Medical Illustrations for Dr. Shashoua

Medical illustrations to assist in patient education for female pelvic medicine

You are here: ...
Home / Case Studies / Patient Communications / Patient Education Illustrations for Urogynecology Conditions
Client: Austin Urogynecology, Texas
Medium: Digital, (Photoshop)

Completing Illustrations for a Surgeon Treating Women’s Pelvic Disorders


Austin labiaplasty logoDr. Shashoua is a surgeon and owner of Austin Urogynecology, a clinic treating women with pelvic disorders based in Texas, USA. Dr. Shashoua specialisess in female pelvic medicine and reconstructive surgery treating urogynecological conditions including urinary incontinence, pelvic organ prolapse, bowel incontinence and vulvar vestibulitis for women.

George Shashoua, MD

George Shashoua, MD

Dr. Shashoua commissioned us to create a range of custom medical illustrations and our role was to come up with unique illustrations that would show the treatment involved for women with pelvic disorders. This is because women can suffer from stress incontinence which is the leaking of urine when sneezing for example caused by a weakening of the muscles and connective tissues that work to support the bladder and the urethra, as well as urge incontinence which is having to rush to the toilet at short notice. Conditions also include vaginal or organ prolapse which is where the organs drop below their normal anatomical setting and cause a bulge or heaviness occurring in the vagina or lower abdomen.

Dr. Shashoua specialising in treating sufferers with prolapse conditions such as enterorocele, which is prolapse of the small bowel, rectocele which is prolapse of the rectum, cystocele which is prolapse of the bladder, perineal decent which is prolapse or weakness of the pelvic floor  muscles.  Our task was to create medical illustrations demonstrating these conditions to be used as part of web and printed patient education materials for patients to refer to when seeking advise about their condition.   

Pelvic Conditions that can affect Women

Perineal descent

Perineal descent

Perineal Descent

Perineal descent is a condition where the perineum bulges below its normal anatomical position descending below the bony outlet of the pelvis. It can be caused by a weakness of the pelvic floor muscles even after normal childbirth, or secondary it can be age related and neuropathic degeneration or traumatic injury during pregnancy and labour.

Our brief was to create illustrations that would show the normal anatomy of the perineum and pelvic floor muscles to include the surrounding anatomy of the balder, uterus, vagina rectum and bowel and then again showing the perineal descent and the descending anatomy forming the bulge. The result to be a side by side comparison for patients to understand the anatomy by studying the change between the two illustrations.

To view the perineal illustrations on the clients website visit here.




Enterocele is a condition where the small bowel has prolapsed and descends into the lower pelvic cavity pushing at the top part of the vagina, creating a bulge. Because the small bowel has prolapsed if will effect the surrounding anatomy as well.

Our brief was to create an illustration that showed how the enterocele caused the bulge through the collapse of the small bowel and how the pelvic floor muscles and the ligaments between the bladder and vagina have weakened, allowing the bladder to also sag into the vagina.

To view the enterocele illustrations on the clients website view here.

Cystocele and rectocele together

Cystocele and rectocele together stage 2

Pelvic Organ Prolapse

Pelvic organ prolapse is a prolapse and the dropping of one or more organs into the vagina and severity is classed from stages one to four, four being the prolapsed organ has dropped as far as possible into the vagina. The prolapse can include all the organs such as the bladder, uterus, small intestine and rectum. The prolapse can be caused by weakening of tissues that support the pelvic organs and can be due to age progression, childbirth, changes caused by menopause, previous surgery especially if a hysterectomy has been performed. Our task here was to create an illustration that demonstrated the collapse of multiple organs due to the weakened muscles that normally hold everything in place.

To view the pelvic organ prolapse illustrations on the client website view here.

“Joanna has a great eye for detail and the illustrations were loved by everyone, most especially by the client.”Stuart Banks, Digital Project Manager, Frontera
“Joanna was right at home working with us to develop illustrations that both met our clinical needs and fit perfectly into the aesthetics of our user interface. Her work is superb!”Michael Gold , Director of Product Development, CareCloud
“We have now received the new folder with your illustrations: I love it!”Lisa Ruckstuhl - Product Manager Osteoporosis, Daiichi Sankyo (Schweiz) AG
“I’m really pleased with how the book finally looks and that is in part huge thanks to Jo for such fantastic and skilled art. The level of detail that Jo achieves is incredible and her medical knowledge clearly abounds. She is always such a pleasure to work with – nothing is too big or small a job. It was all approached with the same cheery manner! Jo always delivered on deadlines too, which is a huge relief to us designers! Many thanks – it has indeed been a pleasure. I would have no hesitation to recommend Jo!”Senior Designer, Duncan Baird Publishers
“Joanna and her team are a pleasure to work with. They are responsive and creative. They turned around several excellent animations and drawings for our video series. We certainly would enjoy working with them again!”David Mathison, MD, MBA, Associate Director of Pediatric Transport, Children's National Medical Center and Assistant Professor of Pediatrics & Emergency Medicine, George Washington University School of Medicine
“Joanna has provided the core illustrations for a number of our iPad Apps, and her illustrations have received terrific reviews from our users. She understands our requirements clearly and also understands the specifics of illustrating for digital media and mobile applications. The quality of her work is outstanding, and she can be relied upon to hit deadlines and deliver to the exact clinical requirements of each project.”Todd Morgan, Co-Founder, drawMD
“Hello Tim and Joanna,
Thank you for the illustrations, you have done an outstanding job on the finished articles… The service provided was efficient and very thorough, we were very happy with the way you able to understand and translate the brief into an illustration which captured the desired output.”Clare Lynex, Senior Medical Writer, UBM Media Asia, Singapore
“We found to be energetic, imaginative, and efficient, a joy to work with!”Dr Sam Alberti, Director of Museums and Archives, Royal College of Surgeons of England, London