Urogynecology

Urogynecology, a sub-specialty of Gynecology and Urology, is dedicated to the study and treatment of pelvic floor disorders in women. Combining aspects of both parent specialties, urogynecologists address issues related to the dysfunction of the pelvic floor and bladder, which often arise due to childbirth, menopause, or aging.

Overview

Urogynecology focuses on the diagnosis, treatment, and management of urinary incontinence, pelvic organ prolapse, and other disorders affecting the pelvic floor. The pelvic floor is a set of muscles, ligaments, and connective tissues that support the organs of the pelvis, including the bladder, intestines, uterus, and vagina.

Conditions Treated

Urogynecologists treat a range of conditions, which may include, but are not limited to:

• Urinary Incontinence – involuntary leakage of urine.
• Pelvic Organ Prolapse – descent of pelvic organs into or through the vaginal canal.
• Fecal Incontinence – involuntary loss of bowel control.
• Interstitial Cystitis/Painful Bladder Syndrome – chronic bladder condition causing bladder pressure and pain.
• Overactive Bladder (OAB) – urgent and frequent need to empty the bladder.
• Dyspareunia – painful sexual intercourse due to medical or psychological causes.

Diagnostic Techniques

To diagnose pelvic floor disorders, urogynecologists may use various techniques, including:

• Urodynamics – studies that assess how the bladder and urethra perform their job of storing and releasing urine.
• Cystoscopy – an examination of the lining of the bladder and urethra using a scope.
• Pelvic Ultrasound – imaging to visualize pelvic organs.
• Magnetic Resonance Imaging (MRI) of the pelvis – provides detailed images of the pelvic floor.

Treatments

Treatments in urogynecology include non-surgical and surgical options:

• Pelvic Floor Physical Therapy – exercises to strengthen pelvic floor muscles.
• Pessary – a device inserted into the vagina to support pelvic organs.
• Medications – for conditions like OAB or interstitial cystitis.
• Surgery – procedures like sling operations for incontinence or repair surgeries for prolapse.

Surgical Interventions

Some of the surgical interventions a urogynecologist may perform are:

• Sling Procedure – treatment for urinary incontinence.
• Sacral Neuromodulation – implants to help control bladder function.
• Vaginal Mesh – implants to support organs affected by prolapse.
• Hysterectomy – removal of the uterus, sometimes part of prolapse treatment.

Training and Certification

Urogynecologists are physicians who have completed medical school and residency training in obstetrics and gynecology or urology, followed by fellowship training in urogynecology. They may be board-certified through the American Board of Urology or the American Board of Obstetrics and Gynecology.

Importance in Women's Health

Urogynecology plays a vital role in women's health, addressing issues that can significantly affect quality of life. With a focus on restoring normal function and alleviating symptoms, urogynecologists help women regain confidence and comfort.

Pelvic floor and reconstructive medicine

This a branch of medicine that deals with female pelvic medicine and reconstructive surgery(also called urogynecology) These physicians provide consultation services and comprehensive management of women with pelvic floor disorders, including:

• urinary incontinence,
• lower urinary tract disorders,
• pelvic organ prolapse, and
• childbirth-related injuries

Urogynecologist / Female Pelvic Medicine and Reconstructive Surgery

Board certification in Female Pelvic Medicine and Reconstructive Surgery is available from

1. The American Board of Obstetrics & Gynecology (ABOG) and American Board of Urology (ABU) or
2. The American Osteopathic Association (AOA) and American Osteopathic Board of Obstetrics and Gynecology (AOBOG)

Difference between urologists & urogynecologists?

The biggest difference between urologists and urogynecologist is that a urogynecologist only treats women while urologists treat both men and women.

Urogynecology Resources
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