Innovative Treatments for Pelvic Health at Any Age

Written By: Savitha Krishnan, MD, a urogynecologist at El Camino Health, specializing in female pelvic medicine and pelvic reconstructive surgery for women. She is passionate about providing effective, minimally invasive care. Dr. Krishnan's goal is to tailor evidence-based treatments to fit the needs of each individual. She is also committed to educating patients about their conditions and treatment options so they can actively participate in their care.

Think incontinence or pelvic prolapse is just part of getting older? Discover how advanced, minimally invasive treatments can restore your comfort, confidence, and active lifestyle—no matter your age. Don’t settle for less; learn about the latest solutions for women’s pelvic health.

As a urogynecologist, I hear the same story nearly every day: "I thought this was just part of getting older."

Whether it’s the runner who stopped training because of leakage, or the grandmother who avoids lifting her grandkids because of a "bulge" sensation, many women suffer in silence. They’ve been told to "just do more Kegels" or to "scale back" their lives.

I am here to tell you that quality of life is not a luxury. It is a medical priority. With modern robotic-assisted surgery, we can restore your anatomy and get you back to your active life, often with a procedure that allows you to go home the same day.

Stress vs. Urge: What’s Happening?

To find the right solution to incontinence, we first have to identify the problem. One in three women experience an incontinence issue so you are not alone. There is no need to be reluctant or embarrassed to talk about the problem with your doctor.

Many women experience a combination of two distinct issues:

1. Stress Urinary Incontinence (SUI): This is an anatomical "backstop" problem. When you cough, sneeze, or jump, the front wall of the vagina should support the urethra. If that wall is relaxed, due to childbirth or menopause, you leak.
2. Urge Incontinence: Often called "doorknob incontinence," this is a disconnect between the bladder and the brain. The bladder contracts without warning, often resulting in large amounts of leakage before you can reach the restroom.

Stress incontinence is most often associated with pelvic organ prolapse (POP). This is a structural failure where the pelvic organs (bladder, uterus, or rectum) drop because the supporting muscles and tissues have weakened.

The Evolution of Treatment: From Conservative to Definitive

Physicians typically start with conservative options. Physical therapy and pessaries (removable support devices) can be good tools. However, they require a high level of lifelong compliance. Data shows that a year into treatment, only about 10 to 15% of patients are still compliant with physical therapy.

Many people who try these find themselves "doctor shopping" because they’re still struggling with the problem, and they aren't alone. And when these conservative measures aren't enough, we turn to the "gold standard" of surgical care.

The Robotic Advantage: Precision and Quick Recovery

When I performed my first sacral colpopexy (the procedure to fix prolapse) decades ago, it was a five-hour surgery after which patients had a multi-day hospital stay. Today, using the da Vinci robotic system, I can complete that same procedure in roughly two hours, and my patients go home the same afternoon.

Why choose robotic-assisted surgery?

The tool itself allows me to work better than we ever thought possible. And since the sacral colpoplexy requires finite work and lots of small sutures, the repair is more precise.

• The "Wristed" Tool: Unlike traditional laparoscopy, which uses straight instruments, the robot gives me a "wrist." This allows for incredibly precise suturing in a very small, vascular area.
• Superior Visualization: The camera provides a 3D, highly magnified view. I can see tiny vessels and nerves with clarity that was impossible in the past.
• Less Trauma: We use five tiny incisions (less than 1 cm each). Because the robotic arms pivot at the incision site without "torquing" the skin, patients experience significantly less bruising and pain.
• High Success Rates: Mid-urethral slings for stress incontinence have an 89% to 94% success rate. Most of my patients never leak again during activity.

Myth-Busting: "I’m Too Old" or "I’ll Be Too Restricted"

I recently operated on a 92-year-old woman who had a phenomenal outcome. She went home the same day. Age is rarely a barrier to regaining your dignity and comfort.

Furthermore, I do not believe in giving "extra restrictions" after surgery. I have patients who are professional weightlifters and marathon runners. My goal is to return each patient to their baseline. This procedure is built to withstand an active life, not to keep you on the sidelines.

Nobody should have to live in diapers or plan your day around the nearest restroom. If your quality of life is being impacted, it’s time to have a conversation with your doctor.

Pelvic Prolapse | Jane’s Story | El Camino Health

This article first appeared in the May 2026 edition of the HealthPerks newsletter.