Have you ever heard of a 'urogynecologist'? Maybe this name is a little new to you. But these are specialists who treat some of the most important, and sometimes sensitive, health problems in women. Today, we'll talk about who they are, what they do, and when you might want to see them. Don't worry, we'll explain it all in simple terms.
Who is this urogynecologist?
Simply put, a urogynecologist is a doctor who specializes in disorders of the pelvic floor in women. Now you might be wondering what the pelvic floor is, right? Imagine that in the lower abdomen area of your body, below your bra, there is a strong network of muscles and connective tissue, or a kind of floor. That's what we call the pelvic floor.
This pelvic floor is very important. Because it holds your uterus, reproductive organs like your vagina , and urinary organs like your bladder , and it is these pelvic floor muscles that support them. Like a strong basket that holds a bunch of stuff, they help keep these organs in order. So, if these pelvic floor muscles become weak or injured, they can cause problems with the functioning of those organs. That's when you need to see a urogynecologist.
What is the difference between a urologist, a gynecologist, and a urogynecologist?
When you hear these three names, you might be a little confused, right? You might be thinking, "They're all the same, right?" Let's take a look at what each of these specialists does. Then you'll understand the difference.
- Urologist: These doctors primarily treat diseases of the urinary system . That is, problems with organs such as the bladder, kidneys, ureters, and urethra. They treat diseases of the urinary system in both men and women. Urologists also treat diseases of the male reproductive system (e.g., prostate problems).
- Gynecologist: A gynecologist, or as we often call them, a gynecologist, treats diseases of the female reproductive system . That means problems with the uterus, ovaries, and vagina (e.g., menstrual irregularities, uterine fibroids). They also focus on breast health. They sometimes treat some simple problems with the female urinary system.
- Urogynecologist: Now, look, the name has both the words 'uro' (related to the urinary system) and 'gyna' (related to the female reproductive system) in it, right? This means that these specialists treat conditions that are related to certain parts of both the fields of a urologist and a gynecologist. To be precise, they specifically treat conditions that are caused by the weakening or damage of the pelvic floor, that is, ``Pelvic Floor Disorders'' . Like a gynecologist, they treat pelvic floor disorders related to the female reproductive system, and like a urologist, they treat problems that occur in the bladder or urethra, especially those related to the pelvic floor.
Just think, sometimes two or three of these doctors can work together to treat your problem.
Although urology and gynecology have been medical fields for many years, urogynecology was recognized as a separate specialty in 2011. Accordingly, urogynecology, or more formally known as Female Pelvic Medicine and Reconstructive Surgery (FPMRS), began offering certification to doctors in 2013.
What kind of education do you need to become a urogynecologist?
Becoming a specialist like this is not easy. After graduating from medical school, a doctor training to become a urogynecologist must complete residency training in either gynecology or urology. Some training programs offer the opportunity to receive training in both. After that, they must complete fellowship training in a specialty called Female Pelvic Medicine and Reconstructive Surgery (FPMRS) .
After this fellowship training, they must also pass an exam to become a board-certified urogynecologist.
Simply put, after graduating from medical school, you have to study and train for about seven years to become a urogynecologist. So they are people who have a lot of knowledge in this field.
What exactly does a urogynecologist do?
Urogynecologists diagnose and treat pelvic floor disorders . Although these pelvic floor disorders can affect both men and women, urogynecologists primarily treat conditions related to experiences that are unique to women. For example, pregnancy, childbirth, and menopause are all risk factors for developing pelvic floor disorders.
Here are some of the common pelvic floor disorders that urogynecologists treat:
- Urinary Incontinence: This is the inability to control the flow of urine . There are several ways to treat this:
- `Stress Incontinence`: The leakage of urine when there is an increase in intra-abdominal pressure, such as when coughing, sneezing, laughing loudly, or lifting a heavy object.
- Urge Incontinence: The sudden, strong need to urinate (urge) results in the loss of urine. Sometimes, the urine is lost before you can even run to the toilet. It occurs as soon as you feel the urge to urinate.
- Overactive Bladder: Frequent (perhaps once an hour), urgent need to urinate. You may have to get up several times during the night.
- Pelvic Organ Prolapse (POP): This is when one or more pelvic organs slip out of their normal position and into the vagina when the pelvic floor is not supported properly. This is similar to the way a wall collapses and furniture falls out. The organs that can prolapse include the bladder (cystocele), uterus (uterine prolapse), part of the rectum (rectocele), and the upper part of the vagina (vaginal vault prolapse). This condition can also be associated with bladder problems. Some people may feel as if something is coming out of the vagina.
- Fecal Incontinence: When the pelvic floor muscles become weak, you may lose control of your bowel movements and unintentionally leak some stool. This may be during a bowel movement or it may be a small amount of liquid stool. This is called Fecal Incontinence.
- Pelvic Floor Dysfunction: This condition occurs when the pelvic floor muscles that control urination and defecation are unable to properly coordinate. This means that the muscles tighten when they should be tight, and tighten when they should be loose. This can make it difficult to urinate or defecate (for example, you can't pass urine even when you try to). It can also cause vaginal pain and pain during sex.
