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Urogynecology

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Urogynecologist
Occupation
NamesDoctor, Medical Specialist, Surgeon
Occupation type
Gynecology, Urology, Specialty, Surgery
Activity sectors
Medicine, Surgery
Description
CompetenciesPatient Care, Education, Research
Education required
Doctor of Medicine, Doctor of Osteopathic Medicine
Fields of
employment
Hospitals, Clinics
Related jobs
Gynecologist, Urologist

Urogynecology or urogynaecology is a surgical sub-specialty of urology and gynecology.

History

In 1893, Howard Kelly, a gynecologist and pioneering urogynecologist, invented an air cystoscope which was simply a handheld, hollow tube with a glass partition.[1] When the American Surgical Society, later the American College of Surgeons, met in Baltimore in 1900, a contest was held between Howard Kelly and Hugh Hampton Young, who is often considered the father of modern urology.[2] Using his air cystoscope, Kelly inserted ureteral catheters in a female patient in just 3 minutes. Young equaled this time in a male patient.[3] So began the friendly competitive rivalry between gynecologists and urologists in the area of female urology and urogynecology. This friendly competition continued for decades. In modern times, the mutual interest of obstetricians, gynecologists, and urologists in pelvic floor problems in women has led to a more collaborative effort.

Education and training

Urogynecologists are medical professionals who have been to medical school and achieved their basic medical degree, followed by postgraduate training in Obstetrics and Gynaecology (OB-GYN). They then undertake further training in Urogynecology to achieve accreditation/board certification in this subspecialty. Training programme requirements and duration varies from country to country but usually tend to be around 2-3 years in most places. Urogynaecology fellowship programmes are available in some countries, but not all and the levels of formal accreditation and certification vary from country to country.

The International Urogynecological Association (IUGA) is a global body for professionals practising in the field of urogynaecology and female pelvic medicine and reconstructive surgery. IUGA facilitates training for physicians from countries which do not have formal training programmes by maintaining and publishing a directory of fellowship programme. IUGA also provides educational opportunities for urogynecologists both online and in-person, develops terminology and standardization for the field. The International Continence Society (ICS) is another global organization which strives to improve the quality of life for people affected by urinary, bowel and pelvic floor disorders through education, and research.

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"[4] 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;[5] one in twenty adult women have depression;[6] one in ten adult women have diabetes;[7] and, more than one in two adult women suffer from pelvic floor dysfunction.[8]

Some conditions treated in urogynecology practice include:[9]

Diagnostic tests and procedures performed include:[9]

Specialty treatments available include:[9]

See also

References

  1. ^ Kelly HA. Medical Gynecology. New York: Appleton, 1908.
  2. ^ Hugh H. Young
  3. ^ Young HH. A Surgeon's Autobiography. New York: Harcourt, 1940.
  4. ^ Howard Atwood Kelly, M.D, 1928
  5. ^ American Heart Association (2006), High Blood Pressure Statistics, retrieved 14 August 2010
  6. ^ Center for Disease Control and Prevention (CDC) (September 2008), Depression in the United States Household Population, 2005-2006, retrieved 14 August 2010
  7. ^ American Diabetes Association (2007), Diabetes Statistics, retrieved 14 August 2010
  8. ^ 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
  9. ^ a b c Mayo Clinic, Gynecology at Mayo Clinic in Arizona, retrieved 14 August 2010
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