Urogynecology is a subspecialty within obstetrics and gynecology that focuses on disorders of the female pelvic floor. The pelvic floor is made up of muscles and connective tissues that support the bladder, uterus, vagina, and rectum and help control bladder and bowel function. Common pelvic floor conditions include pelvic organ prolapse, urinary incontinence, and fecal incontinence.
Women used to have to see multiple specialists depending on the location of their issue. A problem with the bladder – in the front of the pelvis – may be referred to a urologist, the middle section involving the uterus can be seen by the gynecologist and a colorectal surgeon may deal with rectum problems. Yet, all of these organs share the same connective tissue, the same nerves and the same blood supply. Anything done to one is going to affect another. The awareness of this is how the subspecialty of urogynecology came about to create an expertise that masters the entire pelvis.
After years spent developing criteria for assessing quality care, the American Board of Obstetrics and Gynecology and the American Board of Urology in 2013 granted its first certifications in the specialty of Female Pelvic Medicine and Reconstructive Surgery to qualified urogynecologists. The American Board of Medical Specialties (ABMS) approved board certification for Female Pelvic Medicine and Reconstructive Surgery in 2012 to “verify appropriate training, knowledge and credentials in the field.” Physicians had to meet strict criteria to be permitted to sit for the board in 2013. Dr. Litrel and Dr. Haley were among the first specialists in the nation to qualify, pass the exam and receive the board certification. They are among the few board-certified urogynecologists in private practice in the N. Georgia area.
Why should women care about board-certification? Not all physicians are board-certified in a specialty. The certification reflects the vigorous training and performance required to achieve a high level of expertise. The ABMS cites numerous studies that have demonstrated that physicians who are board-certified “deliver higher quality care and have better patient care outcomes than physicians who are not board-certified.”
The National Institutes of Health estimates one-third of women in the U.S. will experience pelvic disorders in their lifetime. Symptoms of pelvic disorders include feeling pressure, urinary or fecal leakage, pain during intercourse, frequent urination or inability to empty bladder. A large study presented at the American Urogynecologic Society’s Annual Scientific Meeting in 2013 reported that a woman’s lifetime risk of surgery for stress urinary incontinence or pelvic organ prolapse is 20%, almost twice the risk previously reported two decades ago.
Board-certified urogynecologists see and treat these issues with greater frequency than non-specialists which results in the highest chance of long-term success. For example, with a traditional surgery for a prolapse repair (native tissue bladder repair), the failure rate is approximately 30%. But a subspecialist with advanced training can perform a surgery such as sacrocolpopexy with a success rate of 88% to 92%. For moderate issues a routine repair is standard, but more advanced conditions call for a surgeon with more advanced training.
Along with being board-certified in urogynecology, our gynecologic surgery specialists provide comprehensive care from routine examinations to check for minor conditions to sophisticated diagnostic tests and surgical treatment for complex problems. These issues may include pelvic reconstruction, laparoscopic surgery, urinary incontinence or pelvic pain. Our specialists consult with each patient to design an individualized care management plan based on various diagnostic and treatment options.
Our specialists choose the least invasive surgical options, which may include a vaginal approach, laparoscopic, or robotic techniques to minimize patients’ recovery times. Patients who undergo minimally invasive surgery may have less postoperative pain and faster recoveries compared to open abdominal surgery. Our surgeons are experienced in the most up-to-date surgical techniques and technology.
For many women who aren’t aware that there are treatments available, pelvic disorders can be embarrassing and may even lead to greater medical complications if not treated. Routine examinations in general physicians’ offices don’t always screen for pelvic floor disorders. Women who are experiencing symptoms should not be afraid to speak up. Symptoms like leaking or vaginal bulges are not a normal part of aging. Urogynecology specialists are used to talking about these issues and can help. Women who take an active role in their care will find that they are not alone and have a variety of options – both surgical and non-surgical – for restoring their quality of life.
Pelvic Organ Prolapse occurs when the muscles and connective tissues that support the pelvic organs weaken, allowing one or more organs, such as the bladder, uterus, vagina or rectum, to drop from their normal position. Symptoms may include pelvic pressure or heaviness, a vaginal bulge, urinary or bowel changes, or discomfort during intercourse. Some women have few or no symptoms. Treatment depends on the type and severity of prolapse and may include nonsurgical or surgical options.
If you are experiencing symptoms of a pelvic floor disorder, our urogynecology specialists can help determine the treatment option that is right for you. Call 770-720-7733 or schedule an appointment online.