What is a urogynecologist?

A urogynecologist is a physician who specializes in caring for women’s urogynecology, urology and pelvic problems. Common disorders treated by a urogynecologist include:

  • Incontinence – bladder and bowel control problems
  • Prolapse – weakening of the pelvic muscles that causes the internal organs to drop down
  • Emptying Disorders – difficulty voiding (going to the bathroom) and not being able to complete the void leaving urine in the bladder.
  • Pelvic Pain
  • Overactive Bladder – having a sudden urge and/or voiding frequently
  • Interstitial Cystitis – Painful Bladder Syndrome

Who should visit a urogynecologist?

Women who have any of the disorders mentioned above should seek treatment from a urogynecologist. Urogynecology is a subspecialty, which means that doctors who are urogynecologists are specialists in this area and have more experience treating these conditions.

When should I seek out a urogynecologist?

If you have incontinence, prolapse or pelvic pain issues that are affecting your quality of life, you should seek treatment from a urogynecologist. These disorders are not just a normal part of aging. A urogynecologist can help women find safe, effective options to help them regain their quality of life.

Your pelvic organs, which include the bladder, urethra, uterus, vagina, small bowel, and rectum, are held in place by a group of muscles that from the pelvic floor inside your abdomen. When these muscles are injured, stretched, or weakened, one or more of the pelvic organs can “prolapse”, or descend out of place. This can cause significant pain, discomfort, and inconvenience, depending on the severity.

There are many possible causes for pelvic organ prolapse, though the most common triggering factor is pregnancy and childbirth. Other conditions that can cause or aggravate a prolapse include: obesity, chronic constipation, chronic respiratory issues that cause constant coughing, hysterectomy (removal of the uterus), and pelvic organ tumors.

Though symptoms will vary with every individual patient, the most common ones include:

  • A constant feeling of pressure from your vagina
  • Chronically feeling full in the lower belly
  • The sensation or feeling as if something is falling out of your vagina or anus
  • Incontinence (fecal or urinary) or the frequent urge to urinate
  • Vaginal pain during intercourse
  • Bowel issues such as constipation
  • Lower back pain

The condition of unintentional leaking of urine or stool is called incontinence, which can impact the quality of your daily life. Fortunately, incontinence can be treated, managed, and even reversed in some cases, depending on the severity and the underlying cause(s).

Urinary incontinence can be classified under 2 types: stress incontinence, and urge incontinence.

Stress incontinence is the leakage of urine when you sneeze, jump, laugh, or engage in any activity that exerts pressure on your pelvic muscles. Urge incontinence occurs when you get the intense urge to urinate, and leak urine before you get to the toilet.  The cause of stress incontinence is a weak pelvic floor, which place women who have experienced pregnancy and childbirth at the highest risk for developing the condition.

In contrast, urge incontinence can be caused by a variety of underlying conditions, which include but are not limited to: bladder stones and urinary tract infections.

You can develop or experience fecal incontinence if you suffer from chronic bowel issues (such as habitual constipation or diarrhea, irritable bowel syndrome, etc.), or sustain pelvic muscle or nerve damage through childbirth or surgery.

The pelvic floor muscles do more than just hold your pelvic organs in place—they also allow you to control your bowel and bladder movements. When these muscles become weak or damaged, it may result in a condition called pelvic floor dysfunction.The most common risk factors for developing pelvic floor dysfunction are pregnancy and childbirth. Other possible causes for this condition include (but are not limited to): traumatic injuries or accidents to the pelvic area, irritable bowel syndrome, habitual heavy lifting, nerve disorder in the pelvic region, and genetic predisposition.

You may be suffering from pelvic floor dysfunction if you experience any of the following symptoms:

  • The inability to complete a bowel movement
  • Constipation or frequent straining pain during bowel movements
  • Frequent urination, but with the inability to urinate smoothly, stopping and starting many times before your bladder is emptied
  • Pain during urination
  • Persistent lower back pain
  • Vaginal pain during sexual intercourse

Voiding dysfunction is a general term that describes any condition that includes difficulty in urination and emptying the bladder. The most common symptoms include urinary hesitancy, urinary urge and frequency, urine retention, slow or weak stream, and chronic dribbling of urine.

This fairly common condition can afflict patients of both genders and all ages. You can develop voiding dysfunction if you have an overactive or underactive bladder and urethra, an undiagnosed nerve dysfunction, or non-relaxing pelvic muscles. There may be a psychological and emotional component in some cases, which can impact the pelvic nerves and muscles and lead to impaired urination. Fortunately, voiding dysfunction is a highly treatable and manageable condition, regardless of the specific cause.