What is urogynecology?

Many women have never heard of a urogynecologist and aren’t sure what they do.  A gynecologist treats the vagina and female reproductive organs.  A urologist treats the bladder, kidneys and male reproductive organs.  So, what is urogynecology and what does a urogynecologist do?  Urogynecology is the field of medicine that addresses pelvic floor disorders in women.  As a result, a doctor who focuses on female pelvic floor disorders is called a urogynecologist.

Pelvic floor disorders are a group of conditions that happen because of weakness in the pelvic floor muscles and/or tears in the connective tissue.  Sometimes you are born with these issues but usually they develop over time.  No matter when they happen, these weaknesses and tears can cause problems with how the pelvic organs work and are supported.  These problems then result in different annoying bladder, vaginal, and rectal symptoms.  Some symptoms of a pelvic floor disorder can include:

• problems with bladder leaking or bladder emptying
• tissue pushing into or out of the vagina,
• difficulty pooping or leaking stool
• pelvic discomfort

Urogynecology focuses on all of the organs, muscles and nerves in the pelvis rather than focusing on just one part of the problem.

What training does a urogynecologist have?

A urogynecologist completed medical school , a residency in either Urology or Obstetrics & Gynecology, and then a fellowship.  Usually this results in an additional 11 years of training after graduating from college.  Board certification has existed since 2013 and the field is officially called “Female Pelvic Medicine and Reconstructive Surgery” or FPMRS.

In my fellowship, I learned from urologists, neurologists, colorectal surgeons, gynecologists, urogynecologists, nurses, minimally invasive surgeons, academic researchers, and physical therapists.  There is so much to learn both in the clinic and in the operating room.  Some of the things that you need to master to be a urogynecologist include:

• • • • • • • • Educating patients
              • Helping women make behavioral changes
              • Advising on medications and over-the-counter therapies  and how theywork
              • Diagnosing and treating nerve issues, pelvic organ prolapse, bladder issues, muscle dysfunction, and anal sphincter issues
              • Performing relevant nerve stimulations
              • Fitting and managing pessaries
              • Perform ALL the surgeries including vaginal and minimally invasive approaches

What is unique about Urogynecology?

Working in this field teaches the importance of working well with other specialists.  Certain surgeries need more than one type of surgeon.  Muscle weakness or muscle tension are frequently part of the problem and physical therapists do the best job of fixing the muscles.  I work with other specialists every day to provide the best clinical care.  And women have better results when the right clinical team is providing all the care they need.

Treating women with pelvic floor disorders can be delicate.  Many women are embarrassed and don’t really want to talk about their ongoing issues.  This makes developing a great office team a must for the patients.  It is so important that everyone working in the office is gracious, welcoming and kind.  The clinical environment needs to be inviting so women are comfortable discussing these intimate problems.

So if you haven’t heard of urogynecology, you are not alone.  But if you have a pelvic floor issue, we can help you.  If you are looking for a urogynecologist, The American Urogynecologic Society keeps a searchable list on their Voices for PFD website. https://www.voicesforpfd.org/find-a-provider/