About Us

Knowledgeable | Experienced | Caring

Doctor's Garely and Rahimi are all board certified physicians in Obstetrics and Gynecology, and Female Pelvic Medicine and Reconstructive Surgery (Urogynecology).

American Board of Obstetrics and Gynecology Certified

The field of Urogynecology is relatively new. This specialty, now called Female Pelvic Medicine and Reconstructive Surgery, requires a full residency in either Ob/Gyn or Urology followed by three years of formal fellowship training. Physicians who complete this rigorous training path are uniquely qualified to care for women with pelvic floor disorders. Because of the scarcity of training programs throughout the US, most medical centers do not have a specialist in this area. Dr. Garely is Professor at Mount Sinai, which is one of only 3 medical centers in New York City with an accredited fellowship program. As a fellowship graduate in Urogynecology, Dr. Garely has been practicing the longest in the New York City area. 

The first board exam used to certify doctors who practice Urogynecology was given in June 2013. Dr’s. Garely and Rahimi are board certified in this specialty, in addition to being certified in general obstetrics and gynecology.

Female pelvic floor disorders can be the source of great anxiety. Common symptoms include loss of bladder control (leaking) when coughing, laughing, sneezing, or exercising (stress incontinence). Sometimes, the problem involves having to go to the bathroom frequently, or not being able to sleep through the night because of constant urges (overactive bladder). Often, women can have the sensation of pelvic pressure, or feeling a "bulge" in the vagina (uterine or vaginal prolapse). Sometimes women can have problems after previous surgery which can lead to pelvic pain, or openings that can form between the bladder, rectum, and vagina (fistula's). Rarely, some women are born with congenital problems which can affect their sexual function.


Expertise in the treatment of urinary incontinence, pelvic organ prolapse, uterine and vaginal prolapse, overactive bladder, cystocele, rectocele, enterocele, stress incontinence, urinary tract infections, female pelvic floor disorders, vaginal laxity, labial enlargement, mesh complications, and complications from previous surgery.

  • Cystocele

    When the roof the vagina starts to bulge, this is called a cystocele. Our team uses a specialized technique that pulls up to its natural attachments.

  • Rectocele

    A rectocele is a bulge that occurs on the floor of the vagina. Dr. Garely can fix this with tiny incisions, without distorting the normal anatomy.

  • Enterocele

    When the bowels push the vagina down. This can be repaired vaginally, abdominally, or laparoscopically depending on many variables.

  • Vaginal Prolapse

    When the vagina starts to drop or turn "inside out", we are able to use laparoscopic instruments to complete a total pelvic reconstruction.

  • Uterine Prolapse

    Women who have a bulge caused by the dropping of the uterus can be treated with both surgical and non-surgical methods.

  • Stress Incontinence

    Women who leak urine when the cough, laugh, sneeze, or exercise can be treated with a minimally invasive procedure called a sling. We also offer biofeedback and pelvic floor therapy.

  • Overactive Bladder

    Women who urinate frequently, have uncontrollable urges to void, and leak without control, will usually respond to pharmacologic therapy.

  • Vaginal Agenesis

    Some women are born with the congenital absence of a functional vagina. Dr. Garely uses the minimally invasive Vecchietti Procedure, and in some cases, graft augmentation neovagina.

Our Affiliations

Mount Sinai Health System

We are full-time members of the Mount Sinai Health System and we are based at Mount Sinai South Nassau. We operate at Mount Sinai South Nassau, Mount Sinai Hospital, and Mount Sinai West.

Our Team

Dr's. Garely and Rahimi are board certified physicians in Female Pelvic Medicine and Reconstructive Surgery

Alan Garely, MD, FACOG, FACS

Chair of Obstetrics and Gynecology, Director of Urogynecology and Pelvic Reconstructive Surgery Mount Sinai South Nassau; Professor of Obstetrics, Gynecology and Reproductive Science, The Icahn School of Medicine at Mount Sinai

A graduate of Hampshire College in Amherst, MA, he obtained his MD from St. George's University School of Medicine. Dr. Garely completed his residency in Obstetrics and Gynecology at Saint Vincent's Hospital and Medical Center of New York and did two fellowships in Urogynecology and Pelvic Reconstructive Surgery. The first was at the University of Connecticut/Mt. Sinai Hospital, and then at the Louisiana State University Medical Center of New Orleans.

