All Medical Services

Details of the services we provide

PELVIC ORGAN PROLAPSE:

Pelvic muscle exercises (Kegel’s):

  • These exercises help strengthen the pelvic floor muscles and aid with the prevention of pelvic organ prolapse. These exercises have not been shown to be very beneficial once the prolapse is considerable in size.

Pessary:

  • A device made of silicon which comes in may different shapes and sizes. This is placed in the vagina to support the vaginal walls, bladder, rectum and uterus.

URINARY INCONTINENCE:

Pelvic Muscle Exercises (Kegel’s):

  • Kegel’s exercises have been shown to be an effective treatment for stress urinary incontinence. Most women require guidance from a medical professional to learn how to contract the pelvic floor muscles correctly for adequate results.

Occlusive Devices:

  • There are several pessaries that are available for the treatment of stress urinary incontinence.

Biofeedback:

  • This term refers to a variety of techniques that teach patients bladder and pelvic muscle control by giving positive feedback when the patient performs the desired action. This feedback may be from an electronic device or verbally from a health professional.

Bladder Training:

  • This treatment for urge incontinence involves teaching a patient to urinate according to a timetable. Gradually, the scheduled time between trips to the bathroom may be increased as the patient’s bladder control improves.

Bladder Irritants:

  • These are different types food and drinks that may be irritating to the bladder. Avoiding these items may improve bladder urgency and frequency of urination. CLICK HERE for a list of Bladder Irritants.

Medications:

  • There are several medications that may be used in the treatment of urge incontinence such as Detral, Ditropan, Sanctura, Vesicare, Enablex, Toviaz, Oxytrol Patch, and Gelnique. There may be some side-effects associated with these medications which will be discussed in detail during the office visit.

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ABDOMINAL SURGERY:

Total Abdominal Hysterectomy:

  • Removal of the entire uterus including the cervix with or without the tubes and ovaries through an abdominal incision. The removal of the uterus my be necessary when performing some BUT NOT ALL surgeries for pelvic organ prolapse.

Supracervical Hysterectomy:

  • Removal of the uterus without the cervix through an abdominal incision. Leaving the cervix may act as a protective barrier when using graft material in surgeries performed in conjunction with the supracervical hysterectomy for pelvic organ prolapse.

Sacral Colpopexy:

  • Attachment of the top of the vagina to the sacrum using a synthetic or biologic graft performed through an abdominal incision. Performing a supracervical hysterectomy may be necessary to perform this procedure if the uterus is present.

Paravaginal Repair:

  • This procedure may be performed abdominally to support the lateral vaginal walls to fix a cystocele (dropped bladder).

FECAL INCONTINENCE:

Sacral Neuromodulation:

  • Electrodes are inserted into the nerves that control the anal sphincter and pelvic floor muscles to treat to treat fecal incontinence.  This procedure was initially used for the treatment of urinary incontinence but has been approved by the FDA for the treatment of fecal incontinence as well.

Sphincteroplasty:

  • Reattach divided muscle edges around anus to correct fecal incontinence.

 

LAPAROSCOPIC & ROBOTIC SURGERY

Total Laparoscopic Hysterectomy:

  • Removal of the uterus (including the cervix) and possibly the tubes and ovaries through small (about 1 cm) laparoscopic incisions. This procedure may be performed laparoscopically or robotically.

Supracervical Hysterectomy:

  • Removal of the uterus without the cervix through small (about 1 cm) laparoscopic incisions. Leaving the cervix may act as a protective barrier when using graft material in surgeries performed in conjunction with the supracervical hysterectomy for pelvic organ prolapse. This procedure may be performed laparoscopically or robotically.

Sacral Colpopexy:

  • Attachment of the top of the vagina to the sacrum using a synthetic or biologic graft performed through small (about 1 cm) laparoscopic incision. This procedure may be performed laparoscopically or robotically. Performing a supracervical hysterectomy may be necessary to perform this procedure if the uterus is present.

Paravaginal Repair:

  • This procedure may be performed laparoscopically or robotically to support the lateral vaginal walls to fix a cystocele (dropped bladder).

URINARY INCONTINENCE

Suburethral Sling:

Placing a small piece of synthetic graft material under the urethra for support in preventing stress urinary incontinence.

Periurethral Injection:

This is an in-office procedure which involves injection of a bulking agent  at the base of the bladder to prevent stress urinary incontinence.

