What Is a Urogynecologist?
Urogynecology is a specialized field of gynecology and obstetrics that involves female pelvic medicine and reconstructive surgery. A urogynecologist is a doctor who diagnoses and treats pelvic floor conditions such as urinary incontinence or pelvic organ prolapse (when the pelvic organs drop due to weak muscles).
The pelvic floor is the part of the body that includes the bladder, reproductive system, and rectum.
The urogynecology specialty is fairly new and did not exist before 2011. Prior to 2011, different types of specialists treated these health issues, and women often 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 manage issues related to the pelvic floor and bladder. This includes overactive bladders, weak pelvic muscles, pelvic organ prolapse, and bladder or fecal 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 the cause of those problems. Common treatment options include:
Some incontinence issues, but not all, can be managed with medications, such as an overactive bladder. Likewise, other pelvic floor conditions might benefit from treatment with medication.
“Bulking agent” injections can be used to help with bladder control issues, specifically stress urinary incontinence. These procedures are typically done in an outpatient setting.
Pessaries are medical devices that are inserted into the vagina. These are used to support the pelvic organs if you have pelvic organ prolapse issues. Pessaries are soft and come in different shapes and sizes. Your doctor can fit you for one during an office visit. You can be taught to remove and insert the pessary on your own for cleaning, or the pessary can be left in place and removed for cleaning regularly in your doctor’s office.
Pelvic Floor Muscle Training
Exercises called Kegels can help with issues such as prolapse or incontinence. Kegel exercises involve squeezing and relaxing the muscles within the pelvic floor. More severe prolapse symptoms can be improved with these exercises—but they may not resolve symptoms completely.
Similar to acupuncture, nerve stimulation treatments can help with overactive bladder symptoms. These are done in an office setting and typically require treatment once a week for several months and then once a month thereafter to maintain benefit.
The urogynecologist may suggest surgery to manage prolapse and incontinence issues. There are different styles and approaches to surgery, and these will vary depending on your condition(s) and your doctor’s preference.
Education and Training
To become a urogynecologist, many years of study and firsthand experience are needed.
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 treated by a urogynecologist include:
- – Incontinence of the bladder and rectum (urinary or fecal/stool incontinence)
- – Stress incontinence
- – Urge incontinence or overactive bladder
- – Prolapse of the uterus, cervix, vagina, or bladder
- – 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 or emotional distress 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 and better after sleeping or lying down for prolonged periods
- – Trouble peeing or emptying the bladder
- – Leaking urine or feces
- – Frequent or urgent peeing
You can get referred to a urogynecologist by your primary care doctor or gynecologist. Be sure to bring up any of these symptoms up 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 will want to know the impact these symptoms have on your quality of life.
The doctor will try to identify what is 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.
If you suffer from any of these pelvic conditions or symptoms and want to learn which treatment options are right for you, schedule an appointment today. Dr. Peter Lotze and his team at Women’s Pelvic Restorative Center are here to help.