What is Urogynecology?

Urogynecology, a subspecialty within Obstetrics and Gynecology, focuses on female pelvic floor disorders such as pelvic organ prolapse (dropping of the uterus and/or vagina) and urinary or fecal incontinence. Urogynecologists diagnose pelvic floor disorders and offer non-surgical and surgical treatments. To reflect the depth of what we do at Beth Israel Deaconess -Needham, our program is also known as Female Pelvic Medicine and Reconstructive Surgery.


What is the female pelvic floor?

The female pelvic floor is the group of muscles, ligaments and connective tissues that keep a woman's internal organs (bladder, uterus, vagina and lower bowel) in place. By acting like a sling or a hammock to support the organs, the pelvic floor has a key role in making the organs function properly.


What is happening inside of me to cause a pelvic floor disorder?

A pelvic floor disorder suggests there is a weakness or tear somewhere within the network of muscles, ligaments and connective tissues supporting your internal organs. This weakening or tear in the support system may cause an organ to shift out of place and improperly function.


What are symptoms of pelvic floor disorders?

There are several symptoms of pelvic floor disorders, and a woman may experience more than one at the same time

  • Problems controlling bladder and bowels that include urine, bowel gas or stool leakage
  • Difficulty emptying bladder or having a bowel movement
  • Problems controlling urinary frequency
  • Recurrent bladder or urinary tract infections
  • Feelings of heaviness, sagging, bulging or even dropping in the pelvic area
  • Feel or see tissue coming out of the vagina

Whatever your symptoms are, we encourage you to see a specialist who is trained to diagnose and treat these types of conditions. There are good non-surgical and surgical treatment options available to improve your quality of life.


How do I know if my symptoms are severe enough to see a specialist?

If your symptoms affect your daily activities, you should speak with your primary care provider about seeing a specialist. There are good treatment options available.


What happens if I ignore the problem?

We understand these problems can be embarrassing, but neglecting them can make the symptoms worse. These are not life-threatening problems, but--if not properly treated--they can have a negative effect on your quality of life. In some cases, although usual, ignoring the problem can lead to serious health complications.


How did this happen to me?

There are many contributing factors to pelvic floor disorders, and almost all of them are beyond your control. Although more common in women who have given birth vaginally, pelvic floor disorders can also affect women who have never been pregnant. And, they affect women of all ages. Other contributing factors include chronic constipation, chronic cough, repetitive heavy lifting, pelvic tumors, excessive weight, weakening of the connective tissues over time, as well as genetics.


How common are pelvic floor disorders?

Pelvic floor disorders are very common. It is estimated that one-third of all U.S. women will be affected by one type of pelvic floor disorder in her lifetime.


Are pelvic floor disorders just a normal part of aging?

Although the frequency of pelvic floor disorders does increase with age, it should not be considered a normal part of aging. No woman should have to "just live with" these symptoms. By visiting a specialist trained to diagnose and treat pelvic floor disorders, you can learn about the numerous non-surgical and surgical treatment options available.


What are the most common kinds of pelvic floor disorders?

Urinary incontinence and pelvic organ prolapse are the most common kind of pelvic floor disorders. The good news is that there are good treatment options available.


How can I prevent myself from developing pelvic floor disorder?

While some cases of pelvic organ disorder are unavoidable, the following suggestions may help decrease your chances of developing a condition.

Strengthen your pelvic floor by doing regular Kegel exercises

Stay at a healthy weight through diet and exercise

Resolve constipation issues because excessive straining can weaken the pelvic muscles. Speak with your physician about constipation, making dietary changes and increasing the amount of fiber in your diet

Quit smoking. Smoking may cause a chronic cough that weakens your pelvic muscles. Smoking also weakens the tissues that support your pelvic organs. If you smoke, ask your physician about strategies to quit

Limit the amount of heavy lifting you do. Speak with your specialist about lifting techniques that won't put as much stress on your pelvic muscles


What kind of medical training does a Urogynecologist have and how do I find one?

After graduating from medical school, Urogynecologists complete their residency in Obstetrics and Gynecology. Next, they complete a fellowship in Female Pelvic Medicine and Reconstructive Surgery that gives them additional training and experience in diagnosing and treating pelvic floor disorders. 

If you need a Urogynecologist, ask your primary care physician for a referral. It is important that you find someone who is experienced and who you feel comfortable with. At BIDMC, our goal is to provide the best experience possible for our patients and their families.