A urogynecologist is a fellowship trained physician who specializes in the diagnosis and treatment of female pelvic floor disorders. This subspecialty combines the fields of gynecology and urology. A fellowship trained urogynecologist has completed a 4 year residency in Obstetrics and Gynecology and spent an additional 3 years in a Urogynecology fellowship program to broaden their expertise in complex conditions that affect the pelvic floor.
Urogynecologists treat a variety of Pelvic floor disorders (PFD). This is a comprehensive term that includes conditions such as uterine and vaginal prolapse, incontinence, voiding disorders, bladder conditions, pelvic pain, dysparunia (painful sex), problems with defication (bowel movements) that are related to PFD, and other vulvar and vaginal conditions.
Urogynecology combines some aspects of both gynecology and urology. In a female patient, the bladder, uterus, vagina, and urethra function in coordination with each other. It is important to have a comprehensive evaluation of the urinary and pelvic systems together in order to fully diagnose and treat pelvic floor disorders.
A urogynecology evaluation begins with understanding the patients concerns and putting this in context with past medical and surgical history. A comprehensive pelvic examination is performed in the office which evaluates the neurologic, musculo-skeletal, and gynecologic health of the pelvis.
Depending on the patients concerns as well as the findings of the physical examination, additional tests may be ordered. Laboratory evaluation such as blood work and urine tests may be warrented.
Other common tests that may be ordered are urodynamics, cystoscopy, pelvic ultrasound, computerized tomography (CT scan), and magnetic resonance imaging (MRI).
Urodynamics are a series tests that are performed in the office to evaluate the bladder and urethra.
This includes evaluation of:
A cystoscope is a specially designed camera that allows the doctor to look inside the bladder. During cystoscopy, the bladder is filled with fluid in order to examine the bladder walls, ureteral orfices, and the urethra.
Urogynecologists work closely with gynecologists, urologists, gastro-intestinal (GI) doctors, and colorectal surgeons. They also work with physical therapists that specialize in pelvic floor rehabilitation. Depending on your condition, a multi-disciplanary approach may be needed to fully diagnose and properly treat your condition.