What is a Urogynecologist?

Urogynecologists are physicians who have completed a residency in either OB-GYN or urology as well as a two to three year specialty fellowship in Female Pelvic Medicine and Reconstructive Surgery. The fellowship training provides these physicians additional expertise in the evaluation, diagnosis and treatment of conditions that affect the pelvic floor.

The pelvic floor is a set of muscles, ligaments and connective tissue in the lowest part of the pelvis that supports a woman’s internal organs, including the bowel, bladder, uterus, vagina and rectum. Weakened pelvic muscles or tears in the connective tissue can occur when excessive strain is put on the pelvis through childbirth, repeated strenuous activity or pelvic surgery. Other factors that can increase the risk of pelvic floor disorders include repetitive heavy lifting, menopause, chronic disease, tobacco use and family history.

What conditions can a urogynecologist treat?

  • Pelvic organ prolapse: One or more of the organs in the pelvis drops down causing a sense of pressure or a bulge in the vagina. It may also cause urinary incontinence, pain or constipation.
  • Stress urinary incontinence: Leakage of urine with coughing, sneezing, laughing or any other activity that increases the pressure on the bladder and/or the supporting tissue.
  • Overactive bladder syndrome: Frequency, urgency (a sudden and strong desire to urinate that is bothersome) and nocturia (waking up more than once at night to void) with or without urge incontinence (accidental urine loss associated with a sudden and strong desire to urinate).
  • Anal and fecal incontinence: Involuntary leakage of gas and/or stool.
  • Fistulas: An abnormal connection between two organs (i.e. bladder and vagina or vagina and rectum)
  • Complications from third and fourth degree tears following vaginal childbirth

What treatment options are available?

There are a variety of non-surgical approaches as well as surgical options that can help relieve the symptoms associated with pelvic floor disorders. After consultation, you and your physician will work together to find the solution that works best for you, your lifestyle and your overall health.

Why should I see a urogynecologist?

While many of the symptoms and conditions listed above are very common, it is important to know that these are not a normal part of aging or something that women need to put up with. Consulting with a urogynecologist will provide you with specialized expertise to help determine the best way to relieve your symptoms and restore your quality of life.

We’re excited to welcome our first urogynecologist, Dr. Tovia Smith, to Virginia Women’s Center. Dr. Smith will work with female urologist Dr. Lonny Green to care for women whose qualities of life are being affected by bladder and pelvic health issues.