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Abdominal Sacrocolpopexy: An abdominal sacrocolpopexy is done to correct a prolapse when the "top" or "apex" of the vagina has come down. An incision is made on the abdomen (either transverse or vertical), and a mesh is used to attach the top of the vagina to a strong ligament that lies along the sacrum, which is part of the pelvic bone.

Anal Sphincter: The anal sphincter is a muscle in the rectum that allows you to control when you have bowel movements or pass gas. This muscle can be weakened by childbirth, especially with births that are traumatic and result in tears.

Anal Sphincteroplasty: An opening in the skin is made between the vagina and anus. The separated muscles are found and put back together with stitches, and the skin over the muscles is also sewn back together.

Anorectal Manometry: This test allows your doctor to see if the muscles of the rectum are strong and able to function properly.

Anterior Repair (anterior colporrhaphy): An anterior repair is a vaginal surgery to correct a cystocele, when the "upper" wall of the vagina that is in contact with the bladder is sagging down, or coming outside of the vaginal opening. This is done by making a vertical incision in the skin of the vagina, and folding the strong tissues just underneath the vaginal skin. By folding these tissues, and stitching them together, the "upper" wall of the vagina is no longer sagging or ballooning, and should become stronger as well.

Anterior Vaginal Wall: Refers to the top of the vagina, the part that is closer to your head. The bladder sits on top of the vagina on the inside and is "anterior" to your vagina.

Anterior: This generally means "in front of" but can be thought of as "closer to your head than your feet" when you are thinking about your pelvis.

Anus: The opening of the lower intestine where solid waste is eliminated.

Biofeedback: Biofeedback uses a computer or machine to show you how your muscles are working, how well you can coordinate the use of these muscles with a full bowel, and to teach you how to improve your control. Sometimes the anal sphincter muscles do not relax properly when you empty the bowel, and so the rectum is not emptied completely. Biofeedback can help to teach you to use the correct muscles to empty the bowel effectively. Improvement of your symptoms will occur over a period of a few weeks to months. If the sphincter muscles and nerves are not too severely damaged, biofeedback usually benefits 50-75 percent of the people who try it. This is not a "quick fix"; you will need to work hard at the exercises to make them effective.

Bladder Irritants: Foods or beverages that stimulate the bladder often contribute to urinary incontinence. The most common are caffeine, decaffeinated coffee, carbonated beverages such as soda, juices and spicy foods.

Bladder Neck: The area where the bladder meets the urethra and is composed of muscles that help control the flow of urination

Bladder Prolapse (fallen bladder): Known as a "cystocele," bladder prolapse occurs when the wall between a woman's bladder and her vagina weakens and lets the bladder drop into the vagina. This condition may cause discomfort and problems with emptying the bladder.

Catheter (catheterization): A thin tube inserted into the urethra that is often used for post-void residual or urodynamic testing.

Congenital Anorectal Malformation: Birth defects that can cause fecal incontinence.

Cystocele (bladder prolapse, fallen bladder): A cystocele occurs when the wall between a woman's bladder and her vagina weakens and lets the bladder drop into the vagina. This condition may cause discomfort and problems with emptying the bladder.

Cystometry: Sometimes also referred to by the general term "urodynamics," cystometry consists of filling your bladder with sterile water, observing the pressure and how your bladder reacts under these conditions. When the test begins, the physician inserts a small soft catheter in your bladder and a tube is hooked up to a bag of sterile water. Your bladder is then filled to around 250 cc (approximately one cup), which most women can hold without needing to urinate. A second catheter, which is connected to a machine or computer, is also inserted. This catheter measures the pressures within your bladder.

Defecography: This is a test that allows your doctor to see with X-ray what is happening when you are having a bowel movement. It allows your doctor to see if there are blockages or pelvic organ prolapse. During this exam, barium paste is placed into your rectum and vagina. You will sit on a special toilet and you will be asked to bear-down, as if you are having a bowel movement. While you are bearing down, X-ray images are taken that allow your doctor to see what happens to your pelvic muscles and bowels.

Detrusor Muscle: A smooth muscle of the bladder that expands and contracts.

