While most women know when to visit a gynecologist, many are still unaware of what a urogynecologist does and when they should see one. This may result in misdiagnosis or under-treatment of urinary leakage, bladder prolapse, and other pelvic floor disorders. It is essential to understand the difference between a urologist and a gynecologist so you can receive the appropriate treatment at the right time. This blog aims to fill that void by discussing both of these areas in detail, when to see a urogynecologist, and why this specialty is becoming crucial throughout India.
What Is a Gynaecologist?
A gynecologist is a physician who specializes in the reproductive health of women and deals with issues related to menstruation, pregnancy, infertility, and hormonal diseases. Regarding urogynecologists vs. gynecologists, gynecologists are the first doctors women visit, and after an examination, they might advise them to see urogynecologists.
Core Training and Scope of Practice
Gynecologists are medically trained doctors who specialize in the health of the female reproductive system. Upon completion of MBBS, they go for post-graduation (MD/MS/DGO) in obstetrics and gynaecology. They have a wide range of expertise on menstruation, pregnancy, childbirth, fertility, and hormonal health.
Conditions a gynaecologist typically treats
Gynecologists treat various conditions and ailments such as
- Irregular periods and PCOS are among the other symptoms.
- Care of pregnancy and childbirth. Care of the pregnant woman and the child.
- Infertility evaluation and treatment. Evaluation and treatment of infertility.
- Fibroids, ovarian cysts, and endometriosis
- Menopause-related concerns
If you are experiencing any of the above symptoms, the first step is to consult a gynecologist.
When a gynaecologist is the right first step
A gynecologist is the first healthcare professional that most women will turn to when facing issues relating to their reproductive and general pelvic health. For symptoms that are a result of periods, pregnancy, or hormonal changes, it is best to see a gynecologist.
What Is a Urogynecologist?
A urogynecologist is a medical professional who specializes in treating disorders affecting the female pelvic floor, such as urinary incontinence, pelvic organ prolapse, and bladder problems.
The additional training that defines the specialty
A urogynecologist is a gynaecologist who has been super-specialized in pelvic floor disorders. They have a fellowship training program in urogynecology and pelvic reconstructive surgery after their basic training.
The overlap between urology and gynaecology
The boundaries between urology and gynaecology are not clearly defined. There can be overlaps in the subject of urology and gynaecology. This specialty is a mixture of urology and gynaecology and treats diseases affecting the bladder, urethra, vagina, and pelvic floor muscles.
What “pelvic reconstructive surgery” means in practice
Pelvic floor disorders related to bladder, bowel, and vaginal support are treated and diagnosed by a subspecialist in urology called a urogynecologist. It is a mixture of urology and gynaecology principles and thus used for total treatment.
Key Differences — Urogynecologist vs. Gynecologist
Area | Gynaecologist | Urogynecologist |
Training Duration | MBBS + MD/MS in Gynaecology | Additional fellowship in urogynecology |
Pelvic Floor Specialisation | Basic understanding | Advanced specialization |
Surgical Scope | General gynaecological surgeries | Complex pelvic reconstructive surgeries |
Bladder/Bowel Expertise | Limited | Extensive |
Conditions Managed | Reproductive health | Pelvic floor disorders |
When the lines overlap
Your gynecologist may initially be able to treat some conditions, such as mild prolapse or early urinary symptoms. If symptoms continue or get worse, however, one should seek out a urogynecologist.
When you need both
In most situations, collaborative care is the best choice. For instance, if a woman is having a hysterectomy for fibroids, she might also need pelvic floor repair; this is where both specialists are needed.
Conditions That Need a Urogynecologist, Not Just a Gynaecologist
Certain conditions require the assistance of a urogynecologist in India and not just a gynecologist.
Urinary incontinence (stress, urge, mixed)
While not usually viewed as a problem, urine leakage can occur and can need special evaluation and treatment.
