URO GYNECOLOGY

Urogynecologists or urogynes are doctors with specialisation in treating women with pelvic floor disorders. A patient is recommended an urogyn to seek help at treating the prolapse and incontinence issues. Despite the fact that general physicians, urologist or OB/Gynaecologist might have the required knowledge to advise on these issues, an urogyn should be consulted when referred because they have additional expertise in this area.

So, a urologist or general physician may refer to a urogyn in case of prolapse problems, fecal or urinary incontinence issues, or for problems with bladder or rectum emptying, bladder or pelvic pain or fistulas.

Treatments under Uro Gynecology

  • Medications involving oral drugs can helo in curing such situations depending on the condition and its seriousness
  • Behavioural therapy like muscle training dietary changes or relaxation therapy can help in managing and mitigating the symptoms of pelvic floor disorders
  • Pessaries is a device that on doctors recommendation is inserted into the vagina to provide support to uterus, bladder, etc. This is recommended depending pf the situation of the patient and this device can be retracted, cleaned and reinserted.
  • Surgery and its type is chosen by the urogyn based on the criticality of the situation. It can be a minimally invasive laparoscopic procedure or a reconstructive surgery, selected by the doctor using his knowledge and expertise in the field.

Primary conditions treated by urogynaecologists

  • Urinary incontinence is the medical term for urine leakage. Experts from American Urogynecologic Society ( AUGS) found it twice as much prevalent in women than in men. Risk factors for urinary incontinence include:
    • Vaginal childbirth
    • Chronic constipation
    • Genetics
    • Diuretic medications
    • Obesity
    • Smoking
  • Overactive bladder is a medication condition where the patient has problems with bladder function that create sudden and irresistible urge to urinate. Some people have an overactive bladder because of their underlying medical issues and conditions like an inflammatory or neurological illness. For most women, however, the reason is unknown.
  • Pelvic organ prolapse is a medical condition when the uterus or bladder drop because of week vaginal muscles. The risk of pelvic organ prolapse includes:
    • Genetics
    • Smoking
    • Pelvic floor injuries
    • Chronic coughing
    • Chronic constipation
    • Obesity
    • Vaginal childbirth
    Wome with obesity is 40 to 75 percent more susceptible to pelvic organ prolapse.

Surgical procedures under Urogynecology

The surgical procedures commonly conducted by urogynecologists include:

  • Culdeplasty is a surgical procedure that repairs an enterocele. An incision is made by the surgeon in the patient’s vagina to find the tissue that supports the bladder and rectum. The tissue is then sutured to the surrounding tissues to elevate the bladder and the vaginal apex and to give them the required support.
  • Burch procedure is the surgical procedure that treats urinary incontinence. During the surgery, the neck of the bladder is released from nearby ligaments using sutures.
  • Paravaginal repair is the surgery that attaches the bladder and the urethra to the pelvic side-walls and restores their position.
  • Posterior repair is essential when the rectum and the vagina are not held up properly so the rectum drops on the back of the vagina. This makes bulge which is called prolapse in case of vaginal bulge and rectocele for the bulged rectum. The procedure tightens up the rectum supports and removes the vaginal bulge.
  • Trans obturator tube is the procedure designed to provide support to the sagging urethra. The purpose of this procedure is to ensure that there is no unintentional release of urine during coughing or vigorous movement.
  • Some other surgeries performed by urogynes are Cystocele and rectocele repair, excision of Bartholin’s gland, Sacral Colpepxy, Sacrospinous ligament fixation, tension-free vaginal tape and colpocleisis