Urogynecology is a subspecialty of Obstetrics & Gynecology offering surgical and non-surgical care for disorders affecting the pelvic floor in women, treating conditions like urinary incontinence, pelvic organ prolapse, voiding disorders, and more.
The American Board of Medical Specialties regulates and offers subspecialty certification in the field of Urolgynecology, officially referred to as “Female Pelvic Medicine and Reconstructive Surgery.”
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About Urogynecology
Urogynecology, or female pelvic medicine & reconstructive surgery, is a subspecialty of obstetrics & gynecology that treats women suffering from bladder and pelvic floor conditions, such as pelvic organ prolapse and incontinence. The “pelvic floor” includes the nerves, tissues, ligaments and muscles of the bladder, vagina, rectum, uterus and cervix. Urogynecology earned sub-specialty accreditation with the American Board of Medical Specialties in 2011, with board certification for doctors beginning in 2013. The majority of urogynecologists are initially trained in the specialty of obstetrics & gynecology, but some may have primary specialty training in the field of urology.
Conditions treated by a urogynecologist typically include pelvic organ prolapse, incontinence, pelvic pain, and urinary tract infections, among others. When diagnosing patients, urogynecologists may employ a number of different testing procedures. First, the physician is likely to review the patient’s medical history and perform a general physical exam which may include a urine test. Depending upon the patient’s symptoms, the physician may also perform bladder tests, MRI scans, electrodiagnostic testing of the pelvic floor, and others to arrive at a diagnosis and prepare for treatment.
Urogynecologists offer unique and personalized treatment plans for each patient, offering both surgical or non-surgical care, depending upon the diagnosis and patient’s medical history. Surgical treatments can range from invasive to minimally-invasive to traditional invasive procedures. Some physicians may employ behavioral treatment techniques as an alternative to surgery or medications. Behavioral treatments may include relaxation therapy, bladder training exercises, performing Kegels to control and strengthen the pelvic muscle, and dietary changes, among others.
Urogynecology Education & Training
Training to become a urogynecologist begins with the completion of an undergraduate degree before completing medical school. After graduating from medical school with an MD or DO degree, the physician usually enters into a four year obstetrics & gynecology residency program (although some urogynecologists may undergo a residency in urology). During residency training, the physician will provide treatment for women in both the pregnant and non-pregnant states, and may begin to take a special interest in pelvic floor disorders.
After completing residency training, the physician may complete a fellowship in the specific field of urogynecology and pelvic medicine. These specialized programs provide the physician with daily experience in treating women with pelvic conditions. During this time, the physician will hone their skills in the surgical and non-surgical treatment of pelvic floor conditions.
Because of their additional fellowship training or expertise in the area of pelvic conditions, urogynecologists are able to offer the highly specialized care that patients with these conditions require. While an OBGYN or family doctor may be able to make an initial diagnosis and provide some basic treatment for pelvic floor disorders, urogynecologists have the experience and surgical expertise to provide more comprehensive care. Urogynecologists are sometimes seen when previous treatments are unsuccessful, or if the patient requires a specialized surgery.