Urogynecology: Difference between revisions
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Revision as of 14:23, 14 August 2010
| Occupation | |
|---|---|
| Names | Doctor, Medical Specialist, Surgeon |
Occupation type | Gynecology, Urology, Specialty, Surgery |
Activity sectors | Medicine, Surgery |
| Description | |
| Competencies | Patient Care, Education, Research |
Education required | Doctor of Medicine |
Fields of employment | Hospitals, Clinics |
Related jobs | Gynecologist, Urologist |
Urogynecology is a surgical sub-specialty of urology and gynecology.
Education
Gynecologists who practice this sub-specialty are called urogynecologists and urologists who practice this sub-specialty are called female urologists. In the United States, urogynecologists have completed medical school and a four-year residency in obstetrics and gynecology and female urologists have completed medical school and a five-year residency in urology. These doctors become specialists with additional training and experience in the evaluation and treatment of conditions that affect the female pelvic organs, and the muscles and connective tissue that support the organs. The additional training focuses on the surgical and non-surgical treatment of non-cancerous gynecologic problems.[1]
A few practitioners have completed a board-accredited fellowship in female pelvic medicine and reconstructive surgery after completing a residency in urology or obstetrics and gynecology. The first fellowship received accreditation in 1996.[2] As of January 2010, there were 30 fellowship programs approved by both the American Board of Obstetrics and Gynecology and the American Board of Urology. [3] These fellowships are three-years for obstetrician-gynecologists and two-years for urologists. Thus, the combined duration of training for female pelvic medicine and reconstructive surgery is seven years after medical school for both urologists and gynecologists. The International Urogynecology Journal publishes a listing of world-wide training programs. [4]
Scope of practice
Urogynecology involves the diagnosis and treatment of urinary incontinence and female pelvic floor disorders. Incontinence and pelvic floor problems are remarkably common but many women are reluctant to receive help because of the stigma associated with these conditions. "There is no more distressing lesion than urinary incontinence-A constant dribbling of the repulsive urine soaking the clothes which cling wet and cold to the thighs, making the patient offensive to herself and her family and ostracizing her from society"[5] Although countless women are bothered by a loss of bladder control, bowel symptoms, and pelvic discomfort they are often not aware that these problems have a name much less how common they really are. Pelvic floor conditions are more common than hypertension, depression, or diabetes. One in three adult women have hypertension;[6] one in twenty adult women have depression;[7] one in ten adult women have diabetes;[8] and, more than one in two adult women suffer from pelvic floor dysfunction. [9]
Some conditions treated in urogynecology practice include[10]:
- Cystocele
- Enterocele
- Female genital prolapse
- Fecal incontinence
- Incontinence (fecal and urinary)
- Interstitial cystitis
- Lichen planus
- Lichen sclerosus
- Müllerian agenesis
- Overactive bladder
- Painful intercourse
- Pelvic organ prolapse
- Rectocele
- Rectovaginal fistula
- Recurrent urinary tract infections
- Urinary incontinence
- Urinary retention
- Vaginal agenesis
- Vaginal septum
- Vesicocutaneous fistula
- Vesicouterine fistula
- Vesicovaginal fistula
- Voiding difficulties
Diagnostic tests and procedures performed include[10]:
Specialty treatments available include[10]:
- Abdominal reconstruction
- Behavioral modification
- Biofeedback
- Botulinum toxin injection
- Dietary modification
- Fascial grafts
- Laparoscopic reconstruction
- Medications
- Pelvic floor re-education
- Pessary (for prolapse and incontinence)
- Pubovaginal slings
- Relaxation techniques
- Robotic reconstruction
- Sacral nerve stimulation
- Urethral injections
- Urethral reconstruction
- Urge suppression drills
- Vaginal reconstruction
References
- ^ American Urogynecologic Society, What is a Urogynecologist?, retrieved 2010-08-12
- ^ Urogynecology Associates, Urogynecology Associates Fellowship Program, retrieved 2010-08-13
- ^ American Board of Obstetrics and Gynecology (January, 2010), Accredited Female Pelvic Medicine and Reconstructive Surgery Fellowships (PDF), retrieved 2010-08-12
{{citation}}: Check date values in:|date=(help) - ^ The International Urogynecological Association (June, 2009), Urogynecology Fellowship Training Program Directory, retrieved 2010-08-13 Requires Paid Subscription
{{citation}}: Check date values in:|accessdate=and|date=(help) - ^ Howard Atwood Kelly, M.D, 1928
- ^ American Heart Association (2006), High Blood Pressure Statistics, retrieved 2010-08-14
- ^ Center for Disease Control and Prevention (CDC) (September 2008), Depression in the United States Household Population, 2005-2006, retrieved 2010-08-14
- ^ American Diabetes Association (2007), Diabetes Statistics, retrieved 2010-08-14
- ^ Goldberg et al. Delivery mode is a major environmental determinant of stress urinary incontinence: results of the Evanston-Northwestern Twin Sisters Study. Am J Obstet Gynecol (2005) vol. 193 (6) pp. 2149-53
- ^ a b c Mayo Clinic, Gynecology at Mayo Clinic in Arizona, retrieved 2010-08-14
External links
- American Urogynecologic Society
- Guide to Learning in Female Pelvic Medicine and Reconstructive Surgery (PDF) Retrieved 2010-08-12.
- International Urogynecological Association
