anal incontinence
  • Urogenital prolapse following radical cancer therapy
  • Urogenital prolapse in neurogenic patients
  • Urogenital prolapse following radiotherapy

Mesh Complications – Prolapse mesh

  • Vaginal erosion/extrusion
  • Bladder/Urethral erosion
  • Rectal erosion
  • Mesh complications following apical repair
  • Mesh complications following rectopexy

Mesh Complications – Mid Urethral Tapes

  • Vaginal erosion/extrusion
  • Bladder/Urethral erosion
  • Ureteric injury
  • Bowel injury

Urethral Conditions

  • Urethral diverticulum
  • Urethral stricture
  • Dysfunctional voiding
  • Complications associated with urethral bulking agents

Chronic Pelvic Pain Conditions

  • Bladder pain syndrome
  • Complex endometriosis
  • Vulvodynia