Dr. Garely has served on the Board of Directors for the American Urogynecologic Society. He served two terms as Chair of the Gynecology and Obstetrics Advisory Board for the American College of Surgeons. Dr. Garely is also a senior oral board examiner for the American Board of Obstetrics and Gynecology. He has published numerous papers and book chapters and has lectured throughout the world. His surgical interests are the repair of pelvic fistulas, removal of transvaginal mesh, and minimally invasive vaginal approach reconstruction for vaginal and uterine prolapse (with uterine preservation). He is the author of “Urogenital tract fistulas in females” in Uptodate, the online medical resource for physicians Under Dr. Garely’s leadership, The Surgical Review Corporation (SRC) has designated Mount Sinai South Nassau as a Center of Excellence in Minimally Invasive Gynecology.


Salma Rahimi, MD, SCM, FACOG

Female Pelvic Medicine and Reconstructive Surgery - Mount Sinai South Nassau; Assistant Clinical Professor of Obstetrics and Gynecology at The Icahn School of Medicine at Mount Sinai

Dr. Rahimi is board certified in Obstetrics and Gynecology and Female Pelvic Medicine and Reconstructive Surgery, and a fellow of the American College of Obstetricians and Gynecologists. After obtaining her Master of Science from the Johns Hopkins School of Public Health, she earned her medical degree from Temple University School of Medicine. She then completed her residency in Obstetrics and Gynecology at Winthrop University Hospital and fellowship in Female Pelvic Reconstructive Surgery at Mount Sinai School of Medicine. In addition to her clinical practice, Dr. Rahimi is the Director of the residency in Obstetrics and Gynecology at Mount Sinai South Nassau. 

Dr. Rahimi is passionate about medical education and is pursuing her Masters in Healthcare Administration at the graduate school of the Icahn School of Medicine at Mount Sinai. She is fluent in Farsi.


Stephanie Esperance, MSN, APRN, FP-BC

Female Pelvic Medicine and Reconstructive Surgery - Mount Sinai South Nassau; Assistant Clinical Professor of Obstetrics and Gynecology at The Icahn School of Medicine at Mount Sinai

Ms. Esperance has a BS in Biology from Pace University, a BSN from Chamberlain School of Nursing, and a Master of Science in Nurse Practitioner from Long Island University CW Post.

She is praised by our patients and is a highly effective practitioner with a strong dedication to provide hands-on, quality patient care. She will assist in facilitating your care whether you opt for conservative management or surgical intervention. Her skills include pessary insertion, posterior tibial nerve stimulation (PTNS), urodynamics and post-operative care. She is bilingual in English and French Creole.


Frequently Asked Questions

Our experienced team will offer treatment options best suited to your specific needs.

Do I need to see a urogynecologist?
If you answer "YES" to any of the following questions, Dr. Garely and his team can help:

  • Do you ever leak urine when you cough, laugh, sneeze, exercise, run, or engage in sexual relations?
  • Do you ever feel that you cannot "delay" running to the bathroom?
  • Do you ever find that if you don't get to the bathroom fast enough that you will have an accident?
  • Do you wake up at night to urinate?
  • Do you feel that you don't empty your bladder after urinating?
  • Do you feel pressure in your vagina?
  • Do you see or feel a bulge in the vagina or rectum?
  • Did anyone ever tell you that your "bladder has dropped"?
  • Did your physician tell you that you need surgery for incontinence or pelvic prolapse?
  • Do you ever have to change positions or put your fingers in or around your vaginal area to help urinate or have a bowel movement?

If I am referred to Dr. Garely but would like to see Dr. Rahimi instead, is that ok?
We work as a team in the Long Island office, and it is never a problem if you would prefer to see Dr. Rahimi. For many of our Russian or Farsi speaking patients this is encouraged. We want our patients to feel comfortable with the care they receive.

Will Dr. Garely operate on elderly or sick patients?
Yes. Many physicians employ "rules" that ensure they only operate on extremely healthy patients. Dr. Garely knows that the "average" patient is not always thin, young, or without medical problems. Having trained and worked at some of the nation’s best medical centers, Dr. Garely is an expert in taking care of "high risk" patients. Working with the patient’s own primary care providers, Dr. Garely can usually prepare even the sickest and oldest patients for successful surgery when indicated. All the hospitals where he operates have specialists who help him manage complicated patients. He is a specialist in using local and regional anesthesia on cases usually done with general anesthesia if that is safer for the patient.

