Introduction to Urogynaecology

Urogynaecology is a sub-specialty of Obstetrics and Gynaecology that combines urology and gynaecology to help women with pelvic floor disorders.

The pelvic floor in women is important as it helps the pelvic organs such as the uterus, bladder, rectum and vagina to be supported both in terms of anatomy and function.

It is typically weakened and damaged from pregnancy, childbirth, ageing and menopause – hence most women are vulnerable to developing problems associated with their pelvic floor in various stages of their life. Pelvic floor disorders, if left untreated, can reduce your quality of life and affect your relationships significantly.

Common pelvic floor disorders include:

Pelvic organ prolapse is when the pelvic organs (i.e. uterus, bladder, rectum or vagina) sag downwards and out of the vaginal opening. This is a common condition affecting 1 in 3 women with children. It may result in symptoms such as feeling a lump or a bulge in the vagina, having a dragging sensation down below, abnormal bleeding or urinary/bowel symptoms if the bladder and/or rectum is involved.

Urinary incontinence is when one leaks urine involuntarily under various circumstances. This can include when you are physically exerting yourself e.g. laughing, coughing, sneezing, jogging, jumping, or when you feel the urge to go to the toilet but are unable to make it there in time. This can occur even in young women e.g. during pregnancy or shortly after childbirth, all the way to menopausal women.

Overactive bladder is when you find yourself feeling the urge to urinate and needing to visit the toilet frequently. If this happens at night while you are sleeping, it is termed nocturia. This can be disruptive to your social activities and work as you may find your life revolving around the toilet.

It is important to note that many women can suffer from different types of pelvic floor dysfunction at different stages of their lives, or more than 1 type of pelvic floor dysfunction at any 1 time. If you suspect that you may be having a pelvic floor disorder, it is best to consult a urogynaecologist as opposed to a general gynaecologist, as he/she is a trained specialist withspecific expertise in diagnosis, investigation and treatment of women’s pelvic floor disorders.

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