- Vaginal Fistulas: This is when an abnormal passageway forms between the vagina and the bladder or rectum, either due to an injury (e.g., during childbirth, surgery) or another medical condition. This can cause urine or feces to leak into the vagina.
Now you probably understand, right? These are uncomfortable, yet very uncomfortable, issues. But remember, there are treatments for this.
What treatments do urogynecologists provide for these conditions?
Once a urogynecologist has diagnosed your condition, they will prescribe the right treatment for you. There is no one-size-fits-all treatment. Treatment depends on many factors, including the nature and severity of your condition, your age, and your general health. Here are some of the treatments they use:
- Prescribing medications: You may be given medications to help control your bladder (e.g., for overactive bladder) or to regulate bowel movements (e.g., for constipation).
- Device insertion: For example, if you have a condition called ``POP'' or pelvic organ prolapse, you can have a device called a ``pessary'' inserted. This is a ring-shaped or other device made of silicone, rubber, or plastic that is inserted into the vagina. It holds the pelvic organs in place. This is a non-surgical treatment.
- Surgeries: Sometimes, especially if other treatments don't work or if the condition is severe, surgery may be necessary. This includes reconstructive surgery, which returns the pelvic organs to their normal positions. Surgery can also help with urinary control problems (such as a sling for stress incontinence). These surgeries may use your own tissues and ligaments, or insert materials (such as mesh ) to strengthen weakened or damaged pelvic floor muscles.
- Pelvic floor strengthening exercises: You've probably heard of Kegel exercises . A urogynecologist will show you how to do them properly. Kegel exercises strengthen your pelvic floor muscles. It's like lifting weights and building muscle. Sometimes they may also work with a physical therapist to use a technique called biofeedback . Biofeedback helps you become more aware of when your pelvic floor muscles are tightening and relaxing. With this awareness, you can gain more control over these muscles and actions that control urination and defecation.
- Suggesting helpful lifestyle changes: They will help you identify and change your daily habits that are contributing to your symptoms. This may include changing your eating habits (e.g., cutting down on caffeine, spicy foods), helping you lose weight, quitting smoking, adding relaxation techniques, or scheduling trips to the toilet to gradually increase the amount of time you can "hold" urine (bladder training).
Why should I see a urogynecologist? / At what time?
You may want to consider seeing a urogynecologist if you have these symptoms:
- If you accidentally leak urine or feces .
- If you feel like you need to urinate more often than usual .
- If you feel like you need to urinate before you go to the toilet , it means you have difficulty getting to the toilet on time.
- If you feel a fullness, heaviness, or pressure in your vagina or pelvic area (like something is stuck inside).
- If you feel like something is coming down or falling out of your vagina , or if you actually feel something like that.
Important: Don't be ashamed to talk about these issues. These are conditions that many women can experience, and there are effective treatments for them. You don't have to suffer alone.
Also, urinary incontinence and pelvic organ prolapse are very personal issues for many people. So, it can be a great relief to see a doctor who, like you, is just as concerned about the female body system and can understand your situation. Then, no matter what the reason for seeing the doctor is, you will feel less afraid and uncomfortable while waiting in the waiting room.
What happens when you go to see a urogynecologist for the first time?
Your experience may vary slightly depending on the reason you're seeing a urogynecologist, but in most cases, these are the things that happen:
- The urogynecologist will talk to you about your complete medical history . This means things like previous illnesses, surgeries you've had, medications you take, and whether anyone in your family has had similar problems.
- They will ask you in detail about your symptoms . This means when they started, how long they have been present, when they get worse, and how they affect your life (e.g., whether they interfere with your ability to travel or participate in social activities).
- They will do a physical exam . This is usually similar to a pelvic exam. They will want to look closely at the organs and tissues in your pelvic floor, their position, and their strength. They may also ask you to show them your vagina or perform a test.
Based on what these tests find, they will suggest treatment for you, or tell you what further tests are needed to make a diagnosis (e.g., urine tests, special tests such as `urodynamic studies`).
What questions should I ask my urogynecologist?
When you meet with your doctor, don't be afraid to ask any questions you have. If there's anything you don't understand, ask again. Here are some questions you can ask:
- What is the most likely cause of my pelvic floor problems?
- How much damage has been done to my pelvic floor?
- What treatments do you suggest for me? What are the pros and cons of each?
- How much strength will I regain in my pelvic floor after treatment? How quickly can I expect to recover?
- What changes can I make to my daily life to maintain my pelvic floor function and prevent these problems from recurring?
- In addition to these treatments, are there things like exercise I can do?
A final take-home message
We don't think much about the muscles that control basic bodily functions like urinating and defecating, do we? When you leak urine like you never did before, or when you feel an unfamiliar fullness in your vagina, it can be really upsetting, embarrassing, and socially isolating.
But urogynecologists understand this very well. They are skilled at diagnosing your pelvic floor problems and identifying the best treatments to help you. They will listen to you and try to find the best solution for you. They have worked with many people who have had similar experiences. If you have these problems, ask your family doctor for a referral to a urogynecologist, or you can make an appointment yourself.
Remember, there's no need to hide these things and suffer, the most important thing is to get help. You're not alone!
` Urogynecology, Pelvic Floor, Urinary Control, Pelvic Organ Prolapse, Women's Health, POP, Incontinence
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