Urogynecology

Why see a urogynaecologist with Swiss Medical Network? 

Urogynaecologists specialise in the treatment of urological, gynaecological and obstetric conditions. They perform examinations and surgical procedures. They also prescribe medications and offer preventive care.

What is urogynaecology? 

Urogynaecology is the branch of medicine concerned with the treatment of pelvic floor problems, urinary and bowel incontinence and pelvic organ prolapse.

Who can see a urogynaecologist?

Urogynaecology helps women of all ages. 

What symptoms does a urogynaecologist treat? 

Urinary incontinence

Stress incontinence is usually the result of the weakening of muscles around the bladder. It is most common with physical activity, such as coughing, sneezing and playing sport. Hormonal changes in the menopause can lead to bladder control issues, particularly in women who have had several children.
Urge incontinence is the result of the bladder involuntarily contracting too much which causes a strong, sudden need to urinate. It usually affects women over the age of 65. It can be caused by a urinary or vaginal infection, a bladder stone or a non-cancerous growth (polyp) in the bladder.

Pelvic organ prolapse

Prolapse is a gynaecological problem where the uterus, bladder and rectum slip down from their normal position. 
Common causes of prolapse include the ageing process, multiple pregnancies and births, menopause, obesity, chronic constipation, a history of pelvic surgery, the presence of uterine fibroids and long-term or repeated heavy lifting.
Symptoms differ depending on the organs affected.
Main symptoms include: 
-    bulge or lump in or coming out of the vagina
-    discomfort or a feeling of heaviness in the pelvis
-    difficulty urinating and feeling like your bladder is not emptying fully
-    frequent need to urinate
-    pain or discomfort when urinating.

What are the potential treatment options in urogynaecology?

Urinary incontinence

Treatment varies depending on the case:
-    perineal and pelvic physiotherapy (rehabilitation of the perineal and bladder muscles)
-    local oestrogen therapy
-    tension-free vaginal tape (TVT) operation 
-    urethral bulking injections with a bulking agent. 

Prolapse

Treatment varies depending on the stage of the condition. 
First-line treatment involves inserting a soft pessary (ring) into the vagina to lift and support the organs. It can be combined with physiotherapy.
Perineal rehabilitation is used to strengthen the muscles of the perineum and slow the progression of pelvic organ prolapse. This rehabilitation makes urinating more comfortable and reduces the feeling of heaviness in the vagina.
A surgical procedure will be offered to patients if the treatments mentioned previously are unsuccessful. This surgery aims to fix organs (bladder, uterus, vagina or rectum) back into place after they have dropped too low in the pelvis. It can also treat stress incontinence.

Care

A clinical examination is carried out to collect your gynaecological, obstetric, medical and surgical history as well as your current health problems. 
Your urogynaecologist may perform:
-    urine testing to check for a urinary infection 
-    urodynamic tests to assess the dynamic function of the lower urinary tract 
-    abdominal and pelvic ultrasound scan (bladder, kidneys, urinary tract)
-    dynamic imaging of pelvic floor muscles 
-    MRI.

Medical follow-up in urogynaecology

This involves assessing and treating urogenital and bowel problems:
-    pelvic reconstruction and rehabilitation
-    pessary insertion
-    conservative, pharmacological or surgical treatment. 

FAQs

Why should I see a urogynaecologist?

If you are experiencing the involuntary leakage of urine or a feeling of heaviness in your lower abdomen, we recommend making an appointment with the urogynaecology department for a consultation.

When should I have a urogynaecological examination?

In the case of urinary or bowel incontinence or if your genital organs have slipped down from their normal position.

What happens in a urogynaecological consultation?

Your urogynaecologist will carry out a clinical examination alongside urodynamic tests to make sure you receive appropriate treatment.