As a subspecialty of both obstetrics/gynecology and also urology, urogynecology focuses on the diagnosis and treatment of pelvic floor disorders in women.
Scope: Conditions, Diseases, Treatments, and Procedures
Urogynecology deals with a wide range of conditions related to the lower urinary tract dysfunction and pain, and that affect the quality of life of the affected women. One of the most common conditions treated by urogynecologists is urinary incontinence, which is a condition that affects the ability to control urine flow. There are two main types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence occurs when physical activity such as laughing, coughing, or sneezing puts pressure on the bladder, leading to involuntary leakage. Urge incontinence is characterized by an overwhelming urge to urinate that is difficult to control.
Bladder prolapse is another condition treated by urogynecologists. It occurs when the muscles and tissues that support the bladder weaken, causing the bladder to drop or bulge and compress the vagina. This can lead to urinary incontinence, pain, and discomfort.
Pelvic organ prolapse is a condition that occurs when the muscles and tissues that support the pelvic organs weaken or stretch, causing one or more of the pelvic organs to drop or compress the vagina. This can cause urinary incontinence, pelvic pain, and discomfort during sex.
Recurrent urinary tract infections (UTIs) can also be treated by urogynecologists. UTIs are infections that occur in the urinary tract, including the bladder, urethra, and kidneys. They are more common in women than men and can cause pain, burning during urination, and frequent urination.
Vesicovaginal fistula (VVF) is a condition in which an abnormal connection forms between the bladder and the vagina, allowing urine to leak out of the vagina. This can be caused by childbirth, surgery, or radiation therapy.
To identify the underlying cause of pelvic floor disorders, urogynecologists use various diagnostic tools including physical examination, urine and other lab tests, and imaging tests such as x-rays, ultrasounds, and CT scans. Once a diagnosis is made, urogynecologists recommend an appropriate treatment plan which can include surgery.
Lifestyle modifications such as diet and exercise, medication, mechanical devices (such as a pessary), and physical therapy are all potential treatments for pelvic floor disorders. Pelvic floor physical therapy is an essential part of treatment for many pelvic floor disorders. It involves exercises that help to strengthen the muscles of the pelvic floor and improve bladder control.
Surgery is sometimes recommended for more severe cases of pelvic floor dysfunction. The type of surgery will depend on the individual case and can range from minor procedures such as transvaginal slings for urinary incontinence to more complex reconstructive surgeries such as sacrocolpopexy for pelvic organ prolapse.
Qualifications, Training, and Certifications
To become a urogynecologist, a physician must complete an accredited residency program in either obstetrics/gynecology or urology, followed by specialized training in urogynecology. Urogynecologists must have a strong background in anatomy, physiology, and pathology, as well as a comprehensive understanding of the female reproductive system.
Related Medical Specialties
Urogynecologists often work closely with other medical specialists, including urologists, obstetrician/gynecologists, neurologists, and colorectal surgeons. These specialists may collaborate with urogynecologists to manage complex cases of pelvic floor dysfunction caused by various underlying medical conditions.