Urogynecology is a medical sub-specialty that primarily deals with pelvic floor disorders, which include conditions like:

• Pelvic organ prolapse – a dropping of pelvic organs (bladder, uterus and/or rectum) into or outside of the vagina caused by a loss of vaginal support.
• Urinary incontinence – leakage of urine with coughing, sneezing and activities, or difficulty holding urine when having the urge to urinate. 
• Fecal incontinence – involuntary loss of bowel control or accidental bowel leakage. 
• Fistulas – abnormal communication between the vagina and rectum (rectovaginal fistula), bladder (vesicovaginal fistula, urethrovaginal fistula), or between the uterus and surrounding organs.

“While these conditions aren’t life-threatening,” says urogynecologist and reconstructive pelvic surgeon Isuzu Meyer, MD, “they are sensitive issues that can be embarrassing to discuss, which often results in some patients not seeking care.

Still, if you have had any of these pelvic floor disorders, you’re far from alone. “Approximately 1 in 3 women will experience a pelvic floor disorder,” says Dr. Meyer. “So, it’s my job to destigmatize these conditions and make patients aware that help is available and they don’t have to suffer in silence.”

Signs you may need a urogynecologist

Common signs or symptoms of pelvic floor disorders include:

1. Feeling or seeing a bulge in the vagina
2. Feeling like you’re sitting on something or feeling discomfort similarly. 
3. Leakage while laughing, coughing or sneezing
4. Cannot hold urine, frequent trips to the restroom
5. Leakage of stool

What to expect at a urogynecologist

Your first appointment with a urogynecologist will include a review of your medical history – including any pre-existing health conditions – and a thorough physical evaluation. 

“Based on this appointment, your provider may order additional tests to assess your condition," says Dr. Meyer. "They will review treatment options and work with you to develop a personalized care plan that meets your goals.”

Treatment options can include:

• Physical therapy
• A device or insert
• Medications – for certain conditions
• Surgery – minimally invasive procedures. Most of urogynecology surgeries are outpatient. Many patients go home on the same day after surgery.

Destigmatizing pelvic floor disorders

Pelvic floor disorders are common and nothing to be embarrassed about. Although discussing these conditions may be uncomfortable, treating them is essential to ensure your best quality of life. 

"Often patients will tell me they didn't know urogynecologists existed or they didn't know where to go for help with their pelvic floor disorders," says Dr. Meyer. "That's why I'm trying to educate families, other medical providers, and the community about urogynecology."

Additionally, while pelvic floor disorders are more common among older women, these conditions aren't a "normal" part of aging and are treatable. Nebraska Medicine's board-certified urogynecologists have specialized training to treat conditions that affect the pelvic organs and the surrounding muscles and connective tissues that support these organs.

"We understand how these disorders can negatively impact your life," says Dr. Meyer. "But you don't have to live in discomfort. Our team offers cutting-edge diagnostic and treatment options and will collaborate closely with your primary care provider and other specialists who are also leaders in their field."