What Is Urogynaecology?
Urogynaecology focuses on the pelvic floor, the layer of muscles and supporting tissue that holds the pelvic organs, including the bladder and uterus, in place. Pregnancy, vaginal birth, menopause and ageing can all weaken this support over time. Carrying extra weight or living with a chronic cough adds further strain.
Which Conditions Are Treated?
The most common concerns include:
- Stress urinary incontinence: leaking when you cough or exercise
- Overactive bladder: a sudden, strong need to pass urine, sometimes with leaking before you reach the toilet
- Pelvic organ prolapse: when one or more pelvic organs drop down into the vagina, causing a bulge or heavy feeling
- Recurrent bladder infections, which may be linked to changes after menopause
What Happens At Your Appointment?
Dr Makanda will ask about your symptoms, how often they happen and what makes them worse. A bladder diary kept for a few days beforehand, noting how much you drink and how often you pass urine, makes the consultation more useful.
A pelvic examination checks the strength of your pelvic floor and looks for signs of prolapse. You may be asked to cough during the examination, which helps to show any leaking, and a urine test rules out infection.
What Treatment Options Are There?
Many women improve without surgery. Pelvic floor exercises, ideally guided by a physiotherapist with an interest in women's health, strengthen the muscles that support the bladder. Bladder training and simple changes, such as cutting back on caffeine, can ease urgency, and treatment to calm an overactive bladder may be added. For prolapse, a vaginal pessary, a small device that supports the pelvic organs from inside, suits women who would prefer to avoid an operation.
When these measures are not enough, surgery may be considered. Gynaecological Procedures include a sling to support the urethra for stress incontinence and repair operations for prolapse.
Is It Too Late To Ask For Help?
It is never too late. Symptoms that began after a birth many years ago can still be assessed and treated. If you have recently had a baby, your postnatal check after childbirth is a good time to raise any concerns. Whenever you feel ready to talk about it, book a consultation.