We here at CTS work together with a number of healthcare practitioners from various backgrounds, but notable among them are urologists, urogynecologists, and gynecologists. Often, we hear patients say to us something along these lines: "I was sent here by a uro-gyne-whatchamacallit... I'm not sure exactly what kind of doctor I saw, actually." It's important for patient and therapist alike to understand what each of these different specialties emphasize in order to provide and receive optimal care.
Urology (sometimes known as genitourinary surgery) is the division of medicine that focuses on disease of the male and female urinary systems as well as the male reproductive organs.
These specialists will treat issues related to the bladder, kidneys, urethra, and in the case of males, the testicles. Some of the common problems urologists see include erectile dysfunction, urinary incontinence, kidney disease, enlarged prostate, interstitial cystitis, urethral stricture, urological oncology (cancer) or bladder prolapse. Urologists graduate from medical school, then participate in a urology residency, lasting a minimum of five years. Some urologists will do additional post-residency training in a one to two year long fellowship in order to become board-certified. Residency training focuses on both surgical and medical treatment of diseases.
Gynecology is the medical specialty pertaining to the female reproductive system (uterus, cervix, vagina, ovaries) and breasts.
This specialty often overlaps with obstetrics, which emphasizes pregnancy, childbirth, and postpartum issues. The majority of gynecologists are also obstetricians. Some of the common problems gynecologists treat are endometriosis, adenomyosis, polycystic ovarian syndrome, female infertility, menstrual issues, uterine fibroids, gynecological oncology (cancer), sexually transmitted diseases, and sexual dysfunction. They also can treat complications related to pregnancy, urinary incontinence, and pelvic organ prolapse. Gynecologists graduate from medical school, then participate in a gynecology residency, lasting a minimum of four years. Gynecologists are board-certified and also have the option of pursuing a fellowship to further their education. Gynecologists may provide surgical and/or medical treatment.
Urogynecology is a relatively new subspecialty combining both of the above fields.
This subspecialty is sometimes known as female pelvic medicine and reconstructive surgery. Physicians in this field are either OB/GYNs or urologists who go on to complete an additional two to three fellowship in urogynecology. These physicians focus on surgical and medical treatment of pelvic floor disorders including pelvic organ prolapse, fecal and urinary incontinence, overactive bladder, dyspareunia (painful intercourse), and chronic pelvic pain.
As you can see, there is a lot of crossover between these fields! Physical therapists work in conjunction with all of these subspecialties to address the muscular and fascial restrictions that accompany pelvic floor disorders. With a solid understanding of the hormonal, musculoskeletal, visceral, and lifestyle (including diet and fluid intake) contributions to pelvic floor dysfunction, physical therapists, physicians, and patients can work together to empower the whole person and make informed choices about their healthcare needs.