International Urogynecology Day, February 20th, is a day dedicated to raising awareness about the vital field of urogynecology and honoring the professionals who work tirelessly to improve women’s health. In celebration of this day, we had the opportunity to interview Dr. Harold Drutz (Canada), Dr. Donald Ostergard (USA), and Dr. Mark Vierhout (The Netherlands), stalwarts in the field.
Picture this: You and your friend Samantha are enjoying brunch at a cafe when, in the middle of the great laughs, her mood suddenly changes, and you see in her face a look of shock and discomfort. She opens up about her struggles with urinary leakage. Despite her outgoing nature, this has been causing her embarrassment and affecting her daily life, making her hesitant to engage in social activities or even enjoy simple outings without worry.
Seeing her frustration, you suggest she see a urogynecologist. “A urogynecologist?!” – she exclaims with surprise. With a relieved expression, knowing she's not alone in this, you see her demeanor return to the fun-loving friend you know.
So, What Exactly is Urogynecology?
Urogynecology is a subspecialty within the field of gynecology that focuses on diagnosing and treating pelvic floor disorders in women. The pelvic floor is made up of a network of muscles, ligaments, and connective tissues that support various pelvic organs, such as the bladder, uterus, vagina, and rectum.
And What Specific Issues Does This Include?
- Pelvic Organ Prolapse: This occurs when pelvic organs, such as the bladder, uterus, or rectum, bulge into the vaginal wall. It can result from weakened pelvic floor muscles and connective tissues.
- Urinary Incontinence: Urogynecologists treat various types of urinary incontinence, including stress incontinence (leakage during activities like coughing or laughing) and urge incontinence (sudden, intense urge to urinate). The latter is also named overactive bladder, mainly if frequent urination is also part of the problem.
- Fecal Incontinence: This involves the inability to control bowel movements, leading to involuntary leakage of stool. Sometimes, pelvic organ prolapse can also cause difficulties in defecation and urination due to obstruction by a prolapse.
- Pelvic Pain: Healthcare professionals working in the field of urogynecology may also address chronic pelvic pain syndromes related to the pelvic floor and related organs.
- Sexual Issues: Sexual issues may arise as a consequence of pelvic floor dysfunction.
What Are the Treatment Options to Help Address These Issues?
Healthcare professionals working in the field of urogynecology employ a combination of medical, surgical, and rehabilitative approaches to manage these conditions. Treatment options may include lifestyle modifications, pelvic floor physical therapy, medications, and surgical interventions such as reconstructive surgery and/or anti-incontinence surgery. Thus, pelvic floor dysfunction is a truly multidisciplinary problem and is best treated by a multidisciplinary team. Many institutions have established specific pelvic floor clinics where all disciplines working in this field closely cooperate.
I Didn’t Know the Field of Urogynecology Existed. When and How Did It Begin?
While the term “urogynecology” may be relatively new, the health issues addressed by those working in this field are not. To shed light on this, IUGA has assembled a History Committee comprising many of the stalwarts in this field. They will delve into the true trajectory, major milestones, and the field's impact on our world from its inception to the present day.
Where Can I Find a Practitioner Working in This Field?
Your primary care physician may be able to refer you to a specialized healthcare practitioner in your area, or you can use the IUGA “Find a Provider” Directory to search for practitioners by location.
How Can I Know More About My Pelvic Floor Health?
Check out the IUGA patient website YourPelvicFloor.org for more information. This dedicated website brings together a wealth of health topics, publications, patient leaflets, patient stories, events, and other resources, all available for free in over 25+ languages. Both patients and practitioners have checked the information provided to ensure it is accurate and easy to understand.
International Urogynecology Day serves as a reminder to prioritize women’s pelvic health, encourage open conversations, and express gratitude to the countless dedicated professionals who contribute to the well-being of women around the world.
Stories That Inspire
A Lasting Impact: The Legacy in Our Field
During my internship, I closely shadowed a renowned urologist, whose name I withhold out of respect. He had a standardized approach to treating young women presenting symptoms like urgency, frequency, or nocturia, employing a specialized instrument called an Otis urethrotomy. This tool, featuring a scalpel blade and a dial, was used for internal urethrotomy procedures despite the symptoms potentially arising from conditions beyond Overactive Bladder (OAB). This experience disillusioned me with pursuing urology as a career path, leading me to shift my focus towards obstetrics and gynecology (OB-GYN), where I completed my training, including a prestigious McLaughlin Fellowship in Canada in 1975.
