What Is Urogynecology?

What is a Urogynecologist?

A urogynecologist is a surgeon who has specialized in the care of women with pelvic floor disorders.

The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that provides support for a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum.

A pelvic floor disorder occurs when women have weakened pelvic muscles or tears in the connective tissue due to excessive strain on the pelvis due to childbirth, repeated strenuous activity, menopause, chronic disease, or pelvic surgery. Other factors that can weaken the pelvic floor include repetitive heavy lifting, tobacco use, and genetics.

The following are some problems that arise from damage to the pelvic floor:

1. Incontinence: loss of bladder or bowel control, leakage of urine or feces.
2. Prolapse: descent of pelvic organs; a bulge and/or pressure; ‘dropped uterus, bladder, vagina or rectum.’
3. Emptying Disorders: difficulty urinating or moving bowels.
4. Pain: discomfort to the lower back, pelvis or bladder and/or urethra.
5. Overactive Bladder: frequent need to void, bladder pressure, urgency, urge incontinence (difficulty holding back urine when having the urge to urinate)
6. Fistulas: abnormal hole between the vagina and rectum (rectovaginal), vagina and urethra (urethrovaginal), or vagina and the bladder (vesicovaginal)

What Treatment Options are Available from a Urogynecologist?

A urogynecologist can recommend a variety of therapies to cure or relieve symptoms of pelvic floor disorders. You should choose the one that works best for your lifestyle and meets your goals.

Sometimes simple changes and interventions can have a significant impact on daily quality of life. He or she may advise conservative (non-surgical) or surgical therapy depending on your wishes, the severity of your condition and your general health. Conservative options include medications, pelvic exercises, behavioral and/or dietary modifications and vaginal devices (also called pessaries). Pelvic Floor Therapy with Biofeedback and Electric Stimulation are also treatments that your urogynecologist may recommend. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse.