Urogynecology

As a fellowship-trained urogynecology specialist, Dr. Lindsey Hahn treats pelvic floor disorders (PFDs), such as incontinence and prolapse, to help restore our patients’ quality of life, as well as to prevent further problems. Dr. Hahn is uniquely trained and focused on women’s pelvic health and is highly attuned to our patients’ sensitivities and needs. Along with the services performed below, women will find us to be caring listeners and dedicated partners in achieving their unique healthcare solutions.

The following list of services, procedures and treatments include conservative procedures, such as lifestyle adjustments, as well as complex surgical options.

  • Loss of bladder or bowel control
  • Stress and urge urinary incontinence
  • Leakage of urine or feces
  • Descent of pelvic organs: dropped uterus, bladder, vagina, or rectum
  • Chronic constipation and urinary retention
  • Pelvic pain
  • Overactive bladder or painful bladder syndrome
  • Fistulas (abnormal hole between the vagina and either the rectum, urethra, or bladder)
  • Vaginal masses
  • Recurrent urinary tract infections
  • Mesh complications from prior surgery

 

 

A number of treatments and procedures exist to treat many of the diseases or disorders. Before recommending specific treatments, we may conduct diagnostic tests.

Diagnostic Tests, Procedures and Treatments

  • Cystourethroscopy
  • Urodynamic Testing
The following services empower patients to take control of their pelvic health by making changes to their diet, lifestyle habits and exercise routines. After a diagnosis we will review techniques and best practices related to each treatment. Patients’ willingness and ability to make these changes are integral to their long-term success.
  • Pelvic floor re-education
  • Behavioral modification, including kegel exercises
  • Dietary modifications
  • Bladder training
Nonsurgical pelvic floor disorder treatments may include medication, electrical stimulation or devices to help improve incontinence or prolapse symptoms. These procedures may be the best next steps when lifestyle modifications are not enough.
  • Medical management
  • Pelvic floor physical therapy
  • Urethral bulking (injections to improve stress incontinence)
  • Third line therapy for overactive bladder and urinary urge incontinence including:
    • Intradetrusor botox therapy for overactive bladder
    • Neuromodulation : InterStim
    • Pre-tibial Nerve Stimulation (PTNS)
  • Pessary (vaginal support device) fitting and management
Often lifestyle changes, therapy and other nonsurgical services may not be viable or successful in treating PFDs. In those cases, I provide a number of surgical options to correct or prevent further problems. I am especially qualified and experienced in performing a range of women’s pelvic floor surgeries, such as hysterectomies, vaginal vault suspension, reconstructions and transvaginal mesh removal.  All the surgeries are tailored for the individual patient, including da Vinci robotic surgery, minimally invasive surgery, vaginal approaches and abdominal approaches. Below is a list of offered surgeries.
  • Sacrocolpopexy (laparoscopic or robotic vaginal prolapse repair with mesh)
  • Uterosacral ligament suspension (laparoscopic vaginal prolapse repair with native tissue)
  • Vaginal vault suspension (repairs or prevents pelvic organ prolapse with native tissue)
    • Sacrospinus ligament suspension
  • Colporraphy (vaginal wall repair with native tissue)
    • Anterior repair
    • Posterior repair
  • Perineorrhaphy
  • Robotic surgery & reconstruction (da Vinci surgical system)
  • Laparoscopic repair & reconstruction surgery (minimally invasive surgery)
  • Vaginal reconstruction
  • Hysterectomy
    • Vaginal hysterectomy
    • Abdominal hysterectomy
    • Robotic hysterectomy
    • Supracervical hysterectomy
  • Autologous Rectus Fascia Pubovaginal slings (tissue sling to support the bladder)
  • Suburethral sling (mesh sling to support the bladder)
    • Tension-free vaginal tape- TVT
    • Mini-sling
  • Burch colposuspension (attaching bladder to pelvic bones)
  • Overlapping anal reconstruction (sphincteroplasty)
  • InterStim sacral nerve stimulation or neurostimulation (implanting electrical stimulation device just above tailbone for both urinary and fecal incontinence)
  • Transvaginal mesh revision/removal (synthetic substance used in previous PFD surgery that can cause complications)
  • Transabdominal and transvesical mesh revision/removal (synthetic substance used in previous PFD surgery)
  • Pelvic floor physical therapy with Levator Ani botox injections (for pelvic pain-non FDA approved)
  • Fistula repair (correcting an abnormal opening between pelvic organs)
  • Repair of urethral diverticulum and other vaginal masses