Subsequent training experiences across Europe and the United States, particularly under influential figures like Stuart Stanton, Paul Donker, and Jack Robertson, further shaped my medical journey. As I approach 80, I reflect on the privilege of being mentored by esteemed professionals like Donald Ostergard while also recognizing the importance of initiatives like the new IUGA History Committee. Such efforts preserve the legacies of pioneers in the field, ensuring their contributions are honored beyond mere obituaries, a task I've undertaken for some of these remarkable mentors.
Harold Drutz (Canada)
Transforming Lives Through Urogynecology
Dr. Jack Roberston taught me about the various aspects of urinary incontinence and its treatment. We encountered many patients who struggled with pelvic prolapse and urinary incontinence, both of which are severe conditions. I was deeply motivated to work in a field where I could alleviate their suffering and improve their quality of life. The cornerstone of urogynecology is the patients themselves. Those suffering from such debilitating conditions often find their daily lives greatly impacted.
For me, the most rewarding aspect was devising personalized solutions to address their individual needs. Witnessing their transformation from pain and discomfort to health and happiness is truly remarkable. I believe it’s crucial for patients to understand that they don't have to endure prolapse or incontinence in silence. Effective treatments are available, and skilled physicians in this field are adept at diagnosing and guiding patients toward reclaiming their quality of life.
Donald Ostergard (USA)
RESOURCES
Top 10 Most Downloaded IUJ Articles
To commemorate this special occasion, we’re delighted to provide you with a list of the ten most downloaded articles from the International Urogynecology Journal (IUJ) throughout 2023. We sincerely appreciate every author who has dedicated countless hours to conducting groundbreaking research and leaving a lasting legacy in the field of urogynecology.
- Strenuous physical activity, exercise, and pelvic organ prolapse: a narrative scoping review
Bø, Kari; Anglès-Acedo, Sònia; Batra, Achla; Brækken, Ingeborg H.; Chan, Yi Ling; Jorge, Cristine Homsi; Kruger, Jennifer; Yadav, Manisha; Dumoulin, Chantale
- When things go wrong: experiences of vaginal mesh complications
Dibb, Bridget; Woodgate, Fee; Taylor, Lauren
- Validity and reliability of the Persian version of the PRAFAB questionnaire in Iranian women with urinary incontinence
Ghaderi, Fariba; Havaei, Naser; Hamedfar, Mahdieh; Berghmans, Bary; Chakeri, Zahra
- Overactive bladder medication — do we need to revisit trospium chloride for our elderly patients?
Bhide, Alka A.; Digesu, G. A.; Swift, Steven
- Impact of COVID-19 on surgical procedures for stress urinary incontinence in the Brazilian public health system
Fornari, Alexandre; Toledo, Luis Gustavo Morato; Canalini, Alfredo Felix; Brandão, Thulio Bosi Vieira; Anzolch, Karin Marise Jaeger; Fernandes, Roni de Carvalho; de Bessa, Jose; Gomes, Cristiano Mendes
- Supervised versus unsupervised pelvic floor muscle training in the treatment of women with urinary incontinence — a systematic review and meta-analysis
Kharaji, Ghazal; ShahAli, Shabnam; Ebrahimi-Takamjani, Ismail; Sarrafzadeh, Javad; Sanaei, Fateme; Shanbehzadeh, Sanaz
- Magnetic stimulation in the treatment of female urgency urinary incontinence: a systematic review
Antić, Anja; Pavčnik, Maja; Lukanović, Adolf; Matjašič, Miha; Lukanović, David
- From thigh to pelvis: female genital prolapse repair with an autologous semitendinosus tendon transplant
Hornemann, Amadeus; Weissenbacher, Tobias; Hoch, Benjamin; Franz, Wolfgang; Lingwal, Neelam; Suetterlin, Marc; Holthaus, Bernd
- Laparoscopic sacrocolpopexy mesh excision step-by-step
Mohr, Stefan; Imboden, Sara; Mueller, Michael D.; Kuhn, Annette
- Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey
Campbell, K. Gillian; Batt, Mark E.; Drummond, Avril
What is a Urogynecology? - Video
IUGA’s Public Relations Committee has produced a brief video to address fundamental questions about urogynecology: What is urogynecology? Who is a urogynecologist? What health issues do they address? When should you visit a urogynecologist?