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Pelvic floor disorders, including incontinence, can significantly affect a person’s life. But many women feel uncomfortable discussing the problem or asking for help. Brown & Toland urogynecologist Victor Velasco, MD, is here to help.

Q: What is urogynecology?

A: Urogynecology is a relatively new field dedicated to the evaluation and management of disorders of the female pelvic floor. Urogynecologists have their training in either urology or gynecology and then pursue subspecialty fellowship training in urogynecology.

Q: What are some common problems treated by urogynecology?

A: Urogynecologists most commonly treat patients with pelvic organ (uterovaginal) prolapse, urinary incontinence, accidental bowel leakage and urogenital fistulas.

Q: What is the pelvic floor?

A: The pelvic floor is a complex collection of structures that surround the pelvis composed primarily  of muscles and connective tissues. They provide support for the organs in the pelvis and are an essential component of normal sexual, bladder and bowel function.

Q: What exactly is pelvic organ prolapse?

A: Pelvic organ prolapse results from a loss of support to structures and organs in the pelvis. This is most commonly due to the effects of pregnancy, vaginal births and normal aging. The symptoms can include vaginal bulging and protrusion of tissue. However, some patients can be asymptomatic and do not necessarily require any treatment.

Q: What treatments are available for pelvic floor problems?

A: Management options can range from expectant management, pelvic floor physical therapy, and pessaries to complex pelvic reconstructive surgery. The field is unique in that it is always focused on the patient’s preferences, experience and desires. Reconstruction is most often achieved through minimally invasive surgery and can be robotic, laparoscopic or vaginal.

Q: Can patients prevent pelvic floor problems?

A: Yes! Maintaining a healthy weight, preventing chronic coughs with immunizations and treating constipation can all help prevent dysfunction of the pelvic floor.

Q: Have you seen significant advancements in recent years? What are they?

A: The most impactful change in our field in recent years has been a deeper understanding of various synthetic materials for augmenting reconstruction. This has led to a better ability to distinguish between materials that are associated with high complication rates and those that are safer with low complication rates and that significantly improve the quality of life for our patients.

Q: What’s the most satisfying part of your job?

A: I love to hear about the experiences that bring joy into the lives of my patients. Patients often tell me they are not able to travel, care for their family, attend concerts or explore nature because of the limitations of their pelvic floor disorders.

A recent example is a patient very recently told me that she hadn’t been able to sit through an entire movie in 10 years but after recent treatment she was able to sit through the entire Avatar movie!

As a urogynecologist, my goal is to optimally treat these disorders so that my patients can get back to the things like this that bring meaning and joy into their lives.

Victor Velasco, MD, began his higher education at Santa Clara University where he earned a bachelor’s degree in Biochemistry and Medical Science. While there, he was also the principal bassoonist for five years in the Santa Clara Symphony. He very much enjoyed his Jesuit education, particularly the focus on using the privilege of a higher education to improve the lives of the people in our communities.

Dr. Velasco then went on to obtain a medical degree from the UCLA David Geffen School of Medicine. His experiences there led him to become passionate about women’s health and surgery, leading to his decision to pursue residency training in Obstetrics & Gynecology at the LAC+USC Medical Center in Los Angeles. He Then completed his fellowship in Urogynecology at the University of California San Francisco’s joint program with Kaiser Permanente.

Dr. Velasco sees patients at Bay Area Gynecology & Oncology in San Jose.

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