Urogynecology targets disorders of the pelvic floor and provides reconstructive medicine to repair problems such as organ prolapse, bladder prolapse, incontinence, or other functional concerns. Urogynaecologists help women with urinary incontinence and pelvic floor dysfunction. The clinical conditions that a urogynecologist may focus on include stress incontinence, overactive bladder, voiding difficulty, bladder pain, urethral pain, vaginal or uterine prolapse, obstructed defecation, anal incontinence, and perineal injury. Pelvic floor disorders affect the bladder, reproductive organs, and bowels. Common pelvic floor disorders include urinary incontinence, pelvic organ prolapse and fecal incontinence. Increasingly, urogynecologists are also responsible for the care of women who have experienced trauma to the perineum during childbirth.They may also care for women with vesico-vaginal or rectovaginal fistulae with specialist training, and in conjunction with other specialties. Urogynecologists or gynecologists will usually use quality of life improvement as a treatment goal, and there is a major focus on optimising symptoms using conservative measures before embarking on more invasive treatments. Common pelvic procedures are Cystocele repair which tightens the tissue that separates the bladder and vagina, and rectocele repair which tightens the tissue that separates the rectum and vagina. Depending upon the severity of symptoms and the health of the patient, conservative, non-surgical therapies are often the first approach used in the treatment of pelvic floor disorders. These include medications, pelvic muscle exercise, lifestyle and dietary modifications, use of a vaginal support device called a pessary, biofeedback and electric stimulation of pelvic floor muscles. If these methods fail to provide adequate symptom improvement, surgery may be used to repair pelvic floor defects.
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