All the characteristics and driving force of The Cleveland Clinic are to be found in this book on pelvic ?oor function. The Cleveland Clinic is a group practice founded in 1921 on the principles of cooperation,collaboration,and collegiality.Its founders believed that many physicians working together will discover better solutions to medical problems than physicians working in isolation. They believed that the combination of disciplines, with their inherent differences in philosophy and skills, will produce a better outcome than might have evolved singularly. The power of the collaborative approach is on full display in this book. The pelvic ?oor unites three separate organ systems. Before this time, each has been approached individually. Urologists, gynecologists, and colorectal surgeons are each trained in their own disciplines, and the pelvic ?oor is subsumed in these larger ?elds of study. When they combine their focus on the pelvic ?oor, they bring their unique perspectives and different approaches to a common goal: the relief of pelvic ?oor syndromes such as incontinence and pelvic organ prolapse.

Table of Contents:
Concept of the Pelvic Floor as a Unit.- Concept of the Pelvic Floor as a Unit.- Epidemiology and Prevalence.- Epidemiology of Non-Neurogenic Urinary Dysfunction.- Bowel Dysfunction.- Genital Prolapse, Urogenital Atrophy, and Sexual Dysfunction.- Evaluation.- Primary Evaluation of the Pelvic Floor.- Urodynamics.- Imaging of the Genitourinary Tract in Females.- Anorectal Physiology.- Anorectal Ultrasound.- Neurologic Evaluation of the Pelvic Floor.- Upper Gastrointestinal Evaluation Related to the Pelvic Floor.- Anatomic Correlates.- Urologic Anatomic Correlates.- Genital Anatomic Correlates.- Colorectal Anatomic Correlates.- Sexual Function.- Female Sexual Dysfunction.- Incontinence Therapy.- Device Therapy for Stress Incontinence.- Medications for Stress Urinary Incontinence.- Sling/Tension-Free Vaginal Tape.- 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: Stress Urinary Incontinence/Fecal Incontinence.- Urgency/Frequency Syndromes Therapy.- Overactive Bladder: Pharmacologic Therapy.- Sacral Nerve Stimulation.- Surgical Management of the Overactive Bladder: Evacuation Disorders.- Irritable Bowel Syndrome.- Irritable Bowel-Anismus.- Prolapse Syndromes Therapy.- Vaginal Pessaries.- Vaginal Vault Prolapse Surgery.- Anterior Vaginal Prolapse.- Vaginal Enterocele Repair.- Vaginal Rectocele Repairs.- Rectal Prolapse Therapy.- Rectoanal Intussusception, Solitary Rectal Ulcer, and Sigmoidoceles.- Case Presentation: Prolapse.- 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.- 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.- Hormonal Influences on the Pelvic Floor.- Hormonal Influences on the Pelvic Floor.- Physiotherapeutic Approaches.- Kegel Exercises and Biofeedback.- Timed Voiding and Fluid Management.- Bowel Retraining for Functional Disorders of the Colon, Rectum, and Anus.- Surgical Therapy: Mututal and Combined Aspects.- Vesico-Vaginal Fistula.- Rectovaginal Fistula.- Enterourinary Fistula.- Management of Urinary Tract Injuries.- Combined Versus Sequential Reconstructive Surgeries.- Severity Assessment.- Voiding Diary.- Scoring Systems.- Quality-of-Life Assessment Tools.