urogynecologists

Urogynecology is a subspecialty of obstetrics and gynecology focused on disorders of the female pelvic floor and lower urinary tract. Urogynecologists diagnose and treat conditions such as pelvic organ prolapse, urinary incontinence (including stress, urge, and mixed incontinence), fecal incontinence, voiding dysfunction, pelvic floor pain, and related sexual and bowel disorders. They often work in multidisciplinary pelvic health teams and coordinate care with urology, colorectal surgery, physical therapy, and nursing.

Training and qualifications vary by country. In the United States, urogynecologists are obstetrician-gynecologists who complete a fellowship in female pelvic medicine and reconstructive surgery (FPMRS) after residency and obtain subspecialty certification. In Europe and other regions, urogynecology or female pelvic medicine and reconstructive surgery is offered as a dedicated subspecialty with analogous training. Diagnostic workups may include patient history, physical examination, bladder diaries, urodynamics, pelvic floor ultrasound or MRI, and cystoscopy in selected cases.

Common conditions treated by urogynecologists include pelvic organ prolapse (anterior, apical, and posterior prolapse), stress urinary incontinence, urge incontinence, mixed incontinence, overactive bladder, defecatory disorders, pelvic floor dyssynergia, and various pelvic pain syndromes. Management ranges from conservative to surgical. Conservative options include pelvic floor physical therapy, lifestyle modification, pessaries, bladder training, and medications such as antimuscarinics or beta-3 agonists. When surgery is indicated, procedures may involve vaginal or abdominal approaches for prolapse repair (including sacrocolpopexy) and continence procedures (midurethral slings, retropubic urethropexy, bulking agents), with attention to evolving techniques and mesh-related considerations.

Professional bodies include the International Urogynecological Association (IUGA), the American Urogynecologic Society (AUGS), and the European urogynecology society (EUGA), which promote education, guidelines, and research.