Urogynecology is a relatively new specialty in the field of medicine. Studies centered around the female pelvic floor started in the 70s but didn't gain approval from the American Board of Medical Specialties until the year 2011. It wasn't until 2013 that the field would have its first certified specialists.
Urogynecology requires a residency in either the Obstetrics and Gynecology specialty or the Urology specialty, which is then followed up by a fellowship. While the study of urogynecology is relatively new, the symptoms and conditions it treats are most certainly not.
What Is the Difference Between a Urologist and a Urogynecologist?
Urology is a more general field of medicine than Urogynecology. For example, urologists treat women, men, and children. Urogynecologists, on the other hand, deal only with matters of a woman's pelvic floor. If you were to see a urologist, you would likely be seeing them for matters pertaining to the bladder, kidneys, ureters, and urethra, while urologists treat a wide swath of conditions, ranging from UTIs to bladder cancer. That said, some of the same problems addressed by Urology are also addressed by Urogynecology.
To put it simply, you can think of a urogynecologist as a pelvic floor doctor. Women who have experienced urinary incontinence, an overactive bladder, or prolapsing of the uterus, vagina, bladder, or rectum should seek treatment from a urogynecologist specifically.
What is Urogynecology?
While there is some overlap with Urology and Gynecology, Urogynecology focuses on the following conditions:
Urinary incontinence (or urinary leakage). Women are twice as likely to experience urinary incontinence than men. Some of the risk factors involved are:
- Vaginal childbirth
- Diuretic medications
- Chronic constipation
- Smoking
- Obesity
Organ prolapse. Prolapse occurs because of weakened vaginal muscles. Some of the risk factors involved are:
- Vaginal childbirth
Pelvic floor injuries
Obesity
Smoking
Genetics
Chronic coughing
Chronic constipation
Overactive bladder. Those with an overactive bladder have a frequent and intense urge to urinate. Oftentimes coinciding with urinary incontinence, the cause of an overactive bladder is largely unknown.
Medical problems with the pelvic floor generally include issues with muscles, ligaments, connectivity tissue, and nerves in the vagina, rectum, uterus, and bladder. Women who experience painful prolapses or have bladder or bowel problems that interfere with their enjoyment of everyday life should also consider consulting a urogynecologist.
Fortunately, treatment is out there! Depending on the severity of the issue, treatments can either be non-surgical or surgical.
Urogynecology Treatments
Urogynecological issues, even small ones, can really get in the way of life. There are several treatment options for those experiencing problems with their pelvic floor. Urogynecologists are equipped to handle everything from evaluation to diagnosis to treatment. The following are some common treatments offered by urogynecologists:
- Behavioral therapy. This includes relaxation techniques, muscle training, and dietary changes. All these things can help manage symptoms if a patient would prefer not to have surgery.
- Medication. Certain medications can help ease and treat specific urogynecological disorders.
- Pessaries. This is a device that is inserted into the vagina to help support the bladder and uterus and can easily be removed for whatever needed reason.
- Surgery. Urogynecological procedures could range anywhere from minimally invasive surgeries to full reconstructions of the pelvic floor.
While some women can manage issues with their pelvic floor, others might experience conditions that are more severe. For example, some might experience constant prolapsing which can lead to frank protrusions. Treatment for this would most likely require a more significant reconstructive surgery.
Pelvic Reconstructive Surgery
Pelvic reconstructive surgery is accomplished by stitching together support tissues in the pelvic floor to help support the bladder, uterus, vagina, or rectum. Oftentimes this is a minimally invasive surgery, though more difficult cases require open surgery.
The success rate for pelvic reconstructive surgery falls in the range of 80%-90%. Patients can expect the procedure to take between two to five hours and expect to stay in the hospital for one or two nights. A full recovery from pelvic reconstructive surgery generally takes anywhere between four to six weeks. Lower abdominal pain is to be expected for two to three days after the procedure.
As with any procedure, there are risks such as:
- Bleeding
- Infection
- Adjacent tissue and organ injury. It is possible that pelvic reconstructive surgery can worsen prolapsing in other areas of the pelvic floor.
- Hernia
- Urinary incontinence
- Urinary retention
- Vesicovaginal fistula—(ulcer caused by surgery)
Urogynecology may be a relatively new field of medicine, but it has advanced quickly and become a huge help to women who struggle with pelvic floor issues. Looking for the "best urogynecologist near me?" Contact us today!
