As a woman, it’s a safe bet you know what a gynecologist is. You also probably know what a urologist is—a physician specializing in conditions that affect the urinary tract. Urologists may treat UTIs, incontinence, cancer and male infertility problems, among other conditions. What you may not know about yet is the physician who combines the expertise of these two specialists, but with a totally female focus—the urogynecologist.
It’s a relatively new option—and about time! Even though women have been dealing with bladder leaks forever, the American Board of Medical Specialties (ABMS)—the organization that oversees certification standards—didn’t add urogynecology as a subspecialty until 2011, and doctors finally began receiving board certification for it in 2013.
The urogynecologist is an obstetrician-gynecologist with additional training in problems that affect our pelvic floor—the collection of muscles, ligaments, tissue and nerves that supports and controls our bladders, among other things. With specialized training in both women’s health and urology, urogynecologists handle everything from evaluation and diagnosis to treatment and management with a primary focus on quality of life. This makes them ideally suited to help women contending with stress and urge incontinence, prolapse and pelvic floor disorders. They understand why women leak and how to help keep those leaks to a minimum. If you feel like your doctor isn’t quite understanding or empathetic about your bladder health concerns, asking for a urogynecologist referral is a good call.
You can expect a visit similar to the gynecologist, including a pelvic examination. There should also be a candid conversation about the symptoms you are experiencing, any life events (such as pregnancy, childbirth or menopause) that had an impact on your pelvic floor health and how living with bladder leaks is affecting your daily life.
When it comes to helping deal with bladder leaks, your urogynecologist is likely going to start with non-surgical strategies. Of course they can recommend surgery if necessary, but the initial treatments may include easy interventions such as a regimen of Kegels or working with a pelvic floor physical therapist If needed, the urogynecologist also can prescribe medications or injections or recommend the use of a specialized device to address prolapse and improve bladder control.
If you’re reading this, you already suspect that a little bit of leakage may be reason enough to talk to a urogynecologist. Other symptoms that might prompt a conversation and require a referral from your primary care physician could include pain during or after sex, pain when you pee or not being able to fully empty your bladder even when you feel the urge. Any of these circumstances might be nerve-wracking, but set anxiety aside, talk to a specialist who understands and get on a path to feeling better and leaking less!