Diarrhea: Very loose or runny stools needing urgent attention and access to a toilet.

Diuretics: A substance that increases the amount or frequency of urine output.

Double Incontinence: Double incontinence is the inability to control both the passage of stool from the rectum and urine from the urethra (the tube through which urine normally goes through).

Dyspareunia: Painful intercourse.

Enterocele: An enterocele is a bulge of the front wall of the rectum into the vagina. This condition may cause discomfort and problems with difficulty having bowel movements.

External Anal Sphincter: The muscle that you use to hold on when the rectum is full and you feel that you need to empty the bowel.

Fecal Incontinence: The inability to control the passage of liquid or solid stool from the rectum.

Flatal Incontinence: The inability to control the passage of gas, or flatus, from the rectum.

Flatus: Another word used for "gas" released from the rectum.

Habit Training: Bladder retraining involves scheduled toileting, gradually increasing the length of time between bathroom trips. This therapy trains the bladder to delay voiding for larger time intervals and has been proven effective in treating urge and mixed incontinence.

Infectious Enteritis: This is a temporary condition that may be caused by a virus or bacteria. Your doctor may ask you for a stool sample to check if there is a "bug" causing your diarrhea. If an infection isconfirmed, treatment with antibiotics may improve your bowel control.

Internal Anal Sphincter: An internal muscle responsible for keeping the anal canal closed at all times except when there is an urge to empty the bowel. You do not have to think about keeping this muscle closed; it happens automatically.

Kegel: An exercise that involves contracting the muscles of the pelvic floor to strengthen them. These are the muscles that you use to stop the flow of urine.

Laparoscopic Reconstructive Surgery: Abdominal surgeries also can be performed laparoscopically, through several very small (one-centimeter) incisions, with the use of a video camera. Abdominal sacrocolpopexy, paravaginal repair and uterosacral ligament suspension can be done with the laparoscope. One advantage of laparoscopic surgery is that recovery time is faster than with abdominal surgery, and postoperative pain is usually less than abdominal-approach surgeries.

Latchkey Incontinence: Going to the bathroom every two hours during the night to avoid wetting oneself.

Ligaments: Ligaments hold the vagina in place by connecting bones and cartilage, and provide support for the pelvic organs. The ligaments in the pelvis are normally strong enough to hold the organs in place; however, they also can be damaged and weakened, possibly leading to prolapse.

Mixed Incontinence: A woman may have a condition that is a mix of both stress and urge incontinence.

MRI (magnetic resonance imaging): This radiology test allows your doctor to carefully look at the appearance of the muscles of the pelvic floor that help you to control your bowel movements and the nerves in your back, which are important to bowel control.

Narcotics: Medicine or drugs used to control pain, narcotics can also alter mood and behavior.

Overactive Bladder: Women with an overactive bladder are not able to wait until it is convenient to empty their bladder. They find that "When I have to go, I have to go." This occurs because the normal ability to tell the bladder to wait until it is the right time is weakened. When a woman feels the need to empty her bladder, telling the bladder to wait simply doesn't work anymore. Some women have to get up frequently during the night to urinate; they may wet the bed and go to the bathroom at least every two hours to avoid wetting themselves. This is sometimes referred to as "latchkey" incontinence.

Overflow Incontinence: This is a rare condition in which women leak small amounts of urine frequently because their bladder is constantly full. With this condition, the bladder does not empty completely and as a result, the bladder becomes progressively swollen. The bladder is unable to do its job properly and urine leaks due to overflow.

Paravaginal Repair: A paravaginal repair can be done through either a vaginal approach or an abdominal approach. It is done to correct a cystocele. This is done by stitching the side of the vaginal wall back to its original point of attachment on the pelvic side wall called the arcus tendineus fascia pelvis, or the "white line." This should restore the bladder and the urethra to their normal positions.

Pelvic Floor: The pelvic floor is composed of muscles and ligaments that form a "sling" across the opening of the pelvis. Muscles and ligaments work together in women to support pelvic organs and structures such as the vagina uterus, bladder and bowel.

