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What is Urogynecology?

Urogynecology is a subspecialty of gynecology that focuses on the combination of women’s health and urology. They treat a range of conditions that involve the pelvic organs that are part of the urinary or reproductive system. An OB/GYN in general practice can provide urogynecology services to their patients in many instances. In more complex cases a urogynecologist is needed, especially when surgery is recommended. A urogynecologist is a doctor who has completed training in both gynecology and urology.

Conditions Included In Urogynecology

Urogynecology involves treating a number of conditions that fall under the category of pelvic floor disorders (PFDs). These conditions affect the pelvic organs and include incontinence, pelvic organ prolapse, and recurrent urinary tract infections.

Incontinence

Urinary incontinence is a condition in which someone loses control of their bladder. It can be mild and only cause occasional leaking. More severe cases may cause urinary urgency so sudden that the person does not make it to the toilet in time. There are several types of urinary incontinence:

  • Stress incontinence: Urine leaks when there is pressure on the bladder from laughing, sneezing, coughing, exercising, or lifting a heavy object.
  • Urge incontinence: The urge to urinate is intense and sudden, resulting in an involuntary loss of urine.
  • Overflow incontinence: There is frequent or constant dribbling of urine from the bladder.

Pelvic Organ Prolapse

Prolapse is when one or more organs slip from their original positions. The field of urogynecology is concerned with pelvic organ prolapse. The pelvic organs include the:

  • Bladder
  • Uterus
  • Cervix 

Recurrent Urinary Tract Infections (UTIs)

UTIs are bacterial infections of the urinary tract. That includes the urethra, bladder, and kidneys. Frequent or recurrent UTIs can be a sign of other conditions like kidney stones or menopause. 

Overactive Bladder Syndrome

A condition in which the bladder muscle squeezes involuntary. When the muscle squeezes, it creates the urge to urinate even if the bladder is not full.

Urogynecology Treatments & Procedures

A urogynecologist or OB/GYN treating a pelvic floor disorder may prescribe a number of treatments and procedures. 

Diagnostic Procedures

If you have symptoms of a pelvic floor disorder, then your doctor may recommend one of the following tests used to diagnose your condition:

  • Urodynamic testing: Measurements are made to help doctors evaluate the function of the bladder, urethra, and sphincter. 
  • Bladder biopsy: Small pieces of tissue are removed from the bladder for testing under a microscope to find abnormalities.
  • Cystoscopy: The doctor uses a thin tube with a camera to view the inside of the bladder.

Non-Surgical Treatments

If a patient is diagnosed with pelvic organ prolapse or urinary incontinence, then the doctor will usually recommend non-surgical treatments before recommending surgery. These treatments are aimed at managing symptoms rather than repair. Non-surgical treatments for pelvic floor disorders include:

  • Behavioral or lifestyle changes
    • Dietary modification
    • Bladder training
    • Kegel exercises
  • Pelvic floor physical therapy
  • Botox for overactive bladder
  • Urethral bulking injections or incontinence
  • Sacral nerve stimulation

Surgical Procedures

If a patient doesn’t respond to non-surgical urogynecology treatments, then the doctor may recommend surgical repair of the pelvic organs. Surgical procedures used to prolapse and incontinence include:

  • Prolapse repair
    • Sacrocolpopexy (vaginal prolapse repair)
    • Vaginal vault suspension
    • Vaginal wall repair
  • Reconstructing the pelvic floor support
  • Hysterectomy
  • Sling placement to support pelvic organs
  • Surgery to repair damage to pelvic organs or anus
  • Transvaginal mesh removal

When to See Your Doctor

If you have the following symptoms, make an appointment to see your doctor to see if you may benefit from urogynecology treatment.

  • Difficulty urinating or emptying the bladder
  • Leaking urine when coughing or laughing
  • A bulge coming out of the vagina
  • Heaviness, fullness, pulling or aching in the vagina that gets worse at the end of the day or during a bowel movement
  • Frequent or urgent urination
  • Frequent urinary tract infections

At Green Valley OB/GYN we offer urogynecology services including urodynamic testing, incontinence evaluation, and incontinence treatment. If you have questions about urogynecology, call us at (336) 378-1110 to schedule an appointment.