Frequently Asked Questions about Urogynecology & Pelvic Health
What is a urogynecologist?
A urogynecologist is a gynecologist with additional years of subspecialty training focusing on pelvic floor disorders like incontinence and prolapse
How does this differ from a regular gynecologist?
Unlike general OB–GYNs, urogynecologists undergo Extra training in pelvic floor medicine and reconstructive surgery
What symptoms should prompt seeing a urogynecologist?
You should see a specialist if you experience urinary leaks, pelvic pressure, bulging, bowel leakage, frequent UTIs, or pelvic pain
Is urinary leakage normal as I age?
While common—affecting ~40% of women aged 60–79—it’s not normal and is treatable
What types of urinary incontinence exist?
Four main types: stress (leak during effort), urge (sudden need), overflow (incomplete emptying), and mixed incontinence
How is urinary incontinence diagnosed?
Diagnosis typically involves history, pelvic exam, bladder diary, stress test, urinalysis, and sometimes urodynamics or cystoscopy
Are there non-surgical options for incontinence?
Yes—pelvic floor training (Kegels), bladder training, lifestyle changes, medications, pessaries, neuromodulation, and bulking injections
What is pelvic organ prolapse (POP)?
POP occurs when organs like bladder, uterus, or rectum descend into the vagina due to weakened support structures
What are common symptoms of prolapse?
Symptoms can include vaginal bulge, pelvic pressure, difficulty urinating or bowel movements, and urinary leakage
What treatments exist for pelvic prolapse?
Treatments range from pelvic floor exercises and pessaries to minimally invasive or robotic surgical repair
Can pelvic pain be related to prolapse?
Yes—pelvic floor weakness, endometriosis, fibroids, or bladder issues can cause chronic pelvic pain .
What is urodynamic testing?
A structured series of tests measuring bladder pressure, flow, and capacity to diagnose types of incontinence
Is pelvic floor therapy beneficial?
Absolutely. Physical therapy improves muscle tone, coordination, and reduces symptoms of prolapse, incontinence, and pain
Are Kegel exercises always recommended?
No—if muscles are too tight or poorly coordinated, Kegels can worsen symptoms. Proper assessment is essential
What is a pessary?
A silicone device inserted into the vagina to support pelvic organs or reduce urinary leakage, often used for non‑surgical management
When is surgery necessary for prolapse?
Surgery is considered if prolapse is severe, symptomatic, or when conservative options are ineffective or unsuitable .
Why is mesh not always used?
Transvaginal mesh is banned/limited due to associated risks (erosion, pain), and its use is now more selective
Can incontinence or prolapse resolve on their own?
No—these often worsen over time and early treatment with exercise or pessaries is recommended
When should I seek help for fecal incontinence?
If you experience accidental stool leakage, urgency, or poor control of bowel movements .
Is it ever too late to treat pelvic floor issues?
Not at all—women of all ages, even decades after childbirth, can benefit from tailored treatment
