Dr. Hilaire W. Fisher, MD

Dr. Hilaire W. Fisher Urogynecologist and Pelvic Reconstructive Surgeon

Dr. Hilaire W. Fisher is a board-certified urogynecologist providing medical and surgical care for women with pelvic floor disorders, bladder-control concerns, pelvic organ prolapse, and other complex benign pelvic conditions.

Her specialty combines gynecology, urinary health, and reconstructive pelvic surgery. She works with patients experiencing urinary leakage, frequent or urgent urination, difficulty emptying the bladder, vaginal pressure, pelvic organ prolapse, bowel-control concerns, or complications following previous pelvic treatment.

Dr. Fisher practises at Women’s Pelvic Restorative Center in Houston, Texas. Her care includes conservative treatment, diagnostic testing, office-based therapies, minimally invasive procedures, and pelvic reconstructive surgery when appropriate.

Patients comparing women’s health physicians can also read about Dr. Christine Murray’s obstetric and gynecological care.

Doctor Information

Name: Dr. Hilaire Wood Fisher, MD, FACOG
Specialty: Urogynecology
Subspecialty: Female Pelvic Medicine and Reconstructive Surgery
Additional Specialty: Obstetrics and Gynecology
Board Certifications: Obstetrics and Gynecology and Female Pelvic Medicine and Reconstructive Surgery
Undergraduate Education: Bachelor of Science in Microbiology, Auburn University
Medical School: University of South Alabama College of Medicine
Medical Degree Completed: 2004
Residency: Obstetrics and Gynecology, University of Texas Health Science Center at Houston
Residency Period: 2004 to 2008
Practice: Women’s Pelvic Restorative Center
Primary Location: Houston, Texas
Hospital Affiliation: The Woman’s Hospital of Texas
Languages Spoken: English
NPI Number: 1972770105
Patient Age Groups: Adults and older adults
Accepting New Patients: Yes, according to her current practice profile

About Dr. Hilaire W. Fisher

Dr. Fisher completed undergraduate studies in microbiology at Auburn University before earning her medical degree from the University of South Alabama College of Medicine in 2004.

She then completed obstetrics and gynecology residency training at the University of Texas Health Science Center at Houston between 2004 and 2008.

Her advanced clinical work focuses on urogynecology and reconstructive pelvic surgery. This field is now commonly known as female pelvic medicine and reconstructive surgery.

Urogynecologists receive specialised training in disorders involving the pelvic floor, bladder, urethra, vagina, uterus, and rectum. These structures work together to support urination, bowel function, pelvic stability, and reproductive health.

Dr. Fisher evaluates how pelvic symptoms affect work, sleep, exercise, sexual health, travel, and everyday independence. She may recommend conservative management, medication, pelvic floor therapy, a support device, an office procedure, or surgery depending on the diagnosis and treatment goals.

Female Pelvic Medicine and Reconstructive Surgery

Female pelvic medicine and reconstructive surgery focuses on noncancerous conditions affecting pelvic support and lower urinary tract function.

Dr. Fisher may evaluate concerns such as:

• Urinary incontinence
• Overactive bladder
• Frequent urination
• Sudden urinary urgency
• Difficulty emptying the bladder
• Pelvic organ prolapse
• Vaginal pressure or bulging
• Recurrent urinary symptoms
• Urinary problems after childbirth
• Bowel-control concerns
• Pelvic floor weakness
• Complications after earlier pelvic surgery
• Fistulas involving pelvic organs
• Pelvic pain related to structural problems

These symptoms are common, but patients may avoid discussing them because they feel embarrassed or believe the changes are an unavoidable part of ageing.

A urogynecological assessment can identify the likely cause and explain which treatment options are available.

Pelvic Floor Disorders

The pelvic floor consists of muscles, ligaments, nerves, and connective tissues that support the bladder, uterus, vagina, and rectum.

Pelvic floor disorders may develop when these structures weaken, stretch, become injured, or no longer coordinate properly.

Factors that may contribute include:

• Pregnancy
• Vaginal childbirth
• Menopause
• Age-related tissue changes
• Previous pelvic surgery
• Chronic constipation
• Repeated straining
• Heavy lifting
• Persistent coughing
• Obesity
• Connective-tissue conditions
• Neurological disease

Symptoms differ according to which structures are affected.

Some patients mainly experience urinary leakage. Others notice vaginal pressure, bowel symptoms, pain, or difficulty emptying the bladder.

Urinary Incontinence

Urinary incontinence means urine leaks when the patient does not intend it to.

The amount may range from a few drops to a larger loss that affects clothing, sleep, exercise, or normal daily activity.

Dr. Fisher may evaluate several forms of urinary incontinence.

Stress Urinary Incontinence

Stress urinary incontinence causes leakage when pressure inside the abdomen increases.

It may occur during:

• Coughing
• Sneezing
• Laughing
• Running
• Jumping
• Lifting
• Exercise
• Standing from a seated position

This type of leakage is often related to weakened support around the urethra or bladder outlet.

Treatment may include pelvic floor exercises, physical therapy, a vaginal support device, urethral bulking treatment, or surgery.

Urgency Urinary Incontinence

Urgency urinary incontinence involves a sudden, difficult-to-control need to urinate followed by leakage.

Patients may also experience:

• Frequent urination
• Nighttime urination
• Leakage before reaching the toilet
• Urgency triggered by running water
• Difficulty delaying urination
• Disruption of work, travel, or sleep

Treatment may involve bladder training, medication, pelvic floor therapy, nerve stimulation, or bladder injections.

Mixed Urinary Incontinence

Mixed urinary incontinence includes both stress-related leakage and urgency-related leakage.

Dr. Fisher may identify which symptom causes the greatest difficulty and recommend treatment in stages.

Treating one form of leakage does not always correct the other, so patients should understand which symptoms each treatment is intended to improve.

Overactive Bladder

Overactive bladder is a group of symptoms involving urinary urgency, frequency, nighttime urination, and sometimes leakage.

It can affect patients who do not have an infection or another obvious bladder disease.

An evaluation may include:

• Review of urinary habits
• Medication assessment
• Urine testing
• Pelvic examination
• Bladder diary
• Measurement of retained urine
• Urodynamic testing when appropriate
• Cystoscopy in selected cases

Initial care may include changes to fluid timing, bladder training, pelvic floor therapy, or medication.

Advanced options may be considered when symptoms continue despite conservative treatment.

Bladder Diary

A bladder diary can help Dr. Fisher understand how symptoms occur during normal daily life.

Patients may be asked to record:

• When they drink fluids
• Type and amount of fluid
• Times they urinate
• Approximate urine amount
• Episodes of urgency
• Leakage episodes
• Activity occurring during leakage
• Number of nighttime bathroom visits
• Use of pads or protective products

A diary is usually more useful when completed honestly over several typical days.

The information can help distinguish stress leakage, urgency leakage, excessive urine production, and habits contributing to frequent urination.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when weakened support tissues allow one or more pelvic organs to move downward toward the vaginal opening.

Prolapse may involve the:

• Bladder
• Uterus
• Vaginal walls
• Top of the vagina after hysterectomy
• Rectum
• Small intestine

Possible symptoms include:

• Vaginal pressure
• A feeling of heaviness
• A visible or noticeable bulge
• Symptoms worsening while standing
• Difficulty emptying the bladder
• Incomplete bowel movements
• Lower-back discomfort
• Discomfort during sexual activity
• The need to press on the vagina to urinate or pass stool

The degree of prolapse seen during examination does not always match symptom severity. Treatment should therefore consider both anatomy and how the condition affects everyday life.

Bladder Prolapse

A bladder prolapse, also known as an anterior vaginal wall prolapse or cystocele, occurs when the bladder pushes against the front wall of the vagina.

Symptoms may include:

• Vaginal pressure
• A bulge near the vaginal opening
• Difficulty starting urination
• Incomplete bladder emptying
• Frequent urination
• Recurrent urinary symptoms
• Leakage
• Discomfort during activity

Treatment can include observation, pelvic floor therapy, a pessary, or reconstructive surgery.

The recommended option depends on symptom severity, prolapse stage, previous surgery, health, and personal preferences.

Uterine Prolapse

Uterine prolapse occurs when the uterus moves downward because its supporting tissues have weakened.

Symptoms may include:

• Pelvic heaviness
• Vaginal bulging
• Lower-back pressure
• Urinary changes
• Bowel symptoms
• Discomfort during sexual activity
• Difficulty remaining active

Treatment does not always require removal of the uterus.

Depending on the condition and patient’s preferences, Dr. Fisher may discuss a pessary, pelvic floor therapy, uterine-preserving surgery, or hysterectomy combined with pelvic support repair.

Vaginal Vault Prolapse

Vaginal vault prolapse can develop after hysterectomy when the upper part of the vagina loses support and moves downward.

Possible symptoms include:

• A vaginal bulge
• Pressure
• Difficulty emptying the bladder
• Bowel movement problems
• Pelvic discomfort
• Reduced ability to exercise
• Symptoms becoming worse late in the day

Reconstructive procedures can restore support to the upper vagina.

The surgical approach may be vaginal, laparoscopic, robotic, or abdominal depending on anatomy, previous procedures, health, and the surgeon’s recommendation.

Rectocele and Bowel Symptoms

A rectocele occurs when the rectum pushes against the back wall of the vagina.

It may cause:

• Vaginal bulging
• Incomplete bowel movements
• Straining
• Pelvic pressure
• The need to press on the vaginal wall
• Discomfort during sexual activity
• A feeling that stool remains trapped

Not every rectocele requires surgery.

Dr. Fisher may recommend improving stool consistency, pelvic floor therapy, reducing straining, or other conservative care before considering reconstruction.

Pessary Care

A pessary is a removable device placed inside the vagina to support prolapsed pelvic organs or reduce selected forms of urinary leakage.

Pessary care may include:

• Selecting the correct size and shape
• Initial fitting
• Checking comfort
• Teaching removal and cleaning when appropriate
• Monitoring vaginal tissues
• Replacing the device when needed
• Adjusting the fit if symptoms change

A pessary can be useful for patients who want to avoid surgery, delay an operation, or manage symptoms while another medical concern is being treated.

Regular follow-up is important because a poorly fitting or neglected device may cause discomfort, discharge, bleeding, or tissue irritation.

Pelvic Floor Physical Therapy

Pelvic floor physical therapy strengthens and retrains the muscles involved in bladder control, bowel function, and pelvic support.

Therapy may include:

• Pelvic floor muscle exercises
• Muscle coordination training
• Bladder-control strategies
• Breathing techniques
• Posture and movement guidance
• Biofeedback
• Relaxation of overactive muscles
• Bowel habit education

Pelvic floor exercises are most effective when the correct muscles are used consistently.

A specialist therapist can assess whether the muscles are weak, tense, poorly coordinated, or affected by another functional problem.

Urodynamic Testing

Urodynamic testing evaluates how the bladder stores and releases urine.

It may be considered when:

• The cause of leakage is unclear
• Several urinary symptoms occur together
• Previous treatment has not helped
• Surgery is being considered
• The patient has difficulty emptying the bladder
• A neurological condition may affect bladder function
• Symptoms continue after previous pelvic surgery

Testing may measure bladder pressure, urine flow, bladder capacity, leakage, and urine remaining after voiding.

Results are interpreted together with the patient’s symptoms, examination, and treatment history.

Cystoscopy

Cystoscopy allows Dr. Fisher to examine the inside of the bladder and urethra using a narrow viewing instrument.

It may be recommended for:

• Blood in the urine
• Recurrent urinary symptoms
• Persistent bladder pain
• Suspected bladder injury
• Complications after pelvic surgery
• Unclear urinary symptoms
• Evaluation of a fistula
• Assessment before or after selected procedures

Cystoscopy may be performed in an office or procedural setting depending on the reason for the examination and the type of anaesthesia required.

Recurrent Urinary Symptoms

Patients may experience repeated burning, urgency, frequency, or bladder discomfort.

These symptoms may be caused by:

• Urinary tract infection
• Bladder irritation
• Incomplete emptying
• Pelvic organ prolapse
• Menopause-related tissue changes
• Bladder pain syndrome
• Stones
• Medication
• Another urinary condition

Repeated symptoms do not always mean a bacterial infection is present.

Urine testing can help determine whether antibiotics are appropriate or whether another condition needs investigation.

Urinary Retention

Urinary retention means the bladder does not empty fully.

Possible symptoms include:

• Difficulty starting urination
• Weak urine flow
• Straining
• Frequent small urinations
• Lower abdominal pressure
• Leakage from an overly full bladder
• Recurrent urinary infections
• A feeling of incomplete emptying

Dr. Fisher may measure the amount of urine remaining after urination.

Treatment depends on the cause and may involve medication changes, catheter use, treatment of prolapse, pelvic floor therapy, or correction of an obstruction.

Urethral Bulking Treatment

Urethral bulking is a minimally invasive treatment used for selected patients with stress urinary incontinence.

A material is injected around the urethra to improve closure and reduce leakage.

Potential advantages may include:

• An office-based or short procedure
• No abdominal incision
• Limited recovery time
• An option for some patients who prefer to avoid more extensive surgery

The effect may not be permanent, and repeat treatment may be needed.

Dr. Fisher can explain how likely the procedure is to help based on the type and severity of leakage.

Midurethral Sling Surgery

A midurethral sling is a surgical treatment for stress urinary incontinence.

The procedure places supportive material beneath the urethra to reduce leakage during coughing, exercise, lifting, or other activities.

Before surgery, Dr. Fisher may discuss:

• Expected improvement
• Type of sling
• Anaesthesia
• Bladder-emptying risks
• Bleeding and infection
• Urinary urgency
• Pain
• Mesh-related considerations
• Recovery restrictions
• Alternative treatments

Patients should understand which symptoms the sling is designed to treat. It primarily targets stress leakage and may not correct urgency or frequent urination.

Pelvic Reconstructive Surgery

Pelvic reconstructive surgery restores support to pelvic organs and vaginal tissues.

Procedures may be used to treat:

• Bladder prolapse
• Uterine prolapse
• Vaginal vault prolapse
• Rectocele
• Enterocele
• Several prolapsed areas together
• Recurrent prolapse after earlier surgery

The operation may be performed through the vagina or through small abdominal incisions using laparoscopic or robotic techniques.

The safest approach depends on the type of prolapse, earlier procedures, general health, sexual function, and personal treatment goals.

Uterosacral Ligament Suspension

Uterosacral ligament suspension uses strong pelvic ligaments to support the top of the vagina or uterus.

It may be performed during prolapse repair or hysterectomy.

The operation aims to restore support while maintaining vaginal depth and function.

Potential risks include bleeding, infection, urinary concerns, injury to nearby structures, continued symptoms, or prolapse returning later.

Dr. Fisher’s published academic work has included outcomes and complications involving laparoscopic uterosacral ligament suspension.

Sacrocolpopexy

Sacrocolpopexy is a reconstructive operation used to support the top of the vagina.

It may be performed through an abdominal, laparoscopic, or robotic approach.

During the procedure, surgical material is used to connect the vagina to a strong supporting structure near the spine.

The procedure may be considered for:

• Vaginal vault prolapse
• Significant upper vaginal prolapse
• Recurrent prolapse
• Selected complex support problems

Recovery and restrictions vary according to the surgical method and other procedures performed at the same time.

Fistula Evaluation

A pelvic fistula is an abnormal connection between two organs.

Examples can involve the:

• Bladder and vagina
• Ureter and vagina
• Rectum and vagina
• Bowel and vagina

Symptoms may include continuous urinary leakage, gas passing through the vagina, unusual discharge, recurrent infection, or symptoms beginning after childbirth, surgery, radiation, or another injury.

Evaluation may require imaging, cystoscopy, dye testing, endoscopy, or examination under anaesthesia.

Repair can be complex and may involve coordination with urology, colorectal surgery, or another specialist.

Menopause and Pelvic Health

Menopause can affect the tissues surrounding the vagina, urethra, and bladder.

Lower oestrogen levels may contribute to:

• Vaginal dryness
• Tissue irritation
• Pain during sexual activity
• Urinary urgency
• Recurrent urinary symptoms
• Burning
• Increased tissue sensitivity

Treatment may include moisturisers, lubricants, pelvic floor therapy, local vaginal treatment, or another option based on medical history and symptoms.

Hormonal treatment is not appropriate for every patient, so individual risks and benefits should be reviewed.

Pelvic Symptoms After Childbirth

Pregnancy and childbirth can stretch or injure pelvic floor muscles, connective tissues, and nerves.

Patients may experience:

• Urinary leakage
• Vaginal pressure
• Difficulty controlling gas or stool
• Pelvic weakness
• Pain
• Changes in sexual function
• Difficulty emptying the bladder
• Symptoms appearing years after delivery

Early symptoms may improve during recovery, while others require physical therapy or additional treatment.

The care plan depends on the type of injury, time since childbirth, future pregnancy plans, and effect on daily life.

Treatment Without Surgery

Meeting with a pelvic reconstructive surgeon does not mean an operation is automatically necessary.

Dr. Fisher may recommend:

• Bladder training
• Pelvic floor therapy
• Lifestyle adjustments
• Medication
• Pessary use
• Treatment of constipation
• Fluid-timing changes
• Vaginal therapy
• Urethral bulking
• Nerve stimulation
• Bladder injections
• Continued observation

Surgery is generally considered when symptoms remain disruptive, structural support is significantly affected, or conservative treatment has not provided enough relief.

Preparing for a Urogynecology Appointment

Patients can prepare by bringing:

• A complete medication list
• Previous pelvic surgery records
• Earlier bladder test results
• Urine-test results
• Imaging reports
• Pregnancy and delivery history
• A list of medication allergies
• Notes about urinary or bowel symptoms
• A completed bladder diary when requested
• Questions about treatment

It may help to record:

• When leakage occurs
• What activity triggers it
• How often urination is needed
• Number of nighttime bathroom visits
• Whether a vaginal bulge is present
• Whether symptoms worsen while standing
• Whether bladder or bowel emptying feels incomplete

Clear information helps Dr. Fisher identify which symptoms need the greatest attention.

Preparing for Pelvic Surgery

Patients approved for surgery may need medical testing and practical planning.

Preparation may include:

• Blood tests
• Urine testing
• Medication review
• Anaesthesia assessment
• Heart testing when appropriate
• Diabetes management
• Treatment of active infection
• Instructions about food and drink
• Transportation arrangements
• Planning for help at home
• Temporary work and lifting restrictions

Patients should provide complete information about prescriptions, non-prescription medicines, vitamins, supplements, and allergies.

Blood thinners and some diabetes medicines may require special instructions. Patients should not stop prescribed treatment without guidance.

Recovery After Pelvic Reconstructive Surgery

Recovery depends on the procedure, surgical approach, patient’s health, and whether several repairs were completed together.

Instructions may cover:

• Incision care
• Vaginal bleeding or discharge
• Pain management
• Bladder function
• Bowel care
• Walking
• Lifting restrictions
• Driving
• Returning to work
• Sexual activity
• Follow-up appointments

Constipation and straining can place pressure on healing tissues. Patients may receive instructions about hydration, diet, activity, or medicines used to maintain comfortable bowel movements.

Research and Professional Experience

Dr. Fisher has contributed to published research involving urogynecology and pelvic reconstructive surgery.

Her academic work has addressed subjects such as:

• Laparoscopic uterosacral ligament suspension
• Sacral colpopexy
• Nerve injuries associated with sling procedures
• Complex pelvic fistulas
• Pelvic reconstructive outcomes
• Surgical complications

Research participation supports continued evaluation of how procedures work, what complications may occur, and how treatment can be improved.

Individual care decisions must still be based on the patient’s symptoms, anatomy, health, and goals.

Coordinated Pelvic Healthcare

Pelvic floor conditions may involve several areas of medicine.

Dr. Fisher may coordinate with:

• Obstetricians and gynecologists
• Urologists
• Colorectal surgeons
• Pelvic floor physical therapists
• Primary care physicians
• Gastroenterologists
• Radiologists
• Pain specialists
• Other pelvic health professionals

Coordination is especially useful when symptoms involve both urinary and bowel function or when a patient has had several previous pelvic procedures.

Patients needing broader gynecological care may also review Dr. Kim Thu Chu’s OB-GYN profile.

Patient-Centered Urogynecology Care

Dr. Fisher provides pelvic healthcare based on each patient’s symptoms, examination findings, previous treatment, medical history, daily needs, and personal preferences.

Her services may include urinary incontinence assessment, overactive bladder treatment, prolapse care, pessary management, bladder testing, pelvic floor therapy coordination, minimally invasive procedures, and reconstructive pelvic surgery.

Patients should confirm current appointment availability, insurance participation, procedure locations, hospital arrangements, and referral requirements directly with Women’s Pelvic Restorative Center.