Pelvic Organ Prolapse: Pelvic organ prolapse is the bulging or dropping of the uterus (uterine prolapse), rectum (rectocele) or bladder (cystocele) into the vagina.

Pessary: A pessary is a device worn in the vagina to help support the prolapsed organ. Pessaries come in many different shapes and sizes, and must be fitted by a doctor. While a pessary may ease your symptoms, it does not repair the prolapse. A pessary can be taken in and out either on a daily, weekly or monthly basis. This will depend on you and your doctor. It does, however, need to come out periodically for cleaning.

Posterior Repair (posterior colporrhaphy): A posterior repair is a vaginal surgery to correct a rectocele, when the "lower" wall of the vagina that is in contact with the rectum is bulging into the vagina, or coming outside of the opening of the vagina. This is done by making a triangular or diamond-shaped incision, and removing some of the extra skin of the wall of the vagina. After this skin is removed, the strong tissues underneath are brought together with strong stitches.

Posterior Vaginal Wall: This refers to the bottom of the vagina. The rectum sits just below the vagina. It is "posterior" to the vagina.

Posterior: "Posterior" generally means "behind" but can be thought of as "closer to your feet than your head" when you are thinking about your pelvis.

Post-void Residual: A PVR is done to determine how much urine is left behind after you urinate. It is normal for the bladder to not empty itself completely of a small amount of urine. Even though you may have voided 10 minutes earlier, urine may still be collected from your bladder. The post-void residual test consists of you first emptying your bladder; within 15 minutes, a catheter is placed in your bladder to determine the amount of urine left behind. Most women have a post-void residual between 0-60 cc. A PVR is done to determine if you have any urinary retention, which can be a sign of an underlying condition. Most doctors will conduct follow up studies if the PVR is over 100 cc.

Prolapse: The protrusion or dropping of the uterus (uterine prolapse), rectum (rectocele) or bladder (cystocele) into the vagina.

Prompted Voiding: A caregiver prompts the incontinent patient to go to the bathroom every two to four hours. This puts the patient on a regular voiding schedule. The goal is simply to keep the patient dry and is a frequently recommended therapy for frail elderly, bedridden or Alzheimer's patients.

Psychotropic: A mood-altering drug such as a sedative or antidepressant.

Pubovaginal Sling: A procedure for the relief of stress incontinence that uses a piece of a patient's own fascia (autologous) or piece of animal tissue. It requires a small abdominal incision ranging from 5-10 centimeters (2-4 inches) on the lower abdomen.

Rectocele: A rectocele is a bulge of the front wall of the rectum into the vagina. This condition may cause discomfort and problems with difficulty having bowel movements.

Rectovaginal Fistula Repair: A procedure in which the tract connecting the vagina and rectum are separated and the area between these two opening is closed in multiple tissue layers.

Rectovaginal Fistula: A condition that occurs when a connection develops between the vagina and rectum and results in stool being passed uncontrollably through the vagina.

Rectum: The lowest part of the large intestine that ends just before the anus.

Robotic-Assisted Laparoscopic Surgery: A newer technology in laparoscopic surgery is robotically assisted laparoscopic surgery with the DaVinci Robot. Abdominal sacrocolpopexy can be performed by the robot-assisted laparoscopic approach. Similar to standard laparoscopy, this procedure is performed through several very small (one centimeter) incisions, with the use of a video camera. The advantage of this approach is faster healing time and shorter hospital stays than with a more traditional abdominal approach to the same surgery, which is performed through a larger abdominal incision.

Sacrospinous Ligament Suspension: A sacrospinous ligament suspension is a vaginal surgery that is used to re-attach the "top" or "apex" of the vagina when it has come down. Normally, the vagina is held in place by the combined action of ligaments (sometimes called fascias) and muscles. The primary problem occurs in women with vaginal prolapse occurs the tissues have failed that normally hold the top of the vagina up in place. This operation attaches the vagina to the sacrospinous ligament through the vagina. There is no abdominal incision. The surgeon makes an incision at the top of the vagina, then reaches up to the ligament and puts four stitches into it. The surgeon then uses these stitches to tie the top of the vagina up. This pulls up the vagina to a normal position.