Pelvic organ prolapse (bladder, uterus, rectum)
Prolapse occurs when organs drop out of place, caused by a weakening of the pelvic floor, and can cause a feeling of heaviness or a bulge in the vagina.
Vesicovaginal Fistula (VVF)
This serious disorder is when there is an abnormal connection between the bladder and vagina, causing constant urine leakage.
Recurrent UTI with structural causes
A recurrent UTI may be associated with structural abnormalities such as stones or an obstruction of the urinary tract.
Urinary hesitancy or retention
If urinary infections occur regularly, it could be associated with a structural or functional problem of the pelvis. Incontinence that occurs when the toilet habits are delayed or interrupted.
Recurrent UTI with structural causes
It is normal to tend to feel like you have to get up to urinate again or to feel like you haven’t emptied your bladder, which may indicate a problem with the pelvic floor.
Vaginismus and Pelvic Floor Disorders
Some specialized pelvic floor therapy may be needed if painful intercourse or tight muscles in the pelvis are present.
Isthmocele / Cesarean Scar Defect
A situation that sometimes develops after previous C-sections but can be corrected using new techniques.
Signs You Should Ask for a Urogynecology Referral
It is best not to ignore any of the following symptoms and seek a referral from your GP to your urogynecologist.
Leaking urine when you cough, sneeze, or exercise
Urine leakage while sneezing, coughing, or during physical activity. This is not normal and is usually a sign of stress urinary incontinence.
A feeling of something “falling out” vaginally
This is a kind of “falling out” sensation that is typically felt in the vagina. It is a feeling that something is going “out” from the vagina.
Incomplete Bladder Emptying
If you often find it difficult to empty your bladder, then further tests should be done.
Recurrent urinary infections despite treatment.
If UTIs occur repeatedly, it can be a sign of structural problems instead of infection.
Pelvic pain that hasn’t resolved with standard treatment
If the pelvic pain persists after normal treatment, it may be caused by other issues. If pain is ongoing, it is advisable to assess pelvic floor dysfunction further.
Post-surgical complications involving the bladder
After surgery, some people experience problems with their bladder. Some people may have bladder problems after surgery.
Is Urogynecology Available in India?
Yes, urogynecology is available in India.
How the specialty is growing in India
Urogynecology is an area of still new development in India, and a growing awareness of and access to it is beginning to emerge. An increasing number of women are coming to terms with hitherto overlooked or normalized conditions requiring specialized care.
What to look for in a urogynecologist
- Advanced training or fellowship in urogynecology.
- Ability to perform pelvic reconstructive surgery. Experience with pelvic reconstructive surgery.
- Access to minimally invasive or robotic techniques
- A holistic approach with the patient at the centre
Dr. Indira Sarin — India’s first female robotic pelvic surgeon
Dr. Indira Sarin is the first woman in India to become a robotic pelvic surgeon. Dr. Indira Sarin is one of the leaders in this area who can provide the latest in robotic and minimally invasive solutions to complicated pelvic floor disorders.
FAQs
Q1. Can a regular gynecologist treat pelvic organ prolapse?
While treatment can be done at first, with moderate to severe prolapse, specialized treatment by a urogynecologist is needed.
Q2. Do I need a referral to see a urogynecologist?
Not necessarily. You can directly see a urogynecologist, particularly if you’re experiencing chronic bladder or pelvic symptoms.
Q3. How do I know if my bladder problem is gynaecological?
Leakage, urgency, and incomplete emptying may not only be due to infection, but they may also be associated with pelvic floor dysfunction.
Q4. Is urogynecology only for older women?
No. Women of all ages, including postpartum women, can benefit from urogynecological care.
Final Words
Knowing the distinction between a urogynecologist and a gynecologist can be beneficial to your health. It is not wise to ignore symptoms like incontinence or discomfort in the pelvic region. Sooner or later, one of the two things will happen: your condition will not get better, or it will worsen.
