Urogynecology is a specialized field of gynecology and obstetrics that deals with female pelvic medicine and reconstructive surgery. Urogynecologists are doctors who diagnose and treat pelvic floor conditions such as weak bladder or pelvic organ prolapse (your organs drop because the muscles are weak).
The pelvic floor is the area of the body that houses your bladder, reproductive system, and rectum.
The urogynecology profession is fairly new. It didn’t exist before 2011. Different types of specialists treated these health issues. Often, women had to see multiple doctors for pelvic floor conditions.
In 2011, the American Board of Medical Specialties approved the certification making urogynecology its own field of study. This has made it easier for women to get the care they need without needing to see multiple doctors.
What Does a Urogynecologist Do?
Urogynecologists handle issues related to the pelvic floor and bladder. This includes overactive bladders, weak pelvic muscles, reproductive issues, and bladder or rectal incontinence (the loss of control when going to the bathroom). Urogynecologists perform evaluations, diagnose and treat patients.
Your treatment plan will depend on the problems you’re having and their cause. Common treatments are:
Medications
Although not all incontinence issues call for medications, some do. Likewise, other pelvic floor conditions might benefit from treatment with medication.
Injections
For bladder control issues and other incontinence issues, “bulking agents” can be used to help. Urogynecologists can do injection procedures with local anesthesia, outpatient, or in the office.
Pessaries -- medical devices inserted into your vagina -- are used to support your organs if you have prolapse issues. Pessaries are soft and come in different shapes and sizes. Your doctor can fit you for one during an office visit. They can be removed for cleaning.
Pelvic Floor Muscle Training
Exercises called Kegels can help issues like prolapse. Kegel exercises involve squeezing and relaxing the muscles within the pelvic floor. More severe prolapse symptoms can be improved with these exercises -- but they won’t correct them completely.
Nerve Stimulation
Similar to acupuncture, nerve stimulation treatments can help an overactive bladder.
Surgery
The urogynecologist could suggest surgery as well. These include:
- Vaginal wall repair
- Bladder installations
- Uterus removal
- Bladder control surgery
Education and Training
To become a urogynecologist, you need many years of study and firsthand experience.
Typically, the path to becoming a urogynecologist involves:
- Getting an undergraduate degree
- Completing medical school
- Participating in residency program in obstetrics and gynecology or urology
- Completing a fellowship in female pelvic medicine and reconstructive surgery
- Passing medical exams
- Becoming certified in female pelvic medicine and reconstructive surgery
Once a urogynecologist has completed the required education and training requirements, they can look for positions at hospitals or private practices. A urogynecologist must keep their certifications up-to- date by taking recertification exams every few years.
What Conditions Does a Urogynecologist Treat?
Urogynecologists treat a variety of pelvic conditions and disorders. Sometimes, these problems happen due to trauma from childbirth, frequent heavy lifting, or other strenuous activity. Types of conditions urogynecologists treat include:
- Incontinence of the bladder and rectum
- Urge incontinence
- Overactive bladder
- Interstitial cystitis
- Prolapse of the uterus, bladder, or cervix
- Frequent urinary tract infections (UTIs)
- Fistulas
Reasons to See a Urogynecologist
Pelvic floor issues can cause pain, bloating and urine or fecal (poop) leakage. These issues can be embarrassing to talk about but they can lead to serious health concerns if left untreated.
You may want to see a urogynecologist if you have:
- Vaginal bulging or something coming out of your vagina
- Fullness or aching in the vagina that is worse at the end of a day or during bowel movements
- Trouble peeing or emptying the bladder
- Leaking pee or feces
- Frequent or urgent peeing
- Frequent urinary tract infections
- Pain during sex
- Pelvic pain
You can get referred to a urogynecologist by your primary care doctor or gynecologist. Be sure to bring up any of these symptoms at your next visit with either of them.
What to Expect at the Urogynecologist
When you visit a urogynecologist, the doctor will review your medical history and discuss any symptoms related to your pelvic floor or bladder. They’ll want to know the impact these symptoms have on your quality of life.
The doctor will try to identify what’s causing your issues by examining muscles, ligaments, connective tissue, nerves, and organs within the pelvis. Once they make a diagnosis, they can work with you on a treatment plan to help you get relief.