When should you see a urogynecologist?

Urogynecology treats disorders of the pelvic floor

Have you been living with pelvic pain? Maybe you’ve have bladder or sphincter issues – do you go to the bathroom on the hour, every hour?

Or maybe you have to book it to the bathroom to keep from having an accident.

These are just a few of the reasons your provider may suggest you see a urogynecologist.  A urogynecologist is a doctor who completes four years of residency training in obstetrics and gynecology. That’s followed by a fellowship in urogynecology and pelvic reconstructive surgery. This specialized training prepares them for treating women with pelvic floor disorders.

What kind of issues can happen with the pelvic floor?

The pelvic floor includes muscles, ligaments, connective tissue and nerves that help support and control the bladder, rectum, uterus and vagina.  When the pelvic floor is weak, has a tear or doesn’t work the way it should, it can cause a pelvic floor disorder. According to the National Institute of Child Health and Human Development, more than one-third of U.S. women have a pelvic floor disorder. Some of the most common pelvic floor disorders include:

  • Incontinence: Losing control of your bladder or bowel, leaking urine or feces.
  • Emptying disorders: Having trouble with urinating or bowel movements.
  • Fistulas: Holes that can develop between the vagina and rectum, vagina and urethra (urethrovaginal) or vagina and the bladder (vesicovaginal).
  • Overactive bladder: Frequent need to urinate, bladder pressure, urgency, having a hard time holding back urine when you need go
  • Pain: Pelvic, bladder or lower back pain. Activities such as penetrative sex can be unpleasant.
  • Prolapse: When a pelvic organ such as the uterus, bladder, vagina or rectum drops, causing a bulge or pressure.

What causes a pelvic floor disorder?

Pelvic floor disorders aren’t just an issue for women who’ve experienced menopause. Women in their 20s and 30s who have had a vaginal or C-section birth can have pelvic floor issues. It’s especially true for those who have borne more than one child. Other pelvic health conditions, such as excessive bleeding and endometriosis, affect younger women as well. Repeated, strenuous activity such as heavy lifting could cause issues as well.

What kinds of treatments are there?

Depending on the specific condition, its severity and your current health, you may need any number of nonsurgical or surgical treatments. Some can include:

  • Medications
  • Pelvic exercises
  • Behavioral and/or dietary modifications a
  • Pelvic floor therapy
  • Surgery

Norton Women and Children’s Hospital as well as several Norton Healthcare surgeons are recognized as a Center of Excellence in Minimally Invasive Gynecology (COEMIG). The designation is for doctors and facilities that provide safe, high-quality surgical care. Norton Healthcare is the only provider in the Louisville area with the designation.

What should I do if I’m having a problem?

The most important thing you can do is to talk to your provider. It can feel intimidating or even embarrassing to admit you’re having issues with incontinence or pelvic pain. The important thing to remember is that it’s not a normal part of aging, nor is it a normal part of menopause. It’s not something you should just accept and deal with alone. Discuss your symptoms and the issues you’re having with your primary care provider first. They can help refer you to an urogynecologist for specialized care and additional expertise.

Center of Excellence in Minimally Invasive Gynecology (COEMIG) program at Norton Women’s and Children’s Hospital

Jonathan Reinstine, M.D., program director

Sarah Kane, M.D., facilitator

David Doering, M.D.

Dwight Pridham, M.D.

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