Urogynecology

Urogynecology is a specialty focus of the Gynecology department of Premier Medical Group.

What is urogynecology?

Urogynecology is a subspeciality within obstetrics and gynecology. A urogynecologist focuses specifically on pelvic floor disorders and pelvic reconstructive surgery in women or people who were assigned female at birth. The pelvic floor is made up of muscles and connective tissues. They support organs, like the uterus and vagina, in your reproductive system. These muscles and tissues also support the bladder and other organs in your urinary system.

What is the difference between urology, gynecology, and urogynecology?

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The easiest way to understand urogynecology is that it focuses on treating conditions that overlap with conditions in the fields of urology and gynecology. The main difference is that urogynecologists do not focus on:

  • Conditions affecting the male reproductive system
  • Breast health

Urogynecologists focus on the female reproductive system, like a gynecologist. They may also treat conditions that affect a patient’s bladder or urethra, like a urologist. If you are still unsure about who you should talk to, it is best to speak about your ongoing symptoms with a general practitioner.

Who needs urogynecology treatment?

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Seeing a urogynecologist may be necessary at different times in your life. Common reasons for making a urogynecology appointment are if you:

  • Dribble or leak urine or stool
  • Need to urinate more often than usual
  • Have difficulty making it to the bathroom in time
  • Feel pressure or a sense of fullness in your pelvis or vagina
  • Feel, or previously felt, like something is falling out of your vagina

Scheduling an appointment with a urogynecologist is the first step toward getting answers. The specialist can speak about your specific experiences and better determine the treatment option that is potentially best for you.

What questions should I ask at a urogynecology appointment?

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Making an appointment with any specialist can feel overwhelming the first time that you do it. Preparing ahead of time with your questions is a useful method to make sure that you do not forget important questions or concerns after you receive a lot of other information.

Questions to ask at your urogynecology appointment are:

  • What led to my pelvic floor issues?
  • How severe is the damage to my pelvic floor?
  • What treatment options are right for me?
  • What is my outlook for regaining pelvic floor strength after I receive treatment?
  • How can I adjust my routine to improve and/or preserve my pelvic floor function?

Urogynecological concerns may seem embarrassing or even surprising if you were not already aware of them. It is important to try and remind yourself that pelvic floor disorders are treatable and the right healthcare provider will help you navigate any of your physical and/or emotional discomfort.

What happens at your first urogynecology appointment?

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Every urogynecology experience is unique. How your appointment goes will be largely dictated by the reason or symptom that brought you to a healthcare provider. A standard appointment is likely to include:

  • A review of your medical history
  • A discussion of any symptoms (what type, when they started, their duration, their effect on your daily life)
  • A physical exam (like a pelvic exam)

Your healthcare provider will use all of the above information to determine the best course of action and what treatment option(s) may be appropriate. Your provider may also recommend conducting additional tests if more are necessary before they can give you a diagnosis.

What are urogynecology pelvic floor disorders?

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Pelvic floor disorders can affect any individual regardless of their sex, but the conditions that urogynecologists treat involve those that are experienced by women or people AFAB. Certain risk factors for developing a pelvic floor disorder may include:

  • Pregnancy
  • Vaginial deliveries
  • Menopause

You may find yourself sitting down with a urogynecologist if you are experiencing:

  • Urinary incontinence: Urogynecologists treat multiple forms of bladder control issues (stress incontinence, urge incontinence, overactive bladder). Arranging an appointment with a specialist is important if you experience any common symptoms related to these conditions (leakage with cough or sneeze, leakage with the urge to urinate, frequent or urgent urination).
  • Pelvic organ prolapse (POP): Organs in your pelvis that slip out of place can include the bladder, uterus, rectum, or vagina. One or more of the organs slipping out of place can be related to bladder problems.
  • Fecal (bowel) incontinence: Weakened pelvic floor muscles can cause an inability to prevent stool from leaking.
  • Pelvic floor dysfunction: The condition is when you cannot coordinate the muscles that control when you urinate or make a bowel movement. Pelvic floor dysfunction is also capable of causing vaginal pain and/or pain with intercourse.
  • Vaginal fistulas: Certain injuries or medical conditions can form a passageway that lets urine or stool leak into the vagina.

The reasons that lead up to individuals making urogynecology appointments are often deeply sensitive and may be difficult to discuss. Speaking with a healthcare provider can help lessen fears or stigmas in a safe and informative environment.

What are urogynecology treatments for pelvic floor conditions?

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Treating pelvic floor conditions looks different for every patient. A urogynecologist may:

  • Prescribe medications to control your bladder or keep bowel movements regular
  • Fit you for a device (like a vaginal pessary if you have POP) to hold pelvic organs in place
  • Opt to perform surgery (reconstructive surgery to correct the placement of pelvic organs or surgery that helps to address any bladder control problems)
  • Recommend pelvic floor strengthening exercises (like Kegel exercises or biofeedback)
  • Suggest that you make lifestyle changes (including your diet, introducing relaxation techniques, timing bathroom breaks)

A urogynecologist may find that one or more of these techniques will provide you with the best, and possibly least invasive, results. If you have already spoken to one specialist, it is not a bad idea to get another opinion so that you feel comfortable with your treatment plan.

What are symptoms of pelvic floor conditions?

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Although there are more than a few possible symptoms of pelvic floor conditions, many women do not experience blatant symptoms at first. If you do begin to notice a concerning or confusing change in how your body feels, there is no need to suffer through it in silence.

Symptoms to discuss with a healthcare professional include:

  • A bulge or the appearance of something coming out of the vagina
  • Heaviness, fullness, pulling, or aching in the vagina (more noticeable at the end of the day of during a bowel movement)
  • Trouble with urinating or completely emptying your bladder
  • Leaking urine
  • Frequently or urgently needing to urinate

Schedule an appointment with a urogynecologist as soon as you notice any of these symptoms.

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