Do all patients in the practice need surgery?
No. Less than half of our patients end up with a surgical procedure. Most patients can be successfully managed with medication or a pessary. Some patients are referred to physical therapists who specialize in pelvic floor disorders and incontinence treatment. Our team is committed to keeping patients out of the operating room. Unless it is absolutely indicated, we will never tell a patient that they "need" an operation.

Do I need to have my uterus removed during vaginal prolapse surgery?
No. This is a highly negotiable point. In some cases, removal of part of the uterus can aid in the repair. Total removal of the uterus is rarely done, and then only in cases where there are abnormal cells or pre-cancer of the cervix. By preserving the lower part of the uterus and cervix, there is no cutting of the vagina, which significantly decreases complications during the repair. While it is not known whether removal of the cervix will impair sexual function, we err on the side of conservatism, and take no chances. Patients who desire future fertility will need special counseling to help them make important decisions.

Do I need to have my ovaries removed if I am having surgery?
No. It is currently recommended that patients undergoing surgery who have reached menopause have their ovaries and tubes removed as a cancer risk reduction strategy. Taking into consideration each patients cancer history, cancer risk factors and family history, our team can tailor a pre-operative plan that is acceptable to each patient. When accessible, the ovaries are visually inspected by our surgeons. If they appear abnormal, only then will they be removed if before menopause or if the plan was to not remove them. If a patient wants to keep their ovaries even after menopause, if they are normal, that is never a problem.

Does Dr. Garely and his team do surgery on patients who "only" need a hysterectomy and no other reconstructive procedures?
Dr. Garely and his team are among the most experienced gynecologic surgeons in the country. If a hysterectomy is indicated, Dr. Garely will review surgical options and help you make the best choice tailored to your problem and perceptions. The best surgical approach is determined by the indication for surgery and a route agreed upon by both you and the team.

Do you use the DaVinci Robot to do hysterectomy's and pelvic prolapse surgery?
When the use of the robot is indicated, members of Dr. Garely's team are the most experienced in the tri-state area. Most patients are surprised to learn that robotic procedures usually take 2-3 times longer than straight laparoscopic surgery, often with more incisions. Robotic procedures can take 3-4 times longer than Dr. Garely's "mini-laparotomy" incision, with multiple small visible incisions on the abdomen compared to his one small incision right over the pubic bone. When consulting any surgeon who promises to do your surgery with the robot, be sure to ask how many cases they have done, and how long the average case will take. The most experienced pelvic surgeons in the world can do this type of surgery with minimally invasive techniques without subjecting our patients to the prolonged operative times associated with the robot, unless it is in the patient’s best interest.

How many days will I be in the hospital?
This depends on the type of surgery performed. In most cases, patients are discharged either on the day of surgery or within 24 hours. No one is "pushed" out of the hospital, and Dr. Garely can usually arrange for a visiting nurse to check on patients at home. Dr. Garely has a very low rate of post-operative infections. This is partly because patients leave the hospital quickly, decreasing the risk of picking up "hospital acquired infections".

I have heard or read bad things about synthetic mesh. Do you use this material?
Yes. Most mesh used in pelvic reconstructive surgery is made of a material called polypropylene. This is commonly called "Prolene", which is one of the products made by Johnson and Johnson. Pelvic prolapse and incontinence is often caused because of a weakness or absence of normal muscle and ligaments. To compensate for these weaknesses, we sometimes need to use materials that can reconstruct or recreate the normal anatomy. We have tried to do this by using the patient’s own tissues. Unfortunately, depending on the type of prolapse, this has resulted in high failure rates. In a quest to achieve better results, new formulations of polypropylene have been developed. This new material is very safe. These new mesh products are thinner, lighter, and less prone to cause complications. Complications include erosion (where the mesh finds its way into the vagina, bladder, or bowel), infection, pelvic pain, and pain during sexual relations.

Research studies have shown that mesh placed through the vagina to fix vaginal prolapse has a much higher rate of complications than mesh applied through an abdominal or laparoscopic incision (often less than 1%). Also, The FDA has evaluated these transvaginal mesh products and compared them to repairs done without mesh. While the mesh may improve the repair of a cystocele (the roof of the vagina), the benefits of placing mesh are outweighed by the complication rates. Therefore, the FDA does not advocate for the use of this material when having a vaginal approach repair of prolapse. Our practice agrees with the FDA guidelines and recommendations.

