About urogynaecology

What is Urogynaecology?

Urogynaecology is a sub-specialty of Gynaecology, and in some countries is also known as Female Pelvic Medicine and Reconstructive Surgery. A urogynecologist manages clinical problems associated with dysfunction of the pelvic floor and bladder. Pelvic floor disorders affect the bladder, reproductive organs, and bowels. Common pelvic floor disorders include urinary incontinence, pelvic organ prolapse and fecal incontinence. Urogynecologists also provide care to women who have experienced trauma to the perineum during childbirth.

Urogynaecologists manage women with urinary incontinence and pelvic floor dysfunction. The clinical conditions that a urogynecologist may see include stress incontinence, overactive bladder, voiding difficulty, bladder pain, urethral pain, vaginal or uterine prolapse, obstructed defecation, anal incontinence, and perineal injury. Urogynaecologists often manage women who have experienced recurrence of pelvic floor symptoms after previous surgery. Urogynaecolgists are also trained in the care of women with vesico-vaginal or rectovaginal fistulae and women with congenital abnormalities of the lower female reproductive system.   

In Australia, Urogynaecology training involves a further three years of training in addition to the specialist training that is required to become an Obstetrician Gynaecologist. This training is approved and overseen by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Contemporary urogynecological practice encourages multidisciplinary teams working in the care of patients, with collaborative input from urogynecologists, urologists, colorectal surgeons, plastic surgeons, elderly care physicians, continence nurses and physiotherapists. This is especially important in the care of patients with complex problems, e.g. those who have undergone previous surgery or who have combined incontinence and prolapse, or combined urinary and bowel problems. Multidisciplinary team meetings are an important part of the management pathway of these women.

Common Investigations performed by a Urogynaecologist

  • Urodynamics
  • Cystoscopy
  • Endoanal Ultrasound
  • Anorectal Manometry

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