Burch Urethropexy:

Placing permanent sutures laparoscopically or robotically to support and suspend the base of the bladder to a ligament on the pubic bone.

Neuromodulation:

Electrodes are inserted into the nerves that control the bladder to treat urinary urgency, urinary frequency, urinary urge incontinence, and urinary retention.

 

VAGINAL SURGERY:

Total Vaginal Hysterectomy:

  • Removal of the entire uterus including the cervix with or without the tubes and ovaries vaginally. The removal of the uterus may be necessary when performing some BUT NOT ALL surgeries for pelvic organ prolapse.

Uterosacral Ligament Suspension:

  • This procedure is performed vaginally to support the top of the vagina to the patient’s own uterosacral ligaments. A hysterectomy needs to be performed to perform this procedure adequately.

Sacrospinous Vaginal Vault Suspension:

  • This procedure is performed vaginally to support the top of the vagina to the patient’s own sacrospinous ligaments in the pelvis.

Illiococcygeal Suspension:

  • This procedure is performed vaginally to support the top of the vagina to the patient’s own fascial supportive tissue.

Total Colpectomy:

  • This procedure is performed vaginally and completely closes the vagina after the correction of the pelvic organ prolapse. Vaginal penetration is not possible after this procedure therefore it is not recommended in sexually active women.

Leforte Colpocleisis:

  • This procedure is performed vaginally and completely closes the vagina without removal of the uterus. Vaginal penetration is not possible after this procedure therefore it is not recommended in sexually active women.

Anterior Colporrhaphy:

  • This is a vaginal procedure to reestablish the supports between the bladder and vagina to fix a cystocele (dropped bladder). It may be performed using a synthetic or biologic graft for a longer lasting repair.

Posterior Colporrhaphy (Rectocele repair):

  • This is a vaginal procedure to reestablish the supports between the rectum and vagina to fix a rectocele (rectum bulging into the back of vagina). It may be performed using a synthetic or biologic graft to achieve a longer lasting repair.

Paravaginal Repair:

  • This procedure may be performed vaginally to support the lateral vaginal walls to fix a cystocele (dropped bladder).

Enterocele Repair:

  • This is a procedure that may be performed vaginally to close the space between the vagina and rectum to prevent or treat the small bowel from pushing into the vagina.

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DR. ARASH RAHI

MD, MSc, FACOG, FPMRS

Dr. Amir Shariati

MD, MS, FACOG, & FPMRS

DIAGNOSTIC TESTING

Cystourethroscopy:

  • Using a lighted camera to view the inside of the urethra (the tube that you urinate from) and the bladder. This test is done to rule out any pathology or other abnormalities in the bladder or urethra.

Urodynamics:

  • A small catheter is inserted in the bladder which measures the function of the bladder and urethra. This test helps determine the type of urinary incontinence and voiding dysfunction present.

Urinalysis:

  • A test that evaluates chemicals and cells in the urine. This test is done on most patients on their initial office visit.

Urine Culture:

  • A test that determines whether a urinary tract infection is present.

Ultrasound:

  • Uses sound waves which allow better evaluation of the anal sphincter, urinary bladder, urethra, uterus, and ovaries. It may be used to determine the size of the lining inside of the uterus in patients who are having uterus sparing surgical procedures.

+1 (954) 570-7644

Josette Richmond

Medical Assistant

Ask us about ThermiVa™

NO Surgery, NO Pain, No Downtime!

FRMIU is now offering ThermiVa™ – a new, non-surgical, breakthrough treatment for women’s health. ThermiVa™ provides the safest and most precise option for restoring the appearance of the labia and tightness to the vaginal canal.

How does ThermiVa work?

ThermiVa™ is an in-office, non-surgical procedure that uses radiofrequency energy to gently heat tissue through an “S” shaped handpiece. Heat and energy shrinks skin and tightens external and internal vulvovaginal tissue. The handpiece features disposable applicator with gentle curves to provide comfort. No downtime is necessary.

Three separate 15-30 minute sessions are recommended over three months, but patients can see immediate results after the treatment and more dramatic results in 3-4 months. ThermiVa™’s effects last 9-12 months. The new tissue will be tighter and younger looking due to new collagen growth and thicker skin resulting from the application of radio frequency to the area.

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