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Understanding Urogynecology: When to See a Specialist

By Mindy Rathe, APRN August 05, 2025 Posted in: Women's Health

The world of women's health can sometimes feel like navigating a maze of specialists. You might be familiar with gynecologists and urologists, but have you heard of a urogynecologist? This specialized field focuses on a crucial, yet often overlooked, aspect of women's health: the pelvic floor.

This post will delve into the world of urogynecology, explaining what these specialists do, the conditions they treat, and how they differ from urologists and gynecologists. Understanding these distinctions can help you make informed decisions about your healthcare and find the right expert for your specific needs.

What is a Urogynecologist?

A urogynecologist is a physician who has specialized training in both urology and gynecology. Their primary focus is on pelvic floor disorders in women and reconstructive pelvic surgery. 

Think of your pelvic floor as a hammock of muscles and connective tissues that support the organs in your pelvis, including your:

  • Reproductive organs: Uterus, vagina, cervix, and ovaries
  • Urinary organs: Bladder and urethra
  • Digestive organs: Rectum

When these muscles and tissues weaken or become damaged, it can lead to a variety of problems, impacting your quality of life.

What Conditions Do Urogynecologists Treat?

Urogynecologists are experts in diagnosing and treating a wide range of pelvic floor disorders, including:

  • Pelvic Organ Prolapse (POP): This occurs when one or more pelvic organs (bladder, uterus, rectum) descend from their normal position and bulge into the vagina. Women often describe feeling a bulge or pressure in the vaginal area.
  • Urinary Incontinence: This is the involuntary leakage of urine. It can manifest as stress incontinence (leakage with coughing, sneezing, or exercise), urge incontinence (a sudden, strong urge to urinate followed by leakage), or mixed incontinence (a combination of both).
  • Fecal Incontinence: This is the involuntary leakage of stool.
  • Overactive Bladder (OAB): This condition is characterized by frequent and urgent urination, often accompanied by nighttime urination (nocturia).
  • Recurrent Urinary Tract Infections (UTIs): Frequent UTIs can be a sign of underlying pelvic floor dysfunction.
  • Painful Bladder Syndrome/Interstitial Cystitis (IC): This chronic condition causes bladder pain, pressure, and urinary urgency and frequency.
  • Vaginal Fistulas: These are abnormal openings between the vagina and another organ, such as the bladder, rectum, or intestine. They can cause leakage of urine or stool into the vagina.
  • Painful Intercourse (Dyspareunia): Pelvic floor dysfunction can contribute to pain during sexual activity.
  • Vaginal Skin Disorders: Urogynecologists can also address skin conditions affecting the vulva and vagina.
  • Blood in the Urine (Hematuria): While this can be caused by various factors, a urogynecologist can help determine if it's related to a pelvic floor issue.

What Sets Urogynecologists Apart?

Urogynecologists possess a unique combination of expertise that allows them to provide comprehensive care for women with pelvic floor disorders. They are trained in:

  • Advanced surgical techniques: Including minimally invasive approaches like laparoscopy and robotic surgery, as well as vaginal reconstructive surgery.
  • Non-surgical treatments: Such as pelvic floor muscle exercises (Kegels), biofeedback, pessaries (devices inserted into the vagina to support pelvic organs), and medications.
  • A holistic approach: Considering the impact of pelvic floor disorders on a woman's overall health and well-being.

Urologist vs. Gynecologist vs. Urogynecologist: Understanding the Differences

It's important to understand the distinctions between these specialties to ensure you're seeing the right doctor for your specific concerns.

  • Urologist: Urologists specialize in the urinary system in both men and women. They treat conditions affecting the kidneys, ureters, bladder, urethra, and prostate (in men). They address issues like kidney stones, urinary tract infections, urinary incontinence, and blood in the urine. They may also treat male reproductive health issues.
  • Gynecologist: Gynecologists focus on the female reproductive system, including the uterus, ovaries, fallopian tubes, vagina, and cervix. They provide routine gynecological care, such as Pap smears, pelvic exams, and contraception counseling. They also manage conditions like menstrual irregularities, endometriosis, fibroids, and pregnancy. While they may address some urinary issues, their primary focus is on the reproductive system.
  • Urogynecologist: As mentioned earlier, urogynecologists specialize in pelvic floor disorders in women. They bridge the gap between urology and gynecology, providing comprehensive care for conditions that affect both the urinary and reproductive systems.

When Should You See a Urogynecologist?

If you're experiencing any of the following symptoms, it's a good idea to consult with a urogynecologist:

  • Feeling a bulge or pressure in your vagina
  • Leaking urine, especially when coughing, sneezing, or exercising
  • Having a sudden, strong urge to urinate
  • Urinating frequently or having to get up at night to urinate
  • Leaking stool
  • Having pain in your bladder or pelvis
  • Experiencing pain during intercourse
  • Having recurrent urinary tract infections

Taking Charge of Your Pelvic Floor Health

Pelvic floor disorders can significantly impact your quality of life, but they are often treatable. By understanding the role of a urogynecologist and recognizing the symptoms of pelvic floor dysfunction, you can take proactive steps to address these issues and improve your overall well-being. Don't hesitate to seek professional help if you're experiencing any of the symptoms mentioned above. Your health and comfort are worth it!

If you have questions about what specialty is appropriate for you, please call (402) 717-2547 and we can help guide you.

Mindy Rathe, APRN
Mindy Rathe, APRN

Mindy K. Rathe, APRN is a Women's Health and Urogynecology provider with CHI Health.

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