A urogynecologist is an expert in both the female reproductive system and the urinary system. 

Here’s how they compare to other clinicians:

• Urogynecologist: Fellowship-trained OB/GYN physicians who treat pelvic floor problems like urinary incontinence (bladder leaks) and pelvic organ prolapse.
• Urologist: Treats urinary issues in men and women, such as UTIs and kidney stones. Most don’t focus on female pelvic floor problems.
• Obstetrician-gynecologist (OB/GYN): Cares for the female reproductive system, including periods, menopause, and surgery. May treat some bladder issues but refer complex cases.
• Midwife: Offers both regular gynecologic and birth care. Can help with common concerns like birth control, menopause, and routine exams.
• Primary care doctor: Handles general health and common issues like UTIs. Can refer you to a specialist when needed.

Urogynecologists have special training in caring for the pelvic floor—including the support of the bladder, uterus, and rectum. They also specialize in helping women who have trouble controlling their bladder and bowels and treating problems that affect sexual function. You might see a urogynecologist if you have:

• Bladder control issues
• Bowel control issues
• Overactive bladder, or a sudden, strong urge to “go”
• Trouble emptying your bladder or bowels
• Problems with sexual function related to pelvic floor issues, such as bladder control, pressure, or vaginal dryness
• Interstitial cystitis, which causes bladder pain and pressure
• Pelvic organ prolapse, which is when your bladder, uterus, or rectum slips out of place
• Frequent urinary tract infections
• Abnormal passageways that form between the vagina and other organs, called vaginal fistula

What procedures does a urogynecologist perform?

The urogynecology care team at Carilion offers many treatments for pelvic problems. They range from simple lifestyle changes to surgical procedures.

Our procedures and treatments include:

• Botox to calm an overactive bladder
• Cystoscopy to examine the urinary tract
• Minimally invasive vaginal and pelvic surgery, both robotic and laparoscopic
• Nerve stimulation to improve bladder and bowel function
• Pelvic floor physical therapy to strengthen or relax pelvic floor muscles
• Urethral bulking agents to slow urine leaks
• Urinary slings, to help support and tighten your urethra and bladder and cut down on leakage
• Urodynamics, or tests to see how well your urinary system works

You don’t need to wait until your symptoms become severe to see a urogynecologist. While some concerns—like an occasional UTI—can be managed by your primary care team, OB/GYN, or midwife, a urogynecologist can help earlier for pelvic floor–related issues.

You may want to consider seeing a urogynecologist if your symptoms:

• Are bothering you or affecting your daily life
• Aren’t improving with usual treatment
• Keep coming back
• Feel concerning, even if they’re mild

Urogynecologists care for women of all ages. A referral from your primary care doctor or OB/GYN can help you get started.

Your first visit will include sharing information about your condition. Your doctor will ask you about your medical history, pregnancies, and lifestyle. You should talk about any symptoms you’re having and how long you’ve been having them.

The urogynecologist will perform a pelvic exam. If needed, the doctor may order tests that look at your bladder function. 

You and your urogynecologist will then develop a care plan. The plan will depend on your specific condition. 

It may include a mix of these approaches:

• Lifestyle changes: Your doctor may recommend losing weight if you’re obese. They may suggest limiting caffeine, alcohol, and carbonated drinks that stimulate the bladder. A high-fiber diet can help with chronic constipation.
• Nonsurgical treatment: Pelvic floor physical therapy can include exercises, biofeedback, and manual therapy. Bladder training is a technique to help you go for longer periods between using the bathroom. You may need a vaginal pessary, a device that your doctor inserts to support your pelvic organs.
• Surgery: You may need surgery for pelvic organ prolapse or bowel control problems. For urine leaks, your doctor may suggest a vaginal sling to help support your urethra (the tube that carries urine from the bladder out of your body when you empty your bladder). They may suggest injections to bulk up the urethra to help reduce leakage.