Joseph Schaffer, M.D. Answers Questions On: Urogynecology

Urogynecology (also known as female pelvic medicine and reconstructive surgery) is a subspecialty of obstetrics and gynecology that deals with disorders of the lower genitourinary tract such as pelvic organ prolapse, urinary incontinence, voiding dysfunction, and pelvic floor dysfunction.

These conditions are on the border between urology and gynecology and are generally quality of life issues. We have many patients who stay home all day because they are worried about their bladder and finding a toilet in time. Urinary incontinence doesn’t kill you, but it can take away your life. We’re able to give those patients back their lives.

Patients have been extremely happy with the treatments they have received here because we offer individualized care. We determine what is best for each patient, which could be anything from medication to physical therapy to pelvic floor therapy to state-of-the-art surgery.

We have a comprehensive approach to pelvic floor disorders, including surgical and nonsurgical treatments for urinary incontinence, pelvic organ prolapse, and other bladder disorders. With overactive bladder, for example, Botox is very effective. It relaxes the bladder and stops the patient from urinating frequently.

Pelvic organ prolapse is related to vaginal delivery, but the problems generally don’t occur until much later on, not necessarily right after delivery. My patients are typically middle-aged and older women.

We don’t know exactly. Part of our research is aimed at identifying risk factors.  Vaginal delivery is a risk factor for prolapse and our research looks at whether different aspects of the process of vaginal delivery can be modified to decrease the future risk of pelvic organ prolapse and other pelvic floor disorders.

The ideal doctor listens carefully to each patient and attempts to understand their unique problem.  The physician should be skilled at the different modalities for evaluation of the problem and should have expertise in all the different treatment options. An individualized treatment plan should be developed based on the specific needs of each patient.