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Should I See a Urogynecologist?

POSTED BY: Florida Hospital

If you’re experiencing overactive bladder, uterine prolapse, or other uncomfortable and frustrating pelvic problems, relief is possible — there’s a medical subspecialty just for you. Urogynecologists are experts in the female pelvic organs and pelvic floor: the muscles, ligaments, connective tissue, and nerves that help support and control the functioning of your bladder, uterus, vagina, and rectum.

We asked board-certified urogynecologist Dr. Bela Kudish of Florida Hospital Medical Group to share some important details about this area of expertise, and just how common these issues are for women.

What symptoms should I look for that might indicate I need to visit a UroGyn?

Dr. Kudish explained that your primary care physician or Ob/Gyn may have knowledge about pelvic floor problems, but a urogynecologist can offer additional expertise.

“You should be evaluated or referred to a urogynecologist when you have problems of pelvic organ prolapse, urinary incontinence unresponsive to medications, problems with emptying the bladder or rectum, or the need for special expertise in vaginal surgery,” she said.

“The most common complaints women have consist of feeling a bulge in the vagina, feeling as if something is falling out of the vagina, pelvic pressure/discomfort, sometimes discomfort with sexual intercourse, difficulty emptying their bladder, sensation of needing to urinate frequently, and a pulling sensation in the groin area,” said Dr. Kudish. “Urinary incontinence presents as a loss of urine with coughing, sneezing, laughing, and as an inability to make it to the bathroom in time to urinate.”

What are the main differences between a gynecologist and a urogynecologist?


“A urogynecologist is a female pelvic medicine specialist and reconstructive surgeon who has completed medical school, a four-year residency in obstetrics and gynecology, and a three-year fellowship in female pelvic medicine and reconstructive surgery,” says Dr. Kudish. “There are some obstetricians and gynecologists who have been performing urogynecologic procedures for many years and, with the permission of the American Board of Obstetrics and Gynecology, were allowed to become board-certified in this subspecialty.”

The additional training that urogynecologists undergo focuses on the surgical and non-surgical treatment of non-cancerous gynecologic problems. As Dr. Kudish explained, “a urogynecologist is not a urologist and does not treat cancerous conditions of the bladder or kidneys, kidney stones, or abnormally formed kidneys.”

Ultimately, urogynecologists are the physicians with the most in-depth knowledge and experience in this specialty. But Dr. Kudish explained that some urologists with appropriate experience who have completed a fellowship in female pelvic medicine and reconstructive surgery have been able to take the written board exam in this subspecialty — they are called female urologists. At this time, only doctors who have completed a fellowship in urogynecology are allowed to be board certified.

Who might experience a pelvic floor disorder?

Many things can affect your pelvic floor, but common causes of damage include childbirth, repeated heavy lifting, straining for bowel movements, some chronic diseases, and surgery.

“One in three women after menopause is affected by these conditions,” says Dr. Kudish.  “With the aging of the baby boomer generation, many of these conditions are anticipated to increase by 50 percent by the year 2050.”

What if I’m embarrassed or anxious about seeing a specialist?

Dr. Kudish feels strongly that as women, we tend to avoid talking about health concerns that feel especially personal or sensitive. But it’s important to know how common pelvic floor issues really are.

“If you have one of these disorders, you are not alone,” says Dr. Kudish. “Until recently, many physicians would have told you that urinary incontinence and pelvic organ prolapse are a part of the aging process that women have to live with. You do not have to live with these conditions! Once a problem is recognized, the next step is to seek an evaluation from either a gynecologist or a urogynecologist, who will be able to discuss and work with you on dramatically improving your quality of life.”

If you suspect you have a pelvic issue, don’t suffer in silence any longer. We’re here to help. To request an appointment or learn more about our treatments and services, please call 855-843-8424.