Seton: A seton is a ribbon of material that is placed in a fistula to aid in healing. Thread, wire, rubber or medicated suture can be used as a seton.

Stress Incontinence: This happens when something you do - such as coughing, laughing, sneezing jumping, lifting, exercising - increases the pressure in your abdomen enough that it pushes urine past the urethra. In other words, some external force pushes on the bladder and urine squirts.

Tension-Free Vaginal Tape (Gynecare TVT): A procedure for the relief of stress incontinence that uses a mesh placed behind the pubic bone and exits on the lower abdomen within the hair-bearing area of the mons in two one-centimeter (one-half-inch) incisions.

Transanal Ultrasound: This is an ultrasound that is done with a probe placed into your rectum. The probe is about the size of a finger and should not be uncomfortable. The ultrasound allows your doctor to see the anal sphincter, which is the muscle that allows you to control your bowel movements. The sphincter may be weakened or torn, and this may be the reason you are having symptoms.

Transobturator Tension-Free Vaginal Tape (Gynecare TVT-O): A procedure for relief of stress incontinence that uses mesh. It differs slightly from TVT. The mesh is directed around the pubic bones to exit at about the crease of the inner thigh from a one-centimeter (one-half-inch) incision.

Urethra: A tube by which urine passes from the bladder to the outside of the body.

Urethral Bulking Agents: There are multiple agents that can be injected into or around the urethra. These agents narrow the width of the urethra and can help to control stress incontinence symptoms.

Urge Incontinence: Women with this are not able to wait until it is convenient to empty their bladder. They find that "When I have to go, I have to go." This occurs because the normal ability to tell the bladder to wait until it is the right time is weakened. When a woman feels the need to empty her bladder, telling the bladder to wait simply doesn't work anymore. Some women have to get up frequently during the night to urinate, they may wet the bed and go to the bathroom at least every two hours to avoid wetting themselves. This is sometimes referred to as "latchkey" incontinence.

Urinalysis: This test is done to determine if you have an infection or other substances found in the urine. It is usually performed at the beginning of any type of bladder test. A clean catch of urine is obtained and then a test strip is dipped into the urine. Results are usually obtained within minutes. If you have a high white blood cell count, it could indicate a bladder infection. For follow-up, doctors may also send your urine to a laboratory to be cultured, which is a more sensitive test.

Urinary Incontinence: Trouble controlling urination.

Urodynamics: Urodynamic testing is a series of bladder tests that are done in order to observe how your lower urinary tract reacts under certain conditions. It is usually performed in order to determine problems with incontinence or prolapse and measures certain aspects of bladder, urethra and pelvic floor muscles.

Uterine Prolapse (fallen uterus): Uterine prolapse is a bulge of the front wall of the rectum into the vagina. This condition may cause discomfort and problems with difficulty having bowel movements.

Uterosacral Ligament Suspension: A uterosacral ligament suspension is a vaginal surgery that is used to re-attach the "top" or "apex" of the vagina when it has come down. The "top" or "cuff" of the vagina is sewn to two strong ligaments, called the uterosacral ligaments, deep in the pelvis.

Vagina: The passage of the reproductive tract leading from the uterus to the exterior of the body in females.

Vaginal Hysterectomy: A vaginal hysterectomy is the removal of the uterus through the vagina, without any incision on the abdomen. When the uterus is very low in the vagina, or coming outside of the vagina, then it is usually necessary to remove the uterus in order to correct the prolapse. Removal of the tubes and ovaries may be done at the same time, and this is something that should be discussed with your doctor if you decide to have surgery.

Vaginal Surgery For Stress Incontinence Symptoms: These are surgeries used to treat stress urinary incontinence symptoms. A piece of tissue or artificial mesh is placed underneath the urethra. It acts as a layer of support so that the urethra is closed off when there is increased pressure in the abdomen (for example, laughing, coughing, sneezing and exercising).

Vaginal Vault Prolapse (fallen/ bulging vagina): In women who have previously had a hysterectomy, it is still possible for the vagina itself to fall down even though the uterus is no longer present. This is referred to as a post-hysterectomy ("after-hysterectomy") vaginal prolapse.