What Kind of Training Does a Urogynecologist Have?
Fellowship-trained urogynecologists have completed medical school, a four-year residency in Obstetrics and Gynecology, and a formal two- or three-year fellowship in Urogynecology and Reconstructive Pelvic Surgery. During the fellowship, these physicians undergo rigorous additional training and experience in the evaluation and treatment of conditions that effect the female pelvic organs, and the muscles and connective tissue that support the organs. The fellowship training focuses on the diagnosis and treatment of urinary and fecal incontinence, urinary and pelvic dysfunction, and pelvic support disorders.
What does “Fellowship-Trained” Mean?
There is currently no “board-certification” in urogynecology, so finding a fellowship-trained urogynecologist gives you the best chance of getting the best treatment for your lower urogynecologic problems. A fellowship-trained subspecialist has spent two or three years of additional training after residency to acquire the skills and sophistication to treat incontinence, prolapse, and pelvic dysfunction. Most fellowship programs were two years in length until the late 1990s, when most programs transitioned to three-year programs. Sometimes, general gynecologists and urologists attend weekend courses or go watch specialists do surgery, but this type of learning does not equal the training of a fellowship-trained urogynecologist.
When Should I See a Urogynecologist?
It is not a normal part of a woman’s aging process to develop uncomfortable, troublesome symptoms of incontinence, prolapse, or pelvic pain. Women need not “learn to live with it.” Effective help is usually available through the services of a urogynecologist.
Although your primary care physician or gynecologist may have knowledge about these problems, a urogynecologist can offer additional, more sophisticated expertise. You should see a urogynecologist when you have problems of prolapse, incontinence, urinary or pelvic dysfunction, or when your primary doctor recommends consultation. Other problems for which you or your doctor might think about consulting a urogynecologist include: problems with emptying the bladder or rectum, pelvic pain, and the need for special expertise in vaginal surgery.
What Treatment Options are Available from a Urogynecologist?
A urogynecologist can recommend a variety of therapies to cure or relieve symptoms of prolapse, urinary or fecal incontinence, or other pelvic floor dysfunction symptoms. He or she should discuss both nonsurgical or surgical therapy although you will ultimately make decisions based on a number of factors including the severity of your condition and your general health. Nonsurgical options include medications, pelvic exercises (Kegels), behavioral and/or dietary modifications, and devices (e.g., vaginal weights, pessaries, urethral plugs). Biofeedback and electric Stimulation are treatments that are most effective when performed as part of a comprehensive pelvic floor program. Safe and effective surgical procedures are also utilized by the urogynecologist to treat incontinence and prolapse. He or she should discuss all of the options that are available to treat your specific problem(s) before you make treatment decisions.
How Do I Find a Urogynecologist?
If you believe that a urogynecologist is the right specialist for you, ask your primary care provider for a referral or contact your hospital’s referral service for recommendations of urogynecologists in your local area. The availability of a fellowship-trained urogynecologist may be limited (for example, Vermont Urogynecology has the only fellowship-trained urogynecologist within the state of Vermont), but usually the extra expertise is well worth the trip. Various web sites provide information to women about urinary incontinence and pelvic prolapse problems.