What is Urogynecology?

Urogynecology is a field of medicine that focuses on the diagnosis and treatment of pelvic floor disorders in women. It deals with problems related to the urinary tract, reproductive organs, and pelvic floor muscles.

These problems can range from urinary incontinence to pelvic organ prolapse and can have a significant impact on a woman’s quality of life. Urogynecologists are specially trained to assess and treat pelvic floor disorders, and they often work with physical therapists, pelvic floor rehabilitation specialists, and other healthcare professionals to provide comprehensive care if you are diagnosed with any related disorders.

Preparing for the test

Urogynecology is primarily used for the diagnosis of PFD - Pelvic Floor Disorder in women. A healthcare provider can diagnose a PFD with a physical examination. During a typical pelvic exam, the doctor may observe or sense a protrusion that suggests a prolapse.

No special preparations are usually needed for a cystoscopy. However, you may be instructed to drink extra liquids ahead of time to make sure that your bladder is full. If you are also having a urodynamics test at the same time, be sure to follow your doctor's instructions for any fluid intake. Take note of the following points:

  • If you experience any signs of a bladder infection before the test, such as burning when urinating or a need to urinate frequently, contact your doctor.  
  • In addition, be sure to inform your doctor of any bladder or bowel control problems and provide information on any medical history, such as past pregnancies, surgeries, and any medications taken.

A healthcare provider may conduct tests based on the results of an examination or the intensity of the symptoms. These include:

  1. Bladder control problems
    • Cystoscopy: This evaluation inspects the interior of the bladder to identify any issues, such as bladder stones, growths, or irritation.
    • Urinalysis: This urine test can be used to identify if there are any indications of bladder infection, kidney issues, or diabetes.
    • Urodynamics: This assessment can be used to measure the functioning of the bladder and urethra. It can help decide on the most appropriate surgical procedure to address certain issues with bladder control.
  2. Bowel control problems
    • Anal manometry: This examination gauges the power of the anal sphincter muscles.
    • Colonoscopy or sigmoidoscopy: This assessment inspects the interior of the colon or sigmoid (the section of the intestines close to the rectum) to search for indications of illness or swelling that could be causing issues.
    • Dynamic defecography: This assessment is utilized to assess the pelvic floor and rectum when the patient is defecating.

What to expect from the test?

Since many tests are covered, you can consider the example of cystoscopy for your reference:

  • The nurse may ask for a urine sample to detect any possible infection.
  • If your bladder is infected, the procedure may not be safe to carry out.
  • You must take off your clothing from the waist down. When you are lying down, the nurse will apply a numbing gel to your urethra. A
  • After that, the doctor will delicately insert a telescope into your bladder, and then add a liquid to it.
  • Generally, the whole process won't take more than ten minutes.

Risk factors associated with the tests

The risks involved are few, which include:

  • Bladder infection,
  • Injury to the bladder
  • Injury to the urethra
  • Difficulty emptying your bladder
  • Blood in the urine       

These risks will be discussed with you before the procedure and are not a thing to be worried about. Feel free to ask any follow-up questions. Your comfort is essential.

When should you consult your doctor?

Consult your doctor if you have:

  • Urine leakage or incontinence
  • Pain while urinating
  • Frequency of urinary tract infections
  • Difficulty initiating urination or completely emptying the bladder

Signs such as these may suggest an issue with the lower urinary tract. Whether you are facing difficulty conceiving or find yourself suffering from any of these symptoms, do not hesitate to consult with a doctor for a timely diagnosis.

Possible results of the test?

You may experience a bit of pain or tenderness when you urinate. This should usually be gone within a few hours. You may also see a small amount of blood due to the catheter.

If you drink 8-16 ounces of water every hour for two hours it may help manage the symptoms. Taking a warm bath or applying a warm, damp cloth to the urethral opening can also help.

Over-the-counter pain medications may be used if needed. Your healthcare provider may also prescribe an antibiotic to prevent infection, but this isn't always necessary. If you have any symptoms of infection, like a fever, chills, or a lot of pain, contact your provider right away.

Request an appointment at Apollo Cradle, Bengaluru - Koramangala. Call 1860-500-1066 to book an appointment.

1. Is surgery always necessary for urogynecological treatment?

No. Most urogynecological conditions can be treated with either surgical or non-surgical methods. Generally, we advise trying the non-surgical approach before you opt for surgery. In the case of skin conditions like lichen sclerosis, surgery is usually not the first choice. The doctor will evaluate the situation closely before deciding on a treatment plan for creams or ointments. As the condition can return, long-term monitoring may be necessary.

2. Can you go home after discharge if you live far away?

It is okay to go home, even if you reside a long distance away, after being discharged from the hospital. To prevent any potential issues, it is wise to rise and move around every hour or so when taking a trip that includes a lot of sitting.

3. How long do the results of the surgery last?

The procedures for treating stress urinary incontinence and vaginal prolapse may be compared to face-lifts, as the tissue will still age with time. Ultimately, the durability of the repairs comes down to genetics and physical activity. The best way to stop the incontinence or prolapse from returning is to avoid any activity that increases intra-abdominal pressure, such as lifting heavy weights or having a chronic cough or issues with constipation.

4. Will you need a catheter after surgery?

Many people who have been hospitalized are discharged without having a catheter. Sometimes though, patients are released with a catheter for a period of one to two days to allow for the reduction of urethral inflammation.

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