When considering the safety of any mesh product or procedure, the skill of the surgeon implanting the material is of paramount importance. Before the FDA warning on transvaginal mesh, some surgeons used vaginally applied mesh with low complication rates. Unfortunately, this procedure is not easily taught, which is one reason there have been so many problems with transvaginal mesh. Also, all mesh placed into the vagina, through the vagina, will shrink and contract. This can pull on the muscles and nerves and can cause pain, erosions, and bleeding. If you see a doctor who wants to place mesh into the vagina to fix a prolapse (not for incontinence), you should seek a second opinion so that you completely understand the risks associated with mesh.

As a matter of practice, just to be safe, Dr. Garely will not use any mesh applied through a vaginal incision to correct prolapse. With years of experience, Dr. Garely is one of the country's foremost experts in the management of mesh complications and removal.

Can I have a surgical repair of my vaginal prolapse without having any cuts on my belly and not have my uterus removed?
Yes. Our team participated in the original research trial for the surgical device called Enplace. This device allows our surgeons to resuspend the vagina and uterus into its natural position using one small cut in the vagina. Combined with other parts of the repair, surgery usually is done within an hour and a half and patients almost always go home the same day. Recovery is very fast, and patients are back to normal activity within a few weeks. Because there are no cuts on the belly, complication rates are very low. Our team are among the highest volume surgeons in the world performing these procedures and we do over 4 per week.

Does Dr. Garely do the surgery himself, or do residents and fellows do the work?
Pelvic reconstructive surgery is very complicated. To maintain his high success rates, Dr. Garely does every major step of the operation himself. Residents and fellows participate in the operation, but his operating room is not a place where anyone "practices" on patients. Dr. Garely will "teach" during his operations, but this is done by demonstration, not trial and error. Residents and fellows are integral to the pre and post-operative care of patients. They are in the hospital 24 hours a day and are involved with the minute to minute care. Dr. Garely's assistants don't do anything without consulting with him first. Because of his association with the Icahn School of Medicine at Mount Sinai, Dr. Garely works closely with the Mount Sinai Health System Director of Gynecology (Dr. Ascher- Walsh) and other members of the department. Dr. Garely and his team have immediate access and coverage from some of the best surgeons in New York City.

Do you have experience with removing mesh or treating patients that have had complications from mesh?
Dr. Garely is among the most experienced surgeons in the country for the treatment of mesh complications. He removes mesh on a regular basis. Patients are referred to his New York practice from all over the country.

Can cosmetic procedures be combined with surgery for incontinence and pelvic prolapse?
Yes. This is a perfect time for concurrent procedures. Patients only need one anesthesia, and operating room costs are usually significantly lower. Labial re-shaping, and vaginal tightening can be done by Dr. Garely. If a "tummy tuck", liposuction, or breast surgery is desired, Dr. Garely can recommend some of the top plastic surgeons in the NY area to participate in the surgery. Insurance will usually cover a large part of the costs.

Is there a way to treat stress incontinence without cutting me?
Yes. Our team were among the first group of surgeons in the country to adopt the Bulkamid procedure. Using a small cystoscope placed into the urethra, a needle injects a small amount of liquid around the urethra. This causes the urethra to tighten up, helping to reduce or cure the leakage experienced with coughing, laughing, sneezing, or activity. This procedure is done under local anesthesia with sedation, so you are comfortable. It usually takes less than five minutes. Success rates are very high, and patients resume normal activity as soon as they leave the hospital.

If medication doesn’t help my overactive bladder, is there anything else that can be done?
Yes. If you don’t respond to medication, we have two great options. The first is an injection of Botox.

Are there any other office-based procedures for overactive bladder other than medication and Botox?
Yes. We utilize posterior tibial nerve stimulation which is FDA approved and usually covered by insurance. This therapy uses a acupuncture needle attached to a mild electrical current. Each therapy session lasts about 1/2 hour and patients need to have 12 sessions.

The next step is something called sacral nerve root modulation. This is a wire that is placed in your back near the nerves that supply the bladder. The wire is attached to a small pacemaker which is also under your skin. Before the pacemaker is placed, you need to show that this therapy will work by doing a one- or two-week trial with an external pacemaker, like a small beeper. There are two companies which make this device, Axonics and Medtronic.

Sacral nerve root stimulation is done in the operating room under local anesthesia with sedation and